Ring Pessary With Support: Who Needs It and How to Choose the Right Size (0–8)

What Is a Ring Pessary With Support?

A ring pessary with support is a circular, medical-grade silicone device inserted into the vagina to provide mechanical support for the pelvic floor and pelvic organs. Unlike the ring pessary without support, this version includes a flexible membrane stretched across its center — providing additional bladder and bladder-neck support that makes it the preferred choice for women who also experience stress urinary incontinence alongside pelvic organ prolapse (POP).

SciMed's Ring Pessary With Support is FDA 510(k) cleared as Class II under FDA Product Code HHN (21 CFR 884.5350), made from 100% platinum-cured medical-grade silicone (USP Class VI), and available in sizes 0 through 8 (44–95 mm outer diameter). HCPCS A4562. $49.99 direct from US manufacturer, free US shipping.

Indications: Who Benefits from a Ring Pessary With Support?

This device is indicated for women with:

• Pelvic Organ Prolapse (POP) Stages I–III — Particularly cystocele (bladder prolapse), uterine prolapse, and vaginal vault prolapse
• Concurrent Stress Urinary Incontinence (SUI) — The central membrane elevates the bladder neck, reducing urine leakage with coughing, sneezing, and activity
• Patients declining or awaiting surgery — A conservative, reversible alternative to surgical repair
• Postpartum pelvic floor weakness — Providing support during pelvic floor recovery
• Women with medical contraindications to surgery

Ring Pessary With Support: Complete Size Chart (0–8)

Proper sizing is critical for comfort, efficacy, and safety. The correct size stays in place during Valsalva maneuver, does not cause discomfort, and does not obstruct urination or defecation. Sizes are standardized across all FDA-cleared manufacturers (SciMed, Milex, Bioteque):

Size	Diameter (mm)	Diameter (inches)	Typical Use
0	44 mm	1.75″	Nulliparous or small vaginal caliber
1	51 mm	2.00″	Small anatomy, mild POP
2	57 mm	2.25″	Smaller-than-average adults
3 ⭐	64 mm	2.50″	Common — first-time patients, mild prolapse
4 ⭐	70 mm	2.75″	Most fitted size (~27% of patients)
5 ⭐	76 mm	3.00″	Common post-childbirth, larger anatomy
6	83 mm	3.25″	Larger-than-average, significant laxity
7	89 mm	3.50″	Marked laxity, post-hysterectomy
8	95 mm	3.75″	Largest with-support size, advanced prolapse

⭐ Sizes 3, 4, and 5 fit approximately 66% of patients (per SciMed 2022–2026 fitting data). Size 4 alone accounts for ~27% of fittings.

Fitting and Insertion Technique

1. Select an initial size based on vaginal caliber measured during pelvic examination (start with size 4 for most patients)
2. Fold the pessary in half and insert it through the introitus
3. Rotate it to a horizontal plane behind the pubic symphysis
4. Verify the pessary sits comfortably with the cervix (if present) resting in or through the central membrane
5. Check fit with Valsalva — it should not expel; one fingertip should pass between the pessary rim and vaginal wall
6. Have patient walk, cough, and squat to confirm retention
7. Instruct patient on self-removal (if applicable) or schedule return visit every 3 months

Care and Maintenance

SciMed's silicone pessaries can be cleaned with mild soap and warm water, rinsed thoroughly, and autoclaved for reuse between fittings. For patient-worn devices, cleaning every 1–3 months under provider supervision is standard. Silicone does not absorb odors or harbor bacteria the way older latex devices did, making it hygienic and durable for long-term use.

Why SciMed Ring Pessaries?

• ✔ FDA 510(k) cleared Class II medical device (Product Code HHN, 21 CFR 884.5350)
• ✔ 100% platinum-cured medical-grade silicone (USP Class VI) — latex-free, odor-free, BPA-free
• ✔ Full size range 0–8 available individually or as fitting sets
• ✔ Autoclavable for office fitting use
• ✔ Made in San Jose, California
• ✔ HCPCS A4562 — HSA/FSA eligible
• ✔ $49.99 direct from manufacturer with free US shipping

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