Question

In uterine prolapse, how to know if the ring pessary is in place?

• A. If not expelled after increased abdominal pressure
• B. If bleeding does not occur
• C. If patient feels discomfort
• D. None

Hint:

A well-fitted ring resists straining and bearing down.

Answer 1

The Correct Option is A

Step 1: A ring pessary is a removable vaginal device used to support pelvic organ prolapse. The clinician needs a simple bedside check to confirm correct placement and fit.
Step 2: A correctly fitted pessary stays seated when intra-abdominal pressure rises. The standard test is to ask the patient to cough, bear down or strain after insertion.
Step 3: If the pessary is NOT expelled despite this increased abdominal pressure, the size and position are appropriate. This confirms it is in place, making option a correct.
Step 4: Absence of bleeding (option b) and patient discomfort (option c) are not reliable markers of correct seating - discomfort actually suggests a poor fit. So "not expelled on straining" is the validated check.