PESSARY FITTING

Pessary Fitting

Envision Physiotherapy is the only clinic in Vancouver that is has a team of pelvic floor physiotherapists that can assess, prescribe and fit you with an internal assistive device called a pessary to help stop your incontinence and/or support organ prolapse.

 

A pessary is an internal assistive device that is worn in the vagina to stop incontinence or support pelvic organ prolapse. It can be easily inserted and removed by the wearer and should not be felt when using it. It can be used just for activities when the prolapse is bothersome, such as running or jumping, or kept in all day long if needed. It helps the user to become symptom free and return to the activities they want to do without leaking urine or experiencing the symptoms of prolapse. You should not feel the pessary, not leak urine and not feel any prolapse when wearing the pessary.

 

Pessaries are made of a soft, flexible silicone and offer a low-risk, effective option for treatment of symptoms of pelvic organ prolapse and/or bladder control management. Current practice guidelines recommend that all people with urinary incontinence and pelvic organ prolapse should be offered pelvic floor exercises and a pessary as first treatment options. [Journal of Obstetrics and Gynecology Canada: 43 (2) Feb 2021 & 42 (4) April 2020]

 

Reasons people choose to use a pessary include:

 

  • Relief of vaginal or rectal heaviness related to prolapse
  • Relief from urinary incontinence (urine leakage)
  • Unsure they want to have surgery for urine leakage or prolapse
  • Does not want to have surgery
  • Not a candidate for surgery
  • To try and prevent increasing prolapse

 

Please come to your pessary fitting appointment with clothing, including shoes, appropriate for a 5-10 minute brisk walk or run outdoors. You will be doing this to have the best test possible that you are purchasing the correct pessary for your needs. We do our best to have the first pessary you purchase be the one that will work for you ongoing. Sometimes different pessaries need to be trialed after the initial one is tried at home as we cannot fully simulate the typical demands made on your bladder and pelvic organs in your daily life.

 

At your appointment you will be fit with a pessary, you will be asked to go for a brisk walk or run with a pessary in place. After the activity you will then empty your bladder. If all is good, you will then learn how to insert and remove the pessary. Once a pessary is fit, you will then need to purchase the specific size and type of pessary identified during your appointment. If you are not able to, or prefer not to, a pessary can still be an option for you. Please contact the clinic to discuss this option.

 

We do not sell pessaries at the clinic. Pessaries can be purchased at specific pharmacies or online. We can provide purchasing information. You will need to return for follow up fitting in approximately 2 weeks from the time you start using your pessary. Sometimes it takes more than one fitting appointment to find the pessary that is best for you.

 

PELVIC FLOOR PHYSIOTHERAPISTS

Meet our team of pelvic health physios who are available to help you.

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Marcy Dayan
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Dikla Barer
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Anna Hudon-Kaide
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Allison Evers
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Meghan Hunt
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*Contact us if you have any more questions regarding Pelvic Health Physiotherapy

Marcy Dayan - BSR, MHA

Marcy is a registered physiotherapist and is a designated Clinical Specialist in Women’s Health which includes expertise in the management and treatment of female, male and paediatric bladder and bowel control problems, vaginal/genital/rectal pain, diastasis abdominis and perinatal low back, SIJ and symphysis pubis dysfunction and pain.

 

Since graduating from UBC in 1984, Marcy has completed postgraduate courses in incontinence, pain, sexual health and counseling, pelvic dysfunction and orthopaedics. She has also completed a Master of Health Administration from the University of British Columbia.

 

Active in clinical practice, teaching and research, Marcy works in private practice at Envision Physiotherapy (False Creek) in Vancouver and in public practice at the Vancouver Coastal Health Authority’s Prostate Cancer Supportive Care Program. 

 

Marcy worked at the Multidisciplinary Vulvodynia Program (now the BC Centre for Vulvar Health) from 2008-2019.  She is a clinical faculty member and lecturer on urogenital pathophysiology in the Master of Physiotherapy program at the University of British Columbia. She is also a guest lecturer at UBC’s Midwifery Program and preceptors UBC midwifery and obstetric and gynaecology residents in clinic.

 

When not at work, you can find Marcy spending time with her family, cycling, kayaking or at her torch melting glass into wonky wine goblets and silver and glass jewelry and sculpture.

Dikla (Dee) Barer - MScPT, BHK (ExSc), IMS

Dikla’s treatment philosophy of client empowerment through education, body awareness, and
customized rehabilitation exercise has led her to her interest in pelvic health. Drawing on over a decade of experience in an orthopaedic clinical setting, she brings a client centred, whole-body, hands-on therapy approach. This approach draws from her depth of knowledge in anatomy and physiology and her breadth and depth of experience in private practice.

 

Dikla has been a practicing physiotherapist in Vancouver for over 10 years. She holds a Masters degree in Physical Therapy from Queen’s University (2008), a Bachelor of Human Kinetics (Exercise Science) from UBC (2005), and is a Certified Gunn Intramuscular Stimulation practitioner (CGIMS). She has additional training in male and female pelvic floor dysfunction including incontinence, pelvic organ prolapse, painful intercourse, perinatal low back and pelvic pain, and abdominal separation, as well as certifications in advanced orthopaedic manual therapy and manipulation therapy.

 

Dikla lives in Vancouver with her husband and two daughters. Outside of work, you can find them on various adventures throughout the lower mainland.

Allison Evers - MScPT, BSc

Allison completed her education at the University of British Columbia’s Vancouver campus, where she obtained a Bachelor of Science (BSc) in Biology and Master in Physical Therapy (MPT). Allison holds her Level 1 Orthopedic Manual Therapy certification and has advanced training in the assessment and treatment of pelvic floor dysfunction, including urinary and bowel control, and pelvic organ prolapse.

Allison recognizes that clients may feel self-conscious discussing the nature of their visit. She brings a sensitivity to her practice, where she promotes a respectful environment that is responsive to her clients’ individual preferences, needs, and values.

One of Allison’s goals as a physiotherapist is to empower clients by giving them the education and tools needed to manage their condition independently overtime with confidence and success!

A proud Vancouverite, when Allison isn’t at work, she enjoys running, camping, and team sports. She also enjoys time spent with her family and friends. 

Anna Hudon-Kaide - BSc, MPT

Anna Hudon-Kaide is a registered physiotherapist with a passion for helping people with pelvic floor dysfunction. She assesses and treats pelvic health conditions such as bladder and bowel control problems, pelvic organ prolapse, painful intercourse, and other genital pain conditions. She is equally passionate about treating perinatal pelvic pain such as pubic symphysis, SI joint and back pain and coccydynia (tailbone pain). 

 

Anna obtained a Master of Health Sciences in Physiotherapy from the University of Ottawa in 2018, and has completed post-graduate training in pelvic floor rehabilitation. Prior to this, she attended the University of Alberta, where she earned a Bachelor of Sciences degree.

 

As an orthopedic practitioner, Anna came to realize how many patients have common concerns related to pelvic health. She also noticed that patients were often too embarrassed to seek advice, or simply unaware that treatment is available. Anna has since joined Dayan Physiotherapy and Pelvic Floor Clinic. She feels an important part of her work is to help shed the stigma of pelvic health concerns and assist people in optimizing the health and function of their pelvic floor, enabling them to fully engage in all aspects of their lives with comfort and joy.

 

Anna is also fluent in French and Japanese!

 

In her personal time Anna enjoys running and camping. She’s new to Vancouver and excited to learn how to sail.

Meghan Hunt - MScPT

Meghan is a physiotherapist with advanced training in pelvic floor physiotherapy, including bowel, bladder, sexual pain, and pelvic pain-related issues. She also has extensive experience with the pre- and post-natal population through her work at BC Women's Hospital, in addition to post-graduate training in manual therapy.
 
 
She graduated with her Bachelor of Science in Kinesiology with Distinction from the University of Calgary, before continuing to the University of British Columbia to complete her Master of Physical Therapy degree. Meghan started training in pelvic floor physiotherapy while studying at UBC, and has been at Envision Physiotherapy ever since.
 
 
Meghan is passionate about helping clients achieve their goals in a safe space using evidence-based treatment, and works with clients of any sex, and any gender. She will always adjust the assessment to your comfort level - an internal exam is not always necessary, and she can discuss this with you during your first visit.