Incarcerated vaginal ring pessary: a case report

We report a rare case of a 75-year-old postmenopausal woman with a long-standing ring pessary for third-degree uterovaginal prolapse, managed conservatively due to significant cardiac comorbidities. She presented acutely with perineal pain, vaginal bleeding, and urinary difficulty. Examination revealed an incarcerated pessary embedded in the anterior cervical lip, encased by a fibrous band causing bladder compression. Prompt bedside surgical release under local anesthesia led to successful removal. This case underscores the importance of strict follow-up in elderly pessary users, as even well-tolerated long-term use can result in unexpected, serious complications.