MILEX Pessary ®

Reference Guide
Pessaries for Incontinence
and Pelvic Organ Prolapse

The Support Your Patient Needs... the Quality You Depend On!
Pessaries are the Pessary Fitting Process
preferred choice Proper fitting of the pessary may require the patient to try several
pessary shapes and sizes. Once a complete pelvic examination has
for women who may been performed, the physician should start with a shape and size
based on physician's experience. Once the correct shape is determined,
prefer to avoid surgery the largest pessary that the patient can comfortably wear is usually
the most effective. After a comfortable fit, a patient should be able
or have medical to squat, sit or stand without delivery of the pessary.

contraindications. The physician’s finger should pass easily between the pessary and the
vaginal wall. The physician should check the pessary to be sure that
Pessaries... the intended function is met. When the indication for the pessary is
stress urinary incontinence, the patient should be asked to cough to
The perfect noninvasive solution test for any leakage of urine, with the pessary out and again with it in.
for assessing or resolving pelvic
organ prolapse, stress incontinence,
urge incontinence and nocturia
associated with urinary retention.

The pessary is a safe and effective device

used to manage a number of gynecologic
issues including pelvic support defects, stress
urinary incontinence and urinary retention.
The pessary was designed to reposition the
appropriate organs as a first line therapy for all
women with prolapse and/or control the timing
of urine flow, thus regaining her quality of life.
The market-leading Milex® silicone pessaries
come in a wide variety of configurations to
afford the optimal fit for your patients’ needs.

As a nonsurgical tool to manage prolapse

and incontinence situations, Milex pessaries
have no peer. The device is inexpensive and
easily managed. It also provides the opportunity
to assess which surgical approach, if any, will
improve the patient’s condition before going
to a surgical solution.

Physicians can use pessaries to assess

the effect of prolapse reduction on
symptoms and assist in determining
surgical options.
Pessary Selection Chart*
Procedentia

Retro Displacement

Incompetent Cervix

Compatible with
Stress Incontinence
Prolapse

Sexual Activity
Ease of
Product

Rectocele
Cystocele
Condition and Selection Criteria Most Common Sizes Material Insertion/

Vaginal Wall
Code
Removal

1 - 2°

3 - 4°
MXPER Ring X 2½ - 3¾" Silicone & Metal Easy X

MXPERK Ring with knob X X X 2¼ - 3½" Silicone & Metal Easy X

MXPRS Ring with support X X 2½ - 3¾" Silicone & Metal Easy X

MXPRSK Ring with support and knob X X X 2¼ - 3½" Silicone & Metal Easy X

MXPCON Incontinence Ring X 2¼ - 3½" Silicone & Metal Easy X

MXPSH Shaatz X 2¼ - 3" Silicone Medium X

MXPDO Donut X X X 2½ - 3¼" Silicone Medium/Difficult

MXPREG Regula X X X X 1¼ - 1½" Silicone & Metal Easy/Medium

MXPGE Gellhorn Flexible X 2¼ - 3" Silicone Difficult

MXPEH Hodge X X X 3½ - 4½" x 2¼ - 2⅝" Silicone & Metal Easy/Medium X

MXPHS Hodge with support X X X 2½ - 3⅛" Silicone & Metal Easy/Medium X

MXPEHK Hodge with knob X X X 3¼ - 3¾" x 115/16 - 2¼" Silicone & Metal Easy/Medium X

MXPHSK Hodge with knob and support X X X X 3¼ - 3¾" x 115/16 - 2¼" Silicone & Metal Easy/Medium X

MXPRI Risser X X X 3½ - 4½" x 2¼ - 2⅝" Silicone & Metal Easy/Medium X

MXPES Smith X X X 3½ - 4½" x 2¼ - 2⅝" Silicone & Metal Easy/Medium X

MXPCOND Incontinence Dish X X 2½ - 3⅛" Silicone Easy/Medium X

MXPCONDS Incontinence Dish with support X X X 2½ - 3⅛" Silicone Easy/Medium X

MXPEC Cube X X X X 1⅜ - 1¾" Silicone Medium X

MXPECT Tandem Cube X X X X 1⅜ - 1¾" Silicone Medium X

MXPGS Gehrung X X X 1⅜ - 1¾" x 2 - 2⅜" Silicone & Metal Medium/Difficult X

MXPGSK Gehrung with knob X X X X 1⅜ - 1¾" x 2 - 2⅜" Silicone & Metal Medium/Difficult X

MXPINF Inflatoball X X X 2¼ - 2½" Latex Easy X

*Source: Viera AJ, Larkins-Pettigrew M. Practical use of the pessary. Am Fam Physician. May 1, 2000;61(9): 2719-26
MILEX Brand Pessary Product Offerings
® P = Prolapse
I = Incontinence

Ring Ring Ring with Knob Ring with Knob Ring with Support Ring with Support
For mild prolapse. Product # in. mm For mild prolapse complicated Product # in. mm For mild prolapse complicated Product # in. mm
by stress urinary incontinence. by a mild cystocele.
Product # MXPER (Pessary Only) MXPER00 1¾ 44 MXPERK00 1¾ 44 MXPRS00 1¾ 44
Product # MXKPER Product # MXPERK (Pessary Only) Product # MXPRS (Pessary Only)
MXPER01 2 51 MXPERK01 2 51 MXPRS01 2 51
(Pessary, Trimo-San, Jel Jector) Product # MXKPERK Product # MXKPRS
MXPER02 2¼ 57 (Pessary, Trimo-San, Jel Jector) MXPERK02 2¼ 57 (Pessary, Trimo-San, Jel Jector) MXPRS02 2¼ 57
P MXPER03 2½ 64 MXPERK03 2½ 64 MXPRS03 2½ 64
MXPER04 2¾ 70
P, I MXPERK04 2¾ 70
P MXPRS04 2¾ 70
MXPER05 3 76 MXPERK05 3 76 MXPRS05 3 76
MXPER06 3¼ 83 MXPERK06 3¼ 83 MXPRS06 3¼ 83
MXPER07 3½ 89 MXPERK07 3½ 89 MXPRS07 3½ 89
MXPER08 3¾ 95 MXPERK08 3¾ 95 MXPRS08 3¾ 95
MXPER09 4 102 MXPERK09 4 102 MXPRS09 4 102
MXPER10 4¼ 108 MXPERK10 4¼ 108 MXPRS10 4¼ 108
MXPER11 4½ 114 MXPERK11 4½ 114 MXPRS11 4½ 114
MXPER12 4¾ 121 MXPERK12 4¾ 121 MXPRS12 4¾ 121
MXPER13 5 127 MXPERK13 5 127 MXPRS13 5 127

Incontinence Ring Incontinence Ring Ring with Support & Knob Incontinence Ring Shaatz Shaatz
w/ Support & Knob
For stress urinary incontinence. Product # in. mm For mild prolapse complicated by Product # in. mm For mild prolapse complicated Product # in. mm
a mild cystocele and stress urinary by a mild cystocele.
Product # MXPCON (Pessary Only) MXPCON00 1¾ 44 MXPRSK00 1¾ 44 MXPSH-1½ 1½ 38
incontinence. Product # MXPSH (Pessary Only)
Product # MXKPCON MXPCON01 2 51 MXPRSK01 2 51 MXPSH-1¾ 1¾ 44
(Pessary, Trimo-San, Jel Jector) Product # MXPRSK (Pessary Only) Product # MXKPSH
MXPCON02 2¼ 57 MXPRSK02 2¼ 57 (Pessary, Trimo-San, Jel Jector) MXPSH-2 2 51
I Product # MXKPRSK
MXPCON03 2½ 64 (Pessary, Trimo-San, Jel Jector) MXPRSK03 2½ 64 MXPSH-2¼ 2¼ 57
MXPCON04 2¾ 70 MXPRSK04 2¾ 70
P MXPSH-2½ 2½ 64
MXPCON05 3 76
P, I MXPRSK05 3 76 MXPSH-2¾ 2¾ 70
MXPCON06 3¼ 83 MXPRSK06 3¼ 83 MXPSH-3 3 76
MXPCON07 3½ 89 MXPRSK07 3½ 89 MXPSH-3¼ 3¼ 83
MXPCON08 3¾ 95 MXPRSK08 3¾ 95 MXPSH-3½ 3½ 89
MXPCON09 4 102 MXPRSK09 4 102 MXPSH-3¾ 3¾ 95
MXPCON10 4¼ 108 MXPRSK10 4¼ 108
MXPCON11 4½ 114 MXPRSK11 4½ 114
MXPCON12 4¾ 121 MXPRSK12 4¾ 121
MXPCON13 5 127 MXPRSK13 5 127
Hodge Hodge w/ Support Hodge w/ Knob Hodge w/ Gellhorn Gellhorn
Support & Knob
For stress urinary For stress urinary incontinence For stress urinary For 3rd degree prolapse/procidentia. Flexible Rigid Short Stem
incontinence for a with a mild cystocele for a incontinence in the For stress urinary incontinence
Product # MXPGE (Pessary Only) Product # Product # Product # in. mm
woman who has a very woman who has a very woman who has a complicated by a mild cystocele
Product # MXKPGE
small vaginal introitus. small vaginal introitus. small vaginal introitus. in the woman who has a small MXPGE-1½ MXPGRS-1½ MXPGSS-1½ 1½ 38
(Pessary, Trimo-San, Jel Jector)
vaginal introitus. MXPGE-1¾ MXPGRS-1¾ MXPGSS-1¾ 1¾ 44
Product # MXPEH Product # MXPHS Product # MXPEHK
Also available in:
(Pessary Only) (Pessary Only) (Pessary Only) Product # MXPHSK (Pessary Only) MXPGE-2 MXPGRS-2 MXPGSS-2 2 51
Short Stem Product # MXPGRS
Product # MXKPEH Product # MXKPHS Product # MXKPEHK Product # MXKPHSK
Rigid Product # MXPGRS MXPGE-2¼ MXPGRS-2¼ MXPGSS-2¼ 2¼ 57
(Pessary, Trimo-San, Jel Jector) (Pessary, Trimo-San, Jel Jector) (Pessary, Trimo-San, Jel Jector) (Pessary, Trimo-San, Jel Jector)
(Pessary Only)
MXPGE-2½ MXPGRS-2½ MXPGSS-2½ 2½ 64
I I I I Short Stem Product # MXKPGRS
MXPGE-2¾ MXPGRS-2¾ MXPGSS-2¾ 2¾ 70
Rigid Product # MXKPGRS
(Pessary, Trimo-San, Jel Jector) MXPGE-3 MXPGRS-3 MXPGSS-3 3 76
MXPGE-3¼ MXPGRS-3¼ MXPGSS-3¼ 3¼ 83
MXPGE-3½ MXPGRS-3½ MXPGSS-3½ 3½ 89
MXPGE-3¾ MXPGRS-3¾ MXPGSS-3¾ 3¾ 95

Hodge Regula Regula Folding

w/ Support For uterine prolapse Product # in. (A) mm (A) in. (B) mm (B) in. (C) mm (C)
Hodge w/ Support w/ Knob
A & Knob (1st and 2nd degree).
MXPREG00 1 25 115/16 49 1⅜ 35
Product # Product # Product # Product # in. (A) mm (A) in. (B) mm (B) Product # MXPREG (Pessary Only)
MXPREG01 11/16 27 2 51 1½ 38
Product # MXKPREG
MXPEH00 MXPHS00 MXPEHK00 MXPHSK00 2¾ 70 1¾ 44 MXPREG02 1⅛ 29 2⅛ 54 1⅝ 41
(Pessary, Trimo-San, Jel Jector)
MXPEH01 MXPHS01 MXPEHK01 MXPHSK01 3 76 1⅞ 48 MXPREG03 1¼ 32 23/16 56 1¾ 44
B MXPEH02 MXPHS02 MXPEHK02 MXPHSK02 3¼ 83 115/16 49 P MXPREG04 1⅜ 35 2¼ 57 1⅞ 48
MXPEH03 MXPHS03 MXPEHK03 MXPHSK03 3½ 89 2 51 MXPREG05 17/16 37 2⅜ 60 2 51
MXPEH04 MXPHS04 MXPEHK04 MXPHSK04 3⅝ 92 2⅛ 54 MXPREG06 1½ 38 2⅝ 67 2⅛ 54
MXPEH05 MXPHS05 MXPEHK05 MXPHSK05 3¾ 95 2¼ 57 MXPREG07 1⅝ 41 2⅞ 73 2¼ 57
MXPEH06 MXPHS06 MXPEHK06 MXPHSK06 3⅞ 98 2⅜ 60 MXPREG08 1¾ 44 3⅛ 79 2⅜ 60
MXPEH07 MXPHS07 MXPEHK07 MXPHSK07 4¼ 108 2½ 64
MXPEH08 MXPHS08 MXPEHK08 MXPHSK08 4⅝ 117 2⅝ 67
MXPEH09 MXPHS09 MXPEHK09 MXPHSK09 5 127 2¾ 70
Cube Tandem-Cube Cube Risser Risser
Support for 3rd degree Support for 3rd degree prolapse/ Cube w/ Holes Designed for patient with shallow Product # in. (A) mm (A) in. (B) mm (B)
prolapse/procidentia. procidentia when single cube pubic notch. Has larger weight
Should be removed nightly. provides inadequate support. Product # Product # in. mm MXPRI00 3⅛ 79 2 51
bearing zone to support vaginal
Should be removed nightly. MXPEC00 MXPECH00 1 25 aspects of pubis. Helpful in cases MXPRI01 3¼ 83 2⅛ 54
Product # MXPEC (Pessary Only)
Product # MXKPEC Product # MXPECT (Pessary Only) MXPEC01 MXPECH01 13/16 30 of repeated miscarriages due to an MXPRI02 3½ 89 2¼ 57
(Pessary, Trimo-San, Jel Jector) Product # MXKPECT incompetent cervix by repositioning
MXPEC02 MXPECH02 1⅜ 35 the weight of the growing fetus. MXPRI03 3¾ 95 2⅜ 60
(Pessary, Trimo-San, Jel Jector)
Also available in: MXPEC03 MXPECH03 1½ 38 MXPRI04 4¼ 108 2½ 64
Cube with Drainage Holes Product # MXPRI (Pessary Only)
Product # MXPECH (Pessary Only) P MXPEC04 MXPECH04 1⅝ 41 Product # MXKPRI MXPRI05 4½ 114 2⅝ 67
Product # MXKPECH MXPEC05 MXPECH05 1¾ 44 (Pessary, Trimo-San, Jel Jector) MXPRI06 4¾ 121 2¾ 70
(Pessary, Trimo-San, Jel Jector)
MXPEC06 MXPECH06 2 51 MXPRI07 5 127 2⅞ 73

P MXPEC07 MXPECH07 2¼ 57 MXPRI08 5½ 140 3 76

MXPRI09 5¾ 146 3⅛ 79
Tandem Cube
MEASURE ACROSS
Product # in. mm
FOR OUTSIDE
MXPECT2-0 1⅜ & 1 35 & 25 DIAMETER
I
MXPECT3-1 1½ & 13/16 38 & 30
MXPECT4-2 1⅝ & 1⅜ 41 & 35
MXPECT5-3 1¾ & 1½ 44 & 38
MXPECT6-4 2 & 1⅝ 51 & 41
MXPECT7-5 2¼ & 1¾ 57 & 44

Incontinence Dish Incontinence Dish Incontinence Dish Smith Smith

with Support Modification of Hodge pessary.
For stress urinary incontinence Dish Dish w/ Support Product # in. (A) mm (A) in. (B) mm (B)
with mild prolapse. For stress urinary incontinence with For stress urinary incontinence
Product # Product # in. mm designed for patients with a MXPES00 3⅛ 79 2 51
mild prolapse and a mild cystocele.
Product # MXPCOND
MXPCOND00 MXPCONDS00 2⅛ 55 well-defined pubic-notch. Helpful MXPES01 3¼ 83 2⅛ 54
(Pessary Only) Product # MXPCONDS (Pessary Only)
in cases of repeated miscarriages
Product # MXKPCOND Product # MXKPCONDS MXPCOND01 MXPCONDS01 2⅜ 60 MXPES02 3½ 89 2¼ 57
due to incompetent cervix by
(Pessary, Trimo-San, Jel Jector) (Pessary, Trimo-San, Jel Jector) MXPCOND02 MXPCONDS02 2½ 65 MXPES03 3¾ 95 2⅜ 60
repositioning the weight of
MXPCOND03 MXPCONDS03 2¾ 70 the growing fetus. MXPES04 4¼ 108 2½ 64
P, I P, I
MXPCOND04 MXPCONDS04 3 75 Product # MXPES (Pessary Only) MXPES05 4½ 114 2⅝ 67
Product # MXKPES
MXPCOND05 MXPCONDS05 3⅛ 80 (Pessary, Trimo-San, Jel Jector) MXPES06 4¾ 121 2¾ 70
MXPCOND06 MXPCONDS06 3⅜ 85 MXPES07 5 127 2⅞ 73
MXPES08 5½ 140 3 76
MXPES09 5¾ 146 3⅛ 79

I
Gehrung with Gehrung/Folding Gehrung Donut
Knob/Folding Support for cystocele and rectocele. Gehrung w/ Gehrung Support for 3rd degree prolapse/procidentia. Not to be deflated
Donut
For cystocele with or without It is also more adaptable in cases Knob/Folding Folding during insertion or removal. See Inflatoball if a deflatable
mild rectocele complicated by of procidentia where the uterus pessary is necessary. Product # in. mm
stress urinary incontinence. tends to herniate when other in. mm in. mm in. mm MXPDO00 2 51
Product # Product # Product # MXPDO (Pessary Only)
pessaries are used. (A) (A) (B) (B) (C) (C)
Product # MXPGSK (Pessary Only) Product # MXKPDO MXPDO01 2¼ 57
MXPGSK00 MXPGS00 11/16 27 1½ 38 1⅜ 35
Product # MXKPGSK Product # MXPGS (Pessary Only) (Pessary, Trimo-San, Jel Jector) P MXPDO02 2½ 64
(Pessary, Trimo-San, Jel Jector) Product # MXKPGS MXPGSK01 MXPGS01 1⅛ 29 1¾ 44 1½ 38
(Pessary, Trimo-San, Jel Jector) MXPDO03 2¾ 70
MXPGSK02 MXPGS02 1⅜ 35 2 51 1⅝ 41
I MXPDO04 3 76
P MXPGSK03 MXPGS03 1½ 38 2⅛ 54 1¾ 44
MXPDO05 3¼ 83
MXPGSK04 MXPGS04 1⅝ 41 2¼ 57 1⅞ 48
MXPDO06 3½ 89
MXPGSK05 MXPGS05 1¾ 44 2⅜ 60 2 51
MXPDO07 3¾ 95
MXPGSK06 MXPGS06 1⅞ 48 2½ 64 2⅛ 54
MXPGSK07 MXPGS07 2 51 2⅞ 73 2¼ 57
MXPGSK08 MXPGS08 2⅛ 54 3 76 2⅜ 60
MXPGSK09 MXPGS09 2¼ 57 3⅛ 79 2⅜ 64

Inflatoball™ Inflatoball–Size
Inflatable for 3rd degree prolapse/procidentia with or without Product # in. mm
a mild cystocele and/or rectocele.
MXPINFS 2 51
Product # MXPINF (Pessary Only)
Product # MXKPINF MXPINFM 2¼ 57
(Pessary, Trimo-San, Jel Jector) P MXPINFL 2½ 64
MXPINFXL 2¾ 70
Trimo-San Vaginal Jelly* Trimo-San Vaginal Jelly
Trimo-San is a recommended adjunct for pessary wearers. Product # Description Size
For complete information, see product enclosure. MX5030 Trimo-San Jelly with Jector 4 oz
*Not sold outside U.S. MXAPP Jector Replacement BX
Has not been tested for use during pregnancy.

1 2 3 4 5

Inches

Note: Shaded areas show the

Millimeters minimum assortment neccessary to
10 20 30 40 50 60 70 80 90 100 110 120 130 fit approximately 85% of patients.
CooperSurgical is the leading company dedicated to providing medical devices and procedure
solutions that improve health care delivery to women regardless of clinical setting. Our company
is fostering that position through expansion of its core businesses and introduction of advanced
technology-based products which aid clinicians in the management and treatment of commonly
seen conditions.

203.601.5200 | 800.243.2974 | coopersurgical.com | 95 Corporate Dr. | Trumbull, CT 06611

©2016 CooperSurgical, Inc 81983 Rev B 12/16