As per standard of care, a vaginal culture will be obtained at any visit if the patient complains of a bothersome, malodorous discharge. In addition to the vaginal culture, patients who report a malodorous discharge will undergo saline irrigation at time of visit and examination of vaginal tissue for erosion. If no vaginal erosion present the pessary will be replaced and the patient will be instructed to continue the previously prescribed regimen of 3 times weekly application of vaginal cream. If vaginal erosion is noted, the pessary will be left out for 3 weeks and the patient will be instructed to use the vaginal cream daily for 3 weeks. The patient will then return to the office after 3 weeks for a vaginal exam and replacement of pessary upon resolution of vaginal erosion.