upper vaginal wall 72 adjacent the urethra 64 instead of requiring a surgical sling extending around the mid urethra 65 as found in mid urethra sling surgery referring to fig6 the pessary 20 is able to brace itself against the vaginal walls 70 through the translation of forces against the mid section 34 of the bridge 22 to the first and second ends 26 28 and the slight elongation of the vagina 52 when the pessary 20 is inserted the first and second ends 26 28 extend outward laterally against the vaginal walls 70 utilizing the natural resistance of the vaginal walls 70 to produce a snug fit when intra abdominal pressure is applied to the urethra additional forces are exerted at or near the mid section 34 of the pessary 20 located behind the mid urethra 65 the shape of the pessary 20 is able to translate the forces applied to the mid section 34 to the generally opposing first and second ends 26 28 in a generally perpendicular direction from the original forces thus the forces applied to the mid section 34 may be used to help maintain or support the pessary 20 at the walls 70 of the vagina 52 in this respect the pessary 20 uses its own unique shape to prevent it from falling out or rotating from its original position without reliance on vaginal notches or a large or more expansive pessary 20 design by utilizing limited points of contact at the vaginal walls 70 the pessary 20 may provide increased comfort to the user however it is contemplated that additional support knobs may.