The club pessary consists of flexible silicone. The stem of the club pessary is supposed to avoid the gliding of the upper lying basis. Only those patients with grade 3 to 4 prolapse of vagina and uterus are treated with the club pessary, in cases where urethra, ring or bowl pessaries do not sustain the pressure and where a cube pessary might increase stress incontinence. Grade 4 prolapse may represent a big problem for the patient and a challenge for the physician. Before inserting the pessary, the prolapsed organs have to be reposed. Thereby the contents of the hernia have to be examined. If other organs apart from the uterus are contained in the prolapse, it has to be carefully pushed back with two hands.