Infections again

Hi and Welcome, Francis,

My apologies for not answering your post before I signed off for the remainder of the month.

The pessary question is a complicated one that I'm sure many members do not feel totally comfortable responding to.

We've been a forum for close to a year, and there have been few (I can't think of any) women writing in with positive, long term experiences with them. I don't have completely comprehensive data, but it seems that for primary rectocele, the pessary is not useful at all. For primary cystocele/UP, the pessary often gives comfortable relief, but is associated with eventual development of rectocele.

The gynecologic data suggests that they can be worn successfully with cystocele and rectocele combined, but that the genital hiatus continues to expand because the pessary is holding the normally flattened vagina open and vulnerable to intraabdominal pressure. How long this would take I do not know.

As for the Trimo-san...I've read elsewhere that just the sort of symptoms you are experiencing are common with this gel. If you wish to continue to wear the pessary, how about trying the very pH-neutral KY jelly and see if your symptoms improve.

My own opinion and experience is that the healthiest long course for living with pelvic organ prolapse is to change your posture so your pelvic organs once again have a correctly shaped frame from which to suspend.

Beyond reinstating the natural shape of the female spine, there are many other lifestyle factors that nourish and provide additional comfort, including Mayan massage, good food, proper seated postures, and non-restrictive clothing.

I believe it is time that our physical therapists take another look at prolapse and develop new techniques for treatment. Practitioners involved in the "New Medicine" such as the organization Healthcare Without Harm and others, are awakening to the fact that the body does not respond well to jerking, shocking, cutting, burning and poisoning.

It has recently occurred to me that the fascial structure of the vaginal wall might respond very well to myofascial therapy - really a Mayan massage from the inside, which is where the problem exists. Myofascial therapy is one of the fastest growing and most effective treatments for a myriad of musculoskeletal and connective tissue disorders. It began as an alternative health modality, yet in the past decade has become quite conventional, with every city in America employing several of these practitioners, many of whom are licensed physical therapists. It is a known fact that the fascial layers of the human body are highly responsive to change-through-therapy.

There are already PTs specializing in intravaginal post-hysterectomy therapy for the "short vagina." And of course, we have an army of PTs providing intravaginal electrical stimulation to the pelvic floor, a painful, barbaric practice that has never been shown to have the least bit of effect on prolapse.

Physical therapists already trained in intravaginal therapy and who are also trained in myofascial theory (or are willing to learn) are the only people qualified and appropriate to do this work.

I do not know that it is NOT being done...but I have yet to hear about it. My sense is that due to the highly intimate nature of the therapy, if anyone has given it thought, the notion has probably has been discarded.

I say,

Frances...I didn't realize you don't have your uterus! The anatomy changes so much that it may well be you will be MORE successful at long term pessary use, since you don't have the piston-effect of the uterus bearing down.