Need help with pessary

Hi Mommynow

I can understand your being unsure. I think if you are going to give the pessary a fair try you need to go back to the Ob and tell him your concerns. He may know whether or not it is the wrong size. Members who use them successully seem to have to try different sizes before they know which is right, then they might need to be refitted again later. My pessary was not worth the effort. I don't use one at all these days.

I know what you mean about the stretching sensation. Mine was too small but I still felt very stretched when removing it. All I needed to do was tip my pelvis back (slouch my lower spine), bear down and it would just pop out quite easily with a stretched sensation. I could never fold it when it was inside. I don't understand why you need such a rigid device when everything in there is like jello! Engineered by a bloke, I dare say! Try some lube to let it slide out more easily.

I never did get that 'tuck it behind the pelvic bone' thing. You might be able to do it if you don't have POP but the first thing a cystocele will do is ease it backwards and off the cliff. Mine just wouldn't stay horizontal. When you think about it, any intraabdominal pressure would tip it over in a flash, so it was once again lying parallel to the vagina, ready to shoot out with the first push.

I think the theory behind the pelvic bone thing is that the pessary will prop/hold your bladder forwards. That will only work if you are in WW posture and the bladder is resting against the front abdominal wall. A prop only works if it is supported at the base by something solid. The only thing supporting the back is a squishy old large intestine! No wonder they slide backwards. I suspect you need a differently shaped pessary, but it might be worth trying a different size first.

If the Ob doesn't show any positive signs of knowing what he is doing in the fitting department, ask him to refer you to somebody who does it all the time. Obs seem to like washing their hands of women after the 6 week checkup. Pessary fitting several months later is not a high priority for them. You might do better with a women's health clinic that advertises that it fits pessaries.

Good luck.

Louise

I encourage you to persist in getting one that works for you.
Have had one for over a year and it makes a great difference on an active day...shopping, gardening, working in my studio, hiking.
Learn what you can about getting it in as far as you can by experimenting.
Try doing that while lying on your back, after doing a couple 'pelvic tilts'.
Once you have it well in, I take it out before or after intercourse, and for a rest on weekends or a couple nights a week.
Good luck.

I agree, fitting a pessary is an art that not all practitioners do well. The Ob-Gyn surgeon I initially consulted about my prolapse condition (cyctocele, uterine, and rectocele) said a pessary would be of no use and would cause too many problems even if I tried one. Well, he's a surgeon, that's his focus.

It's worth seeking out someone with extensive experience with fitting pessaries, someone patient and supportive of pessary use. I suspect that attitude isn't common, even in most gyn practices.

Then I went to an Gyn Nurse Practioner who was highly recommended by several people. It was worth the long wait for the appt day. She was very knowledgable and said that there's no way to know for sure if a pessary will help without trial and error. She tried first the style that is easiest to insert and remove, a ring pessary that folds in half for insertion. Then she tried one size up, but I could feel that one, so I went home with the first one, the smaller size. She said we would keep trying with sizes and styles until I found one that worked best for me. But I did very well with that first one so I haven't tried another style! I went back for an assessment appt a few weeks later to make sure it wasn't irritating my tissues and everything was fine.

So I have been using this pessary for almost two years, all the time. I take it out and clean it in the shower once or twice a week (more often during my period) and leave it in during intercourse, too. I feel much better with the pessary in, though it isn't like not having prolapse at all. But it makes the condition far more bearable.

But I feel quite certain that the nurse practitioner I see would be very patient with trying as many different pessaries as I needed, in order to help me manage this condition. While she is not critical of surgery, she said that many women can manage a very long time with use of a pessary as long as the pessary is the right one.

My younger sister had a prolapse condition after the birth of her first child (in her early 30s). It was much worse after the birth of her second child two years later and she didn't get very much support from her Ob-Gyn for quite a while ("it's normal" baloney). Finally she was referred to another doc and she had surgery, which was a disaster; it failed not long afterward. Her regular ob-gyn fitted a pessary, but it was a style my sister couldn't remove easily and she got UTIs from it. So she gave up. Then she had another surgery, with a hysterectomy that time and a different surgeon. That doc had very little tissue to work with and said he did the best he could. It also failed a short time later. She just copes the best she can now. She still sees her long-time gyn doc; she is very resistant to the notion that her doc isn't a good fit for her needs. Even after my good experience with a pessary, she doesn't reconsider trying a new doc.

But I have learned from my sister's unfortunate experiences. I don't do anything irreversible and I don't settle for doctors who can't see the big picture. It's worth the search to find a good fit (both pessaries and pessary fitters).

Hi and thanks for the encouraging story about the pessary and pessary fitter. Regarding your sister, I think it’s pretty common for women who get caught in the machine to become emotionally and physically dependent upon it to the point of unfounded obedience and loyalty.

Yes, “reversible” is a very good concept to keep in mind when weighing medical options.