should i try a pessery?

Welcome and yes, I would see if a pessary would work. They are very helpful in some percentage of women with primary cystocele/rectocele.

:-) Christine

To be honest I would actually for the first time in my life disagree with Christine (Eeps - Sorry Christine)

If you go with the Pessary - I have found that you can in alot of circumstances go on to need the Pessary for life! (This has happened to my Mother who now needs it for life) This may be as the body gets used to having 'help' and gets lazy (In my opinion)Which is why I would always say to use other avenues first.

I had a pessary for 18hrs (It moved and I took it out)and now after the fact I found myself having gone from 1 Prolapse to 3 - But that may be as my Dr was rough and evil and a bit (lot) meannnnnnnnnnnnnn... Then I was told by a Gynae who looks after my Mother that the size of Pessary my Dr fitted was 'Way to large'

If you have minor symptoms I would go with Posture first before trying anything else - If that is not effective enough for you then after a while I would try the Pessary (Or Sea Sponge)

Good luck :-)
Sue

Look into the eyes - They hold the key!
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg

I think you could try the posture and other advice from Christine first and if you need more help than try the pessary. Unfortunately I have tried everything on this site (before this baby) and I was still suffering with annoying pressure so I will be trying a pessary after I heal from this childbirth. I tried seasponges too and it did nothing. I think it is worth trying all natural avenues first because that is all it takes for many women. But I don't think there is anything wrong with trying a pessary too if you need that. It is better than having surgery!

I am thinking of having a ring pessary fitted by my doctor, he will fit it then I go back every 4 months for a check up...Can a pessary cause any other problems..I am 63 years so I don't think I will have any more children LOL...I have uterine prolapse which is very low most of the time...My only relief seems to be when I lie down..Your book has just arrived so I will start reading that today..I have been very low and depressed the last few days, I have no confidence...normally I get up each morning 5am walk then do a workout then I feel great for the day but I really can not walk my prolapse drops right down opens the doors and cervix just pops out to smile at the world which I find a little sore and uncomfortable. This is why I thought a pessary may help....

For what it it worth, I tried several types of pessaries to find the best compromise after an unsuccessful surgery for bladder prolapse. After one year, I was a stage three prolapse which is worse than where I was pre-surgery. I wanted to avoid another surgery. I wore it for a year in-between the yeast infections that it seemed to cause. The pessary lifted the bladder and caused some relief, but I had to re-adjust it frequently because my bladder kept falling out of the front and got pinched in this position by the pessary. (This is not something that you can easily correct when you spend your day in front of a classroom.) When it started causing pressure on my back wall, my Dr. suggested not wearing it for this could potentially cause other serious problems.
I spent my summer trying to figure out how to keep my bladder inside my body for it seemed that my muscles had become weaker while wearing the pessary. It was about this time that I discovered this site and learned about exercises and posture and that surgery is not the only alternative.
Not wearing the pessary, using the stategies, trying to build my health, and listening to my body, I am developing the ability to hold my bladder higher up in my body. Every week I am seeing more improvement.
I will put the pessary in for those times when I know that I must be up and about for a longer period of time, but I find that I have more sense of what is happening with my body without it. I can't help thinking that it just helps me more when I am using my muscles. Still it is a nice crutch for those situations when I wonder how else I could manage.
Good luck,

theodora

Thanks for your information Theodora....I am so confused at the moment as my uterus seems to be low most of the time which puts me in a depression and I don't want to do anything or go anywhere...I have started to read the book and do the posture..well I have trouble can't understand how to drop the lower belly..but I suppose that will happen soon...I would like to try a pessary but as I said it worries me that other things will go wrong...Last week I bought some lovely skirts and tops because I find slacks rub and become uncomfortable...I will start the exercises tomorrow.. so I am trying everything...So I will hold off on the pessary for awhile...thanks again

Hi Bling

I posted on this a couple of weeks ago, but darned if I can find it now! Try exploring it this way. Try standing in posture with your arms down, the tips of your fingers touching, little fingers resting on the top of your pubic bone. Breathe in slowly through your nose, then breathe out. When you next breathe in try to breathe the air down deep into your lower belly, expanding your lower belly under your fingertips, keeping your shoulders low and don't breathe into your chest. You will be breathing with your diaphragm only. You may find that you do this and still can't lower your belly. Just do your best, then when you have inhaled, think of your belly as a big bag of grain being held against your belly by your hands. Now tip your pelvis forward a little and let your hands take the whole of the weight of the bag of grain. This should allow the lower transverse abdominus muscle relax.

It's worth a try anyway, and quite a pleasant sensation. I am a serial tummy puller-inner, and I find myself continually doing this to relax my lower belly, when I am doing something strenuous. I am hoping it will become second nature after a while.

Cheers

Louise

WOW That really worked....But what a strange feeling, I have always walked tall shoulders back and tummy in. Also it took less than 2 weeks for the book to arrive here ( Aust ),so you were right it didn't take long. Thanks..

Hi,
If you are having doubts about the pessary you could try a v2 support belt. It is a maternity item but some women on this forum have tried it and find it quite helpful.
It is a thick band of elastic that goes under the crotch and around the hips. It has a thick padding under the crotch and helps to hold everything up.
Just a thought.
Regards,
Flora.

Hi Bling

Glad your book has arrived. Now you can find out the full story. There is so much in the book. I still refer to it repeatedly. I find that the chapter on pelvic anatomy is really useful; it is not light reading but it is great to be able to see in pictures what all the different muscles and organs do and what happens when you correct your posture.

The breathing thing worked, eh? It is a strange sensation, isn't it. I think that's because we are so accustomed to keepng that muscle contracted. We normally don't feel it relaxed very often.

My logic tells me that muscles need to both contract and relax. It is a muscle that my physiotherapist tells me is kind of like a corset for the spine, protecting the stability of the pelvis and spine during exertion (I have some ragged lumbar discs). That's fine during exertion, but I figure it should be relaxed when we are at rest, and somewhere in between for the rest of the time, not locked up in contraction all the time so we can have a flat tummy.

Cheers

Louise

I have stage 2 uterine prolapse - no noticable cystocele or rectocele. Having returned from a vacation, I decided to start using my new Sea Sponge on a daily basis when I return from work every afternoon. I didn't feel comfortable wearing it to work yet in case I needed to remove it. Put it in yesterday about 5:30 and I felt wonderful. It stayed in place and I actually forgot it was there. About 10:00 I went to take it out. And what did I find but the beginnings of a cystocele, filling the space that my cervix had been previously occupying. Today everything is back as before - my cervix is there, and no sign of a cystocele. Needless to say I am not wearing the sponge any more.

Hi dhammask Did you try a pessary? I am still holding back and I am working with the posture and exercises.

I don't think a pessary can hurt you at all, as long as it is fitted correctly and you are alert for signs of trouble. I don't believe it can weaken you further. Your uterus is supported by ligaments which become stretched in prolapse. Your vaginal wall tissue is weakened as your bladder and rectum bag through it, like tiny micro tears in fabric. As gravity exerts the downward force, countered by these damaged and weakened tissues holding it up, the tissues are under strain.

Put some tennis balls into a stocking with runs in it and you will see the weight pulling on the fabric, possibly extending the runs and further damaging it. Now put your hand under the tennis balls and support them with your hand. The force is no longer on the fabric of the stocking. Likewise, a pessary supports things, relieving the tissue of the strain of being pulled by the weight of the organs they support. So logic tells me, a pessary might possibly DELAY further weakening and damage.

Why are we advised not to strain against stool? This puts yet more downward force on the tissues attempting to hold stuff up, damaging them. That seems logical and correct. Therefore the reverse should be true; removing weight from the tissues should be good for it. This is not a case of muscles benefiting from more weight like building your biceps by working with heavier and heavier dumbbells. This is tissue that is already being stretched beyond safe limits, and already damaged. Anything that relieves the strain they are under seems like a good thing to me.

All that being said, pessaries have a big down side. They are in the way if you have an active sex life. They can make you incontinent while they are in, because they pull the bladder up and remove the kink that holds in your urine. They can stretch and pinch the introitus inserting and removing them, which I think might POSSIBLY further damage THE INTROITUS. But not the internal support structure... no, no way do I think that can be harmed from pessary use.

Pessaries can cause crush injuries if fitted wrong, and infections, and excessive discharge. So they are not without problems. But they are FAR, FAR preferable to surgery, and when successful can greatly improve your quality of life. If you always have a pessary to fall back on, you are far less likely to let yourself be talked into surgery. Pessaries really ought to become much more utilized by the gynecological profession.

No they are not for everyone. But before you reject them, make sure you have been to someone who is well experienced and qualified to fit them properly. There are many kinds and sizes; not all are right for every woman. I see nothing wrong with you waiting a while and trying the posture and so forth to see if that is all you need. Pessaries are a bother; just one more contraption to manage, so if you can become happy and functional with your prolapse without a pessary that is probably preferable. If they do prevent further damage, my feeling is, the help is minimal and you're probably not much worse off without it. But I really don't think they can hurt you. Again, can't say it often enough.... the greatest way they can help is by being used INSTEAD OF surgery!

oh forgot to add... the pessary should not be used to replace the healthy lifestyle changes Christine recommends. This is mainly because you may not wish to wear the pessary constantly, and many women can't, because of discharge issues, or other reasons. Even if you can now you may not be able to in the future. Following the Whole Woman program to maximize your comfort and happiness without the pessary is vital. But - for me - the pessary adds fantastic benefits as an occasional thing to have in my arsenal of weapons against this condition. :-))

It certainly is important that you be fitted properly. I had one inserted by my GYN and within a few weeks it caused me great pain. She had difficulty removing it which caused me to believe that it was too large. I was fitted with a 2nd one and within a few weeks, I woke up with great pain feeling it had moved. Her nurse attempted to remove it with great difficulty causing my tissues to bleed. From that day on, I have suffered (8 months) with constant unending rectal pressure and groin pain. The only thing than relieves it is predisone steroids. I have had MRI, CAT scan, bone scan....seen 5 doctors, acupuncture etc. with no relief. I am beginning to feel it is neuropathic pain caused by injury removing the pessary. It has totally impacted my life. Needless to say I do not wear one today, but wish that I could because of the prolapse. This, I am sure, is an isolated case and I would never advice a woman not to try it.

Was fitted for a pessary - she had an awful time trying to find one that fit, wasn't too large, etc - settled on a cube like device - first time fitted gave up after 4 days, cramping, odor, discharge - went back for check up and we're going to try it again (this time with some cream to help with the ordor and discharge - new problem is it stays in place for about 4 hours and then starts sliding out. . . any one have suggestions . . . and what is the sea sponge I'm hearing about. Do you have to be worried about toxic shock with the sea sponge?

Stevie,
I tried sea sponges several times and have had no luck. They are very irritating for me. Maybe I don't get it up high enough, but it seems to push right back out. Getting the sponge out is a challenge too. It feels like your own tissue so I end up pinching myself trying to find it. The info that came with the sponges said that they have a lower risk of TSS, but can still pose a threat. I have tried trimming them down, but they still feel awful. I am not giving up yet, I am giving it another shot this week, if I still can't figure out how to get one in and wear it without problems, they are going in the trash. The post partum gals are posting about the improvement they are seeing in their prolapses. Have you noticed things getting better too? I am sorry your pessary didn't work. Trying one was going to be my last choice, but I wonder now if I should even fool with it. With my hormones declining daily I don't hold out much hope that things will improve like the younger gals, but with the exercises and posture I hope to make my prolapse stable and even feel ok someday. Connie

Hi sea sponge triers

You could try attaching a tail of dental floss to the sea sponge so you can grab it while it is in your vagina.

Take a length of floss about 12 inches long and thread it onto a needle. Run a thread from one end of the sponge to the other in and out from one surface to the other, then turn around at the end and thread it in and out back to the other end. You can flatten the sponge or leave it plump as you go. The extra threads will reinforce the sponge so you can pull as hard as you like without pulling the tail off the sponge.

Not sure if it will be satisfactory, but it will give you the confidence to push the sponge in as far as you can and know that it can be retrieved easily. You could try inserting some water soluble lube, either with the sponge, or into your vagina before you remove the sponge, if you find that it is difficult to remove.

Good luck.

Louise

Louise's idea about sewing the floss works! I tried it a few months back. The sponge didn't work for me (irritating, bleeding) but I never "lost" it again after I sewed the floss onto it. The first time I used it, without the floss to grab and retrieve it, was a nightmare!

Good luck...lots of people swear by it. Wish it had worked for me!

~Mae

i firstly went to see my doctor as i was suffering from postmenopausel bleeding...he arranged an appointment at the gynea at the hospital and gave me some OVESTINE cream to use daily until my appointment came thru which was 4th march.....i was told by the consultant that i have a mass coming thru the vagina with the possibilty of a prolapse....i have vulva irritation but no discharge and a moderate cystocele...i have no incontinance but i do suffer with IBS so have problems with my bowels... i was fitted with a ring pessery i felt no major discomfort at that time...after 2weeks i was in so much pain and bleeding i called the emergency doctor who then told me to go to accident and emergency at the hospital...the ring had caused several ulcers thru rubbing and i had to have it removed..it was excrutiatingly painful and i have been suffering since with pain and bleeding the consultant told me only to use the OVESTIN once a week...( the bleeding actually stopped on 31st march)..i had a internal and abdominal scan nearly 2 weeks ago and am waiting for the results..the radiographer did say theres nothing to worry about...i have been doing pelvic excercises daily to strenghthen my muscles..i did find that by not using the OVESTIN frequently i was feeling very uncomfortable internally dry and very sore..so i am using it every other day until i go back to see the consultant..i was feeling quite positive last week but i did some lifting in the garden and now i feel the mass has dropped lower and its uncomfortable to sit down..i do not want an operation but really dont know what my other options are until i see the consultant again...i came across this site by accident and am i glad i did as its so informative...

Hi Dollie

Sorry to hear about your pessary experience. Sounds like your body really didn't like it. Some women find that a pessary is a useful part of their POP arsenal and find that there are minimal side effects.

Ovestin may be helping with the dryness, but it is supposed to only be used every few days, as it contains an oestrogen which releases slowly. By usng it more often you are taking more oestrogen into your vagina than the doctor prescribed. You might be better off to use something that does not contain oestrogen in between times, eg a personal lubricant or one of the vaginal *moisturisers* (not lubricants).

Re the lifting you did in the garden, I do quite heavy physical stuff in the garden myself and find that sometimes my POPs come down a bit for a few days if I do something really strenous where my posture suffers, for too long. But they do go up again once I ease off a bit. I have just done two days of heavy physical stuff, laying brick paths, digging, mending fences and laying out reticulation fittings. My POPs feelt a little low last night, but are fine today. I have been out in the garden for about six hours today as well.

I find that if I apply the Wholewoman posture principles to whatever I am doing I can pretty much do anything, whether it is sitting, standing, getting around, carrying and lifting things, dancing or whatever else I get up to. It really is the critical part of keeping prolapse symptoms at bay.

I am sure you will be laughing at thoughts of surgery after 12 months or so. Give it time, expect little setbacks and you will be fine. Clean up your diet, loosen your clothes around your belly and move mindfully. Best of luck.

Louise

hi louise
thankyou for your input...i was very confused as to the usage of ovestin as i have seen 3 different doctors and theyve all told me different..my doctor told me to use it every day..the second a gynea consultant told me 2 to 3 times a week and the last gynea doctor at A/E told me once a week..so it gets totally confusing...i have only just joined this site so am unsure what these Wholewoman posture principles are ... at the moment all im doing are pelvic excercises in the mornings and in the evenings..i am suffering a lot with vulva irritation at the moment... the doctor game me some morhulin cream which seems to help a bit...in the uk it seems that the doctors try to get you to have an operation to deal with this problem and this is something i do not want to go thru as i have read up on all the pros and cons...and found that invariably the prolapse could happen again in 3/4 years time after the first operation and then you will need another operation.. i to hope i will be laughing in 12 months time at the thoughts of surgery..as you say it is acceptance of the condition that will mark the way forward..

Hi Dollie

The Morhulin cream may be quite useful for your vulva, but a moisturiser or lubricant may be more useful for your vagina.

Re the Ovestin, I would be reading the info sheet in the packet if you have received conflicting information on dosage. If you don't get anything definitive from that I would suggest asking a pharmacist. They are trained in pharmaceutical drug use. They know far more about drugs and pharmaceuticals than doctors, or they can put their hand on information about them for you. Another source of info would be a menopause clinic or support group.

Cheers

Louise

after nearly 3 weeks of having the ring pessery removed i am feeling a bit more comfortable...i am not so sore and the pain is slight...i have been doing my pelvic excercises regularly and have noticed an improvement...yesterday i did a bit of light gardening and i can now feel my prolapse..it isnt painful just a bit achy..it hasnt dropped completely out of the vagina but i can feel it just sitting there...i have just recieved a phone call from my gynea doctor saying he wants to see me tomorrow for my scan results ..i am really fretting about this as i do NOT want surgery...i am glad ive read up on prolapses as it does give me some guidence when discussing it tomorrow..im just concerened i will be pressured into have an operation when i dont have to... :(

That is some great great advice that I got here recently!
Just know that you know your body better than anyone else does, and that you don't need to rush into anything, surgery or otherwise.
It's okay to say 'I need to think about that' no matter what you're being told.
Sometimes knowing that I don't have to make a decision on the spot allows me to take in information without the pressure of needing to take action.
Wishing you well- keep us posted.

Hi Dollie

Crazylady is absolutely right. When you go to a gyno they have several products to sell to you. The first is their knowledge of anatomy, the second is a diagnosis, the third is medical and surgical solutions for that diagnosis.

Just like you go to a fruit and veg shop you can buy what you want and leave the rest. You can also buy nothing at all, purchase at the supermarket instead, or go home and grow your own.

Gynos are not the only pathway to fixing your body. All they are is a person who has studied at medical school and learned some stuff about the human body, particularly fertility, looking after pregnant women's health and the medical side of getting babies out of Mummies' Tummies. They also learn about the nuts and bolts of the female reproductive tract and all the things that can go wrong with it in their medical model, and things the medical model has invented to do to women to make these things disappear. They are only interested in negative outcomes of their treatment if it is in the first five years after treatment. No research is done post 5 years out, so nobody knows how many women's bodies go awry after that. There is *zero* data.

Your gyno is one member of the team you put together to help you to manage your health. Some are more interested in ensuring that you don't get sick. Some are more interested in fixing you up when you do get sick. Others seem to be more interested in doing things to you that research shows will ultimately fail and have you back in the waiting room with a similar or different problem. And some are no help at all, except in emptying your wallet. That's life. Car mechanics and hairdressers show the same characteristics. Choose carefully, take lots of specific questions, some critical analysis of their advice and decide from there in the light of advice you receive and information you find out from other health professionals and personal resources.

Nobody can make you have surgery. Nobody can stop you having surgery. The decision is yours. If you are not ready to make that decision, then don't make a decision. Just wait until you have decided what is the best path. Wait years if necessary. Once surgically altered you cannot wind back the clock to your previous body state, and further surgery is likely to be less successful than the first (on that subject there is research evidence to show it).

And if you are being pressured, just flee! Anything under pressure will explode in your face eventually. He probably just wants to tell you what the scan has shown, and what he would potentially do about it. You need that info, having come thus far.

thankyou crazy lady and louise ..its great to get some moral support and talk to women that are in a very similar situation...also its good to have feed back and understand whats going on before the consultation with consultant...as i do feel sometimes the doctors talk down to you and can be very patronising...will pop back later to let you know how i got on...

am back from the hospital...my prolapse is very slight so the pelvic excercises have helped so will keep those up on a regular basis..so thats one worry out the way...i will just have to be careful and not do any heavy lifting...the scan showed thickening of the lining of my womb so they took a sample of my womb lining to see if anything shows up..(i have to wait 2-3 weeks for the results)it was very uncomfortable just like a bad period pain...the consultant told me to STOP using the OVESTIN cream as it is confusing my body as i am putting hormones in it that shouldnt be there..(now thats 4 different doctors telling me all different)so am stopping the once a week routine right away..its seems that one problem is leading into other problems...oh the joys of women hood...

Hi Dollie,

4 different doctors giving you four different opinions! I can see why they call it practicing medicine! Amazing. I will never crease to be amazed at how little the medical profession knows about so many things. That is why it is so important to know your own body and as much as you can about what's going on with it. Then you can feel good about making the decision about what you think is right for you.

Good news about only having a slight prolapse! Take good care of yourself and you'll probably be able to keep it that way, or perhaps make it better!

Regards,
~Mae

Well, that's another appointment out of the way. Sorry to hear that you have this other uterus lining thing to worry about now. Hey, isn't that what happens when your body is getting ready to ovulate? It is 2 weeks since your bleeding stopped, isn't it? Could it just be normal cycling that hasn't quite given up completely?

They really have put you through the mill with all these different diagnoses, prescriptions and tests. I am not surprised if your body is doing crazy things after all that prodding and poking.

This last advice, to stop the Ovestin, might be right. I think I would be wanting to just give my body a rest for a while, before putting it through any more. Doctors will always find something abnormal, and dress it up with a fancy name. The question is whether or not their discovery has the potential to kill you sooner rather than later. In my ignorance I suspect not. They are more likely interpreting your frequent doctor visits to wanting to be fixed up, rather than wanting to know what is going on. There is a world of difference.

Deal with the biopsy result in a couple of weeks. Try not to think about it now. The worry won't do you any good at all. Just give it all a break and let your body settle down.

If vaginal dryness is still bothering you I would suggest Wholewoman balms I find they are really great as lubricant and general salves. The vulva balm has really healed up my sore, cracked hands too, after all the garden work I have been doing and the Bliss Balm is just lovely when I am feeling dry. You probably don't need anything else. Many women find that a bit of simple lubrication will also help your organs to move back to where they belong, without being kept down by vaginal dryness and stickiness. Wholewoman balms seemed quite expensive when I first investigated them, but you use so little each time, and there is very little waste, cos there is no spillage.

Cheers

Louise

oh mae i did laugh when i read your comment re; doctors practising medicine...we as women are certainly guinea pigs when it comes to doctors solving our gynea problems...

yes louise i agree my body is in a bit of turmoil not knowing what to do next...my head is following that way to lol...i do agree with what you are saying theres no point in worrying as it isnt going to get me any where it will only stress me out more...funny really we have kids and when going thru the menopause we think right thats it all done and dusted and there you are ending up on a doctors couch with legs up in the air....i have an appointment with my own surgery this morning with another problem..(severe rash under breasts ) that wont clear up even after prescribed medication so will call in at the pharmacy re; the moisturisers...it is annoying as i am in the uk and theres no outlet for the Wholewomen products...perhaps that would be something that christine would consider in the near future..i am feeling really sore this morning ( am having to wear a pad) after a restless night and have had a lot of bleeding which i was warned about and may last a few days...oh isnt it fun being a woman!!!!! NOT!....