Pessary trial

Body: 

Pessary trial #1: The first day has revealed that the knob on my ring-with-support pessary gives a little too much "extra support" to the urethra, making urination more difficult and prolonged. Fail.

Next step: Return to the practitioner's office and try pessary #2, same size but without the knob. I'm hoping for greater comfort.

I'd like to mechanically stabilize the cystocele and fight off gravity for a while by wearing a pessary. Tampons are okay, but they tend to absorb too much moisture sometimes and aren't really the right shape. They do help, though, and if I really can't adjust to a pessary I'll invest in some more sport tampons.

One day at a time, right, ladies?

Saddleup

Yep, one day at a time, and one step at a time. So glad you are doing this pessary thing so thoroughly, and that you have found a practitioner who can provide you with these different options.

L

Hi! Where do you get the sports tampons? I think I'll try it when needed for my cystocle. For now everything is doing good with my posture. I was thinking of wetting the tampon some with sterile water so it doesn't cause a dryness and make it hard to remove.
Any suggestions of how other women use them?

Heading to work have a great day,
Sarah

Hi, Sarah:

As you might find elsewhere in these posts, many of us have found Playtex Sport Tampons to be useful in giving our bladders some support. Sometimes I've used the regular size and sometimes I've used the supers. I think their main virtue is that they are shorter in length and therefore easier to keep in than many tampons. They are also quite easy to insert, with a plastic applicator.

I've never tried water on them. I do, however, smear lots of Bliss Balm on the plastic applicator tip, figuring that much of it will end up inside. One time I left one in for several hours and did feel like like the membranes were a bit on the dry side when I removed it. We learn to do things that work. I hope this helps.

Saddleup

Please consider the composition of the tampons that you are using, for your own health and the environment.

Dioxins are a nasty, and so are plastics.

Here is a site that I found, where you have a good choice:

http://www.natracare.com/products/feminine_products.htm

Thank you,

Hugs, Oceanblue

Dear Oceanblue:

Well, I sorta wish I didn't know that, but it is better to be informed than to cause more damage out of ignorance. I'll try to find them at a local health food store and see how they work out for me. Thanks.

The thing is that when you are dealing with something as serious as POP and you find something that works to mechanically support the tissues and make you feel normal, you don't always care what else is going on. It's just such a relief to find a low-tech solution.

Rayon and cotton are both natural materials--rayon comes from wood fiber, I think. Apparently, how it's processed is what makes a difference.

Saddleup

I am really pro-pessary, and recent events have confirmed that. I just wish I could be free to explore the range of pessaries made, as I suspect another type would suit me even better. As I am over 60 and British, the NHS hospital kindly supplies and fits me with doughnut pessaries free (no choice), and unlike in the US they are supposed to stay in for months until a doctor changes them during a checkup. I began with a ring pessary fitted by my GP, then the hospital gave me a doughnut and months later a bigger doughnut. Each has been an improvement on the one before.

The other day things were feeling bulgy, perhaps because I had been pushing things by skipping (jumping rope), so I decided to have another go at inserting a sponge ON TOP OF my doughnut. I never could get the sponge in before, but this time I cut it in half and inserted the 2 (moistened)halves one after the other. THIS FELT REALLY GOOD. However, come bedtime I realised that, unlike the hard plastic doughnut, sponges really could not be left in indefinitely without washing. But when I tried to fish them out, I discovered that they had migrated into the hole in the doughnut and were impossible to grasp, what with bulges and pessary and all. I even tried tweezers, but was really scared of damaging my insides. Panic! Would I have to ring up my GP next day and beg someone to remove my pessary so the sponges could be extracted? Would anyone there have the necessary skills? A & E? (Emergency Room?)

Well, in the end I pulled the pessary out myself. I don't know what the US pessaries can be like, that you can take them in and out all the time. This one seemed designed to stay in for life. It was scary and very uncomfortable, but in the end I did it. I hadn't seen it before, and IT IS BIG! Amazing that I feel nothing when it's inside. And the re-assuring thing was that it was perfectly clean - all those secretions that end up in my knickers had clearly rushed past it and left it pristine. So I don't worry now about leaving it in for months.

In order to get something from all this hassle, I decided to experiment with life without pessary - the first time since last February. But I quickly found that fast walking led to dampness and a much more frequent need to urinate. And everything down there felt so soft and formless - I missed that firm handle with which to push my bulges up inside. 24 hours later I put my pessary into a mug, poured on near boiling water and inserted the nicely softened doughnut without discomfort or problem. Since then, I have run round the park through the snow for 48 minutes without the least dampness (except to my feet, of course!)

My experiences lead me to think that pessaries can be really helpful, but finding the right shape and size is very hit and miss. I shall keep on trying to find the perfect pessary, while appreciating how much the one I have is doing for me. Good luck to anyone who is on this path.

Wow, that's good, Alix! Pessaries often seem to be a bit hit and miss. You have really pushed the envelope with your whopper! It is great to hear one wholly positive story. Interesting that your doctor said to come back for a 'clean and refit' every few months, when it was possible for you to do it yourself, as have so many women. I wonder exactly what they do when they clean and refit, ie do they examine the vaginal walls for damage, or whatever else? Or do they just *assume* that women will not want to check the pessary themselves, or would be unable to? Or is it (where there is no NHS) just fishing for repeat visits?

L

Thanks Louise. The system here in the UK is that every few months (theoretically about 4 but actually more like 6) a nurse or doctor takes out the pessary and fits a brand new one, having first checked for any damage in the vagina, in the case of which they prescribe topical oestrogen and don't refit til the damage has healed. The young, inexperienced hospital doctors I have met were very shocked at the idea I might manoeuvre my pessary in and out myself. It seemed a totally novel thought to them. It is very odd that though this is their specialism, they seem never to have explored the topic on the web, discovered this site, or learned that in the US things are done differently. With the first, especially, I had the impression that she had had very little training and was dealing with her consequent lack of confidence by being authoritarian.

However, the pessary I now have is such a tight fit, I really wouldn't want to have to yank it out often - I don't think it would do my insides any good at all. Also, for someone like me who has no wish to be sexually active, a pessary that stays in for months without attention is great - it enables me to feel and act almost normal! But for all that, I am not forgetting to try to do all I can for myself in every other way. I am planning to have a go at Nauli soon - when I have got more urgent things like my income tax return (due 31st Jan.) out of the way.

Our NHS system has its pluses and minuses. It's great not to have to suspect my doctors of trying to sell me things or talk me into more visits than I need. On the other hand I can't storm out and take my business elsewhere if I don't like what my doctor is saying. And treatments may be offered or denied not because of my needs but to fit in with hospital budgets. A physio recently revealed to me that the poor choice of pessaries available is quite deliberate - these ones are very cheap (c.£2 per pessary)! As my anti-surgery choice saves the NHS untold money, I think they should lavish luxury pessaries on me!

hi there, just reading some of your comments below i have been offered a pessary and often wonder about how i would get on with one and was reading about the tampons helping with mechanically stabilizing the prolapses and it just came to mind that someone suggested to me last week about a new product similar to a tampon called a femme cup just for menstrual purposes, i had never heard of such a thing before but just looked it up and seems quite a good product. Am wondering wether this product may also infact help people like ourselves.

Just wondered has anyone tried this product and if so did they find it comfortable. I have a moderate cystocele and am thinking of purchasing as it seems very enviromentaly friendly and think it might also bring me some comfort. Did a search for posts on here about it but found nothing.

young1 x

Hi Young1

Not sure about this one, but it sounds like the Instead Cup, which we have discussed. Put "instead cup" into the search box to find posts mentioning it, then click on each topic and use your browser's Find function to scan each topic for highlighted text, as some of the topic strings are quite long!. Good luck.

L

Hello,

I'm still waiting for the next pessary. I tried a "tester" model in the Dr.'s office and it seemed fine. It's been ordered and should be available for me next week.

Meanwhile, I had a complete physical with pap smear today, and my primary care physician noted that my cervix was quite low. She had to push it back, actually. My own observations tell me that the cervix is lower than it once was. But the urogynecologist keeps telling me my uterus is still well-supported. The nurse practitioner fitting me with pessaries thought it was great that we "only" needed to support my bladder. So I'm a little confused.

Could the cervix be higher or lower at different times of day, or with different activity? Are health care practitioners sometimes really unobservant? I thought I "just" had a cystocele. Lately it's even been feeling a little better. I really don't want my uterus to fall down too! I've been doing the DVD workout and firebreathing.

Dear body: will everything kindly stop falling so that I don't keep worrying about how much worse this will get? Thanks.

Saddleup

Sure can, Saddleup. My cervix is pretty much up and out of the way these days, but my cystocele sometimes causes a bit of vulval pressure, as does my rarely-present rectocele. They used to move around a lot more and swap places. I don't care which one is lowest, as long as they don't cause unpleasanat sensations. They are all, in Christine's words, like big bags of jello, and they make their own arrangements in response to the way we use our bodies.

I don't know about health care practitioners. They get to examine us maybe once a year. We live in our bodies all the time. I think they are not so much unobservant, but narrow in focus, and usually examining us lying down, in a posture that will give them a very poor picture of what is really happening when symptoms bother us, while standing up. Just have a feel in there for yourself in different positions and at different times of the day, before and after different types of exercise and activity. Feel from the front, but also from the back, both in WW posture and slouched over.

L

Hi, Louise:

I think maybe the family practice doc sees a certain range of anatomical variation in the pelvic area. She probably sees a lot more "normal" pelvic organ placement and not too many prolapses. The uro-gyn and the nurse practitioners who work with him see prolapses every day. So maybe their definition of "well-supported" is different from the other doctor's.

At any rate, I now have the new pessary installed. So far, it seems to be working. It is very small and stays in place nicely, a silicone ring with support. It is so small, though, that it's difficult to bend it in half for insertion or removal--kind of stiff and springy. But I'm getting used to it.

I figure that if wearing a pessary makes me feel normal, then I won't be stressing so badly about the prolapse. It's hard to get something off your mind if you constantly feel a physical sensation to remind you of it. And maybe, just maybe, it will support my pelvic organs and give the fascial tissue a rest while I work on posture and diet and exercise.

Saddleup

Saddleup, I am really pleased you have finally got a pessary that promises to work better for you. If it doesn't do what you want, don't despair but try another type. A year into all this, and at the 3rd attempt I have finally got a pessary that makes a very appreciable difference. I can run round the park for 48 minutes without diving into the public loo, arriving home with dry knickers. I have been monitoring my bladder capacity, and though it seems to vary according to what else is going on with my POPs, I can often hold as much as 650 mls and one morning it was 800! which is way over the "normal" 400-600.

If I can maintain results like this, I really don't mind keeping a plastic ring inside me for the rest of my life.

I do hope life will start to feel more normal for you now.