Pessary...My new best friend!!

I wanted to respond last time you wrote about your pessary success story and your post slipped by me. Tonight I'm bleary-eyed after a very long day of work and then playing with my dear gd for hours this evening and then stuffing us with pancakes at 9:00 at night! Thanks for posting again and tomorrow I will read your story more closely. I just think it's wonderful that some women can wear them so successfully and I hope that will be the case for you for many long years to come. Christine

Thanks again for checking in with us, Mae, and posting this great story. I’ve always said it is women with primary cystocele who have the greatest success with the pessary. A true, primary uterine prolapse falls back to fill the “cul-de-sac” area at the top of the back vaginal wall. This condition or a significant rectocele will often push a pessary right out - no matter what.

It will be interesting to hear how you fair through the years. Our dear Flora (where is she?!) has worn a ring-with-support for decades. We have also had post-hysterectomy women using them successfully for the long term. This is why all women should know about pessaries and go through several fittings to determine if they can wear one comfortably. The issue is not cut-and-dried, which is why so many providers don’t bother with them. I find it amazing that pessary designs haven’t changed or expanded in how long - at least thirty or forty years. But really, is there any silicone pessary other than the thin disc that large numbers of women can wear over time? Seems not, and some of those designs are murderous! Only a man would fit a cube, donut, or maxi-plug into the flattened vaginal space - lol.

:) Christine

Thanks, Mae, for posting your success story about your pessary!

Here is my question for Christine and anyone else who has knowledge. How do I know if a pessary would be a good thing to try? Also, didn't STWW say that over the long term, the pressure from the pessary could further weaken and stretch some of the pelvic support system to the point that a pessary may not work any more?

I received the WW bundle about two weeks ago and have been trying to incorporate the posture and beginning exercises into my routine. I've also tried the firebreathing.

I am concerned that I may not be doing something right. Yesterday and today, my prolapse was out farther than it has ever been. I have been diagnosed with a cyctocele. It is at the opening of my vagina and sometimes protrudes beyond the opening (as it has for the last 2 days). I still have all of my pelvic organs. Will the posture and exercises really help a lot in a prolapse as advanced as mine or should I be considering a pessary?

Also, one of my greatest joys is teaching Israeli folk dancing. How do I continue doing that and manage my prolapse? Would a pessary help? I'm only 52 years old and am in very good health otherwise.

I really appreciate the help I've gotten from STWW and this website.

Thank you!
love2dance

hi love2dance
I havent tried a pessary, but I think the only way to really know if it would be a good thing would be to try it. I would insist on learning how to remove it myself, and if you dont like it, you don't have to use it.
also, I think the WW posture and exercises can absolutely be helpful for an advanced prolapse. obviously there is no way to tell how much change you can expect, but so many of us have experienced change in the size/position of the bulge as well as reduction of symptoms, so its definitely worth a shot.
and I dont' see why you cant continue to teach israeli folk dance, so long as you maintain WW posture. which I believe you can easily do with that form of dance.

Eeee! Mae! Lovely to hear from you, and to read how well you are doing. Your story is a true affirmation for perservering with all sorts of possibilities, even if they don't sound promising. This is the way of being in charge of your own wellbeing.

Thanks for posting this very positive story. I figured you would be going OK. Silence is usually a good sign.

Pop back again later and give us an update. I do so hope you will continue to do well.

Louise

Dear Mae, love2dance, and all:

I am happy to hear of your success, Mae, and your newfound ability to play with the grandbaby! I would like to share my recent experiences.

My ring-with-support style of pessary helped me a lot for several months. Then, I started to experience random bouts of urinary incontinence while the pessary was in place. This was not what I had in mind, as you may imagine.

I spoke with the nurse practitioner who had fitted me for the pessary. She said that it can eliminate the "kink" in the urethra that a cystocele produces. So the urethra is straightened out, I guess, and there's not much to prevent the urine from leaking out at times. She suggested I restart the PT exercises I learned last fall (Kegels and other related exercises) and keep them up indefinitely. I do the Kegels in approved Whole Woman style, per one of Christine's posts. I do think they help, and one reason is that the "quick flick" contractions help the muscle surrounding the bladder to retain its tone. My PT told me that as we age, our fast-twitch muscle fibers get really lazy and they need some stimulation. So I'm starting those again.

Here's another thing: I tried using a tampon, Play Tex Sport Super, instead of the pessary, and it worked great. No leaks, no feeling of sagging out. Yes, I have to change it maybe once during the day. I used Bliss Balm as a lubricant. There is very little risk of Toxic Shock Syndrome because there is no blood. The nurse told me there is a style of pessary similar in shape to a tampon but it is much more difficult to insert and remove. I'm not interested in using one I can't control.

When I first tried a pessary, it was a ring with support plus a little knob to put pressure on the urethra. Nice idea, but I could hardly pass urine with it in place. I don't know--maybe I'll try one again. There is a lot of trial and error in this whole endeavor of dealing with POPs. We have to get creative.

With the pessary, I was told to purchase Tri Mo San gel, which acidifies the vagina and prevents infections which may occur when a foreign body is in place for a long time. I use a little of that as a lubricant for the pessary, in addition to inserting the stuff once a week.

I agree that pessaries should be promoted more by physicians. They are a reasonable alternative for a lot of women which can allow us to do the things we love to do. For some women, tampons or sea sponges do the same thing. The nurse told me a lot of her patients use tampons for support when they do things like playing tennis! Perhaps the motto here ought to be "whatever works!"

Best wishes,
Saddleup

Mae do you think it would help if you have a rectocele. This comment is for anyone, really need help. Would a pessary help a good sized rectocele?If i have one, 2 doctors disagree! Like I should be surprised!
Anxious for reply
Struggling today

Trying to get into the excercises but still confused about the Nauli?
No one answered my question yet. Do you think it would be ok to do beginner excercises if you feel the pop and rec. Nothing major but isn't that the only way to strengthen the tissue? Just gotta get to NM for fine tuning. LOL Really!!!

Thanks

You should exercise whether you feel any bulges or not. The strengthening of muscles will be ongoing. Just don't overdo it on bad days and stay in posture, always.
Melly

Where do I find out about the above mentioned "Kegels in approved Whole Woman style, per one of Christine's posts". . . .?

Here is a link to the blog on WW kegels in the WW post:
http://wholewoman.com/blog/?p=105

Hi Heavenly,

Yes, I can see that you need more explanation. The problem is, I can't explain firebreathing and nauli in words any better than I demonstrated them both on the dvd and in the virtual WWCenter.

I hear your concern about exercise, but all we are doing with these movements is moving the organs toward the front of the body and away from the pelvic outlet at the back of the body. If you sense something is making your prolapse worse, please stop immediately.

Does anyone have any feedback on the new little workout in the village WWCenter? If one is able - and I know many of us here have physical limitations - I think that program would lift a rectocele and help close the rectovaginal fascia in pretty short order. If the intensity or speed of the exercises is too high, modulate to your own ability.

There is an old saying, "A (wo)man cannot serve two masters." This is so true of prolapse. We either do the work full on - diet, posture, exercise, the whole nine yards - or we just go get it "fixed". There really isn't a lot in between.

Wishing you well,

Christine

sorry Christine, I can't look at videos at the moment. sick computer. I can't even open my email program. I can still use the Forums. Computer off to hozzie this afternoon for major surgery. Organ replacement, not repair.

L :-(

Hi Christine,

Just wanted to let you know I think the exercises in that video are a total blessing! Especially for someone like me who has had other physical limitations preventing me from doing all the other exercises in their fullness, these are absolutely on target for my working towards a stronger body.

However, when I try to do the firebreathing on all fours, it seems to push the bladder out just a little. I have watched it three times and tried to listen closely to make sure I'm doing it right. It seems that I am but also seems like the pushing out isn't quite right, although I am not deliberately trying to push it out. When you exhale and pull up, are you suppose to start the "pull" with flexing the sphincter and pulling up from there? I haven't done that, just pulled up with the belly.

At any rate, the floor exercises on the belly are exactly what I was looking for to help strengthen the glutes and all those other muscles whose name I cannot remember.

Love and blessings,
Grandma Joy

Hi Grandma Joy!

I am so glad! I was hoping you especially would enjoy moving energy up and down your spine.

This week I have a lovely elder woman visiting from Denver and we have both agreed that we like firebreathing and nauli standing better than on all fours. I just pull in my belly, but there doesn’t seem to be quite the leverage as when standing. Just skip those if they don’t feel right.

Also thought of you when I included Rock the Baby. It’s kind of Tai Chi-like and gently works the chest and upper back.

Like I said in the video, exercise should feel good. So many of those done on the back just feel strenuous.

Love and hugs,

Christine

Hi Mae,

I have accidentally left a ring-with-support pessary in during sex. It wasn't a problem as I recall, but probably not comfortable enough to purposefully repeat the experience.

I believe all women should go through the pessary drill to see if it can work for them. But if the pessary refuses to stay put after several attempts, she may not be one of the lucky ones. In general, prolapse coming from the back is a particularly strong force in a direction that spits pessaries, sponges and tampons right out.

~Christine

Christine,

I'm currently having my first menstrual period with POP. I've discovered that tampons are no longer going to work for me (BOO HOO!). It feels like it's going to fall out any minute and also feels sort of raw and chafing. Do you think this means I'm likely to have similar feelings with sponges and pessaries, too? I am getting fitted for a pessary tomorrow but hate to waste money on it if my body is just going to reject the thing. I have uterine prolapse, cystocele, and rectocele.

Thanks for your input!
Carrie

hi carrie
what type of tampons are you using? I find that the short ones (I like o.b.) are easier to position well and do not get pushed out

hi heavenly
the exercises I find most helpful are nauli, firebreathing, the plies from the workout in the book (in that order) and those are really the only ones I get around to doing.
mostly, for me, its posture, posture, posture and some deep breathing/arm flapping/walking now and then.
you can do the exercises even if you feel the POP but like christine said, if its making things worse, stop/modify
and just to clarify...when we talk about strengthening tissue we're not so much concerned with strengthening the pelvic floor per se, but the whole pelvic girdle (hips, thighs, back, low abdomen) and really the whole spinal support system. WW isn't so much about holding the pelvic organs in with strong pelvic floor muscles, but about holding the pelvic organs in place with the position of your spine and power of your breathing.
strong pelvic 'floor' muscles are good to have, but are (imo) a tad overrated when it comes to prolapse.

oh, and just to add...took me a loooooooong time to figure out how to nauli. I gave up a bunch of times and finally just kept trying till it clicked. definitely worth the effort though. keep at it!

hi mae
how is your little grandbaby? ready for a sibling I think.......

sometimes I am loath to try what is in my mind a 'last resort' because what if it doesnt work? then what?? but I'm glad you finally pulled that pessary out of the drawer and that its working for you

I sort of felt like those were aimed at me and it feels good doing them. Thank you so much for those particular exercises. I had been trying to figure a way to do something that wouldn't be the wrong thing to do.
I didn't get to get into the Tai-Chi very much because of a sinus infection, inner ear infection and the vertigo, but I did notice when standing with feet apart, the prolapse seems to hang down more.
I'm just glad I can get into the exercises more now albeit very slowly.

You have no idea how good it feels to be able to do an exercise without something else happening and becoming so frustrated!

Love and hugs back,
Grandma Joy

I was fitted for a pessary a little over a month ago and I can't believe the difference it makes. My gyno seemed to know exactly what size and kind. I told him I wanted one I could remove and clean myself. It took me several trys, but I finally was able to remove it on my own. I don't even know it is there and and forget about it. I too had tried the sponges (they shot right out of there!) and the tampons would get damp and they too would migrate their way out of me.
I was scheduled for surgery a year ago and cancelled it after reading Christine's book. After getting used to the idea of a pessary, I am so glad I gave it a try. I absolutely don't feel a thing and forget about the prolapse.
Another plus: I notice when I have the pessary in place, I no longer have the urge to urinate. My doctor told me that since it was holding my bladder in place, the uretha was no longer bent which gave me the constant sense of needing to urinate all the time. He also told me I could leave it in for sex.

Wonderful, wonderful, Mae. Are you going to try and find a crash helmet for DH the first time, just in case?

I have not been on the forum in quite a while, but the last few weeks, my uterine and bladder prolapses have noticeably worsened. I have to push them up several times a day- every time I use the bathroom, actually. I never have relief except when I am horizontal, which for me is about 6 hrs at night. I found some other websites and read a lot of comments from women who have pessaries and I am thinking that I will make an appt with my gyn and get fitted. I am so tired of having my parts falling out. I do not wish to have surgery as I know most of you feel the same. I also dont want to continue pushing my parts up several times a day. My gyn has been supportive of my decision to not have surgery and she suggested a pessary when I was in a few months ago. I didnt get fit then, but I think I am ready to try now. I am 51 and in excellent health, I swim 4 miles per week and am a good weight and strong. I would want to remove the pessary on my own, as I dont want to need to see a dr for that. I saw some with a little silicone string that hangs down, and thought that might not be so comfortable. What do those of you with pessaries recommend as a good one to try? Do different pessaries respond/ work better with some prolapses rather than others? My cervix is right at the opening to my vagina, nearly always- it doesnt stay up when I push it up, just falls back down. I also have a bladder prolapse. Other than annoyance I have no other symptoms (well I do have to pee all the time) - fine with sex, no pain with swimming or walking, and I do all kinds of things sportswise. LEt me know your experiences with the pessary types and recommend away. I look forward to hearing from you.
Trish

Let me start by saying I have bladder prolapse and rectocele and I went for my first pessary fitting last week. It was a ring with support and tried two different sizes but neither were successful. Reason was, both put tremendous pressure on my rectum/anus and both also made me feel like I had to urinate constantly. So this week the GYN tried an incontinence ring with support and although this one puts less pressure on my rectum, I can still feel the pressure which is very uncomfortable.

I'm wondering if anyone has had rectum discomfort while using using a pessary. My doctor was not specific about it or why it is happening and any info would be appreciated. Also if you have experienced rectum/anus pressure with a pessary, I'd love to know what type of pessary works for you. I am afraid no pessary will be comfortable and I will be at a loss. I do not want another surgery. I already had a flap made inside to hold up the bladder but it failed. Sorry I don't remember the name of the procedure.

Please help with info if you can.

SaraLee

Hi SaraLee,

Although statistics vary, it seems somewhat less than half of women can wear a pessary successfully. Prior surgery decreases the ability to wear one by a fairly wide margin. If I manage to get the pessary to hold my uterus forward for a while, it does press on my bowels, which is very uncomfortable.

There is some percentage of women who do beautifully for decades on end with a ring pessary, but these seem to be women with primary cystocele. Your surgery most likely reduced the natural cushion of your front wall, allowing a more severe prolapsing of the back wall.

It is so much better to be free of it and instead work with my musculoskeletal structure to pull the internal organs forward. For me (I have a surgically induced prolapse), my symptoms are a constant signal to pull up into the posture.

We are all working with this day by day, year by year. I am breaking the bad habit of typing on my laptop in bed, which is not only heck on my prolapse, but has given my a case of carpal tunnel in my right hand. Nobody is perfect! :)

Christine

2 comments:
I read on a website- women who leave pessaries in are more apt to have long term success-
My surgeon who has dealt for years with prolapse gave me a donut - saying the larger surface area it touches is more likely to succeed for me and he also said I would not hurt myself by putting in and out and that it is in rite if it stays in. My husband is capable of doing this difficult chore.

Also the sex is of course an issue but we modify our lives as we choose sometimes....
The weight of my bladder without the pessary is too much...Contents of my rectum is important- I try to keep soft and empty...

Thank you Christine. Knowing I am not a freak and not alone has eased my concern. I wondered if the previous surgery had something to do with the pressure I'm feeling near my rectum and your explanation helped me better understand . Now I need to concentrate more on posture and learning new ways to heal myself. I feel so much better knowing there is hope.

SaraLee

Wow!! That's great. Are you still having success with the pessary??

Hi everyone! I'm surprised you're not mentioning other pessaries that might help, not just ring. UK NHS only offers ring, and I could not tolerate it either, cdnt pooh etc, way too intrusive. There are others that look interesting, eg gellhorn, cube, inflatable donut and more. I would like to use one that I can take out at night, ring was too painful to do that, too rigid. Sponge (from moon times) were really comfy and worked but started to bleed, so tampon worrying to me. May send off for gellhorn or cube. Why isn't there more help with this? Best wishes, ideas welcome!

Hi spongebob - did you happen to read my and Christine's responses to your other post?
https://wholewoman.com/forum/comment/54742#comment-54742

All pessaries have some potential to worsen prolapse. This is not what the Whole Woman work is about (and this is after all, the WW forum, dedicated to the WW work). That being said, you can certainly comment and ask questions about pessaries, and read up on other threads using the search box up above and to the left on this screen. Others who use pessaries may respond. - Surviving

Hi Everyone!

In this forum string, Christine mentions a series of exercises she thinks are good for rectocele help. Where might I find those now? That was several years ago, it looks like.

Hi violin1 and welcome,
There are not specific exercises for rectocele, because everything we do with the whole woman work is meant to pull our pelvic organs into the lower belly and away from our vaginas. Most importantly that is learning and maintaining the whole woman posture, because while in posture, we are breathing into the belly and pinning those organs there with intraabdominal pressure.
Do some serious reading on this site to familiarize yourself with Christine's work, and then head over to the store and look over the many great products there to help on on your way with whole woman.

Thanks so much! I have her book and have been reading up. I just wondered what she was referring to up in this thread, because I wanted to start with that! It sounded good! :-) I sent her an email asking her which product to start with, so hopefully I'll know where to begin. I've been working with the posture!

Hi violin1,
The First Aid for Prolapse is actually a great way to start. It is the beginning of this work with practical everyday recommendations and awesome exercise to build on posture.

I absolutely am grateful for my pessary. It is an Eva ring with support and it has made me mobile, again. I can bounce without wanting to throw up. Has anyone here gone on to have laparoscopic. surgery?

Hi Angels - since you are post-hyst, and you are doing fine with the pessary, I suggest you leave well enough alone. All "repair" surgeries have extremely high failure rates, and who knows where you will end up. Whole Woman is dedicated to keeping women off the operating table, so this forum may not be the best place to get the kind of help and advice you seek, if you have already chosen a surgical path.

The pessary may eventually further aggravate the rectocele, and if you find it not so comfortable after awhile, this may be the reason. Just something to bear in mind.

Thanks for posting - Surviving

Does anyone else notice that their pessary seems to be very low in vagina but holds POP (bladder) in place?

I had a pessary fitted in 2015 and it was replaced by the Dr every 6 months. Made by Smith's Medical in the UK. I was never shown how to remove it myself- this was done by my Doctor. I understand there are so many women with prolapse and yet to find a support group in NZ has proved unsuccessful. I have had problems with it rubbing and so it has been removed - now I am left with everything hanging out while I am given an appointment to be seen by a specialist. 4 months wait. Imagine it - after being supported for 3 years now to be left with none. I am reverting to homeopathic remedies in the hope I can manage it myself. I now have bladder and uterus protruding like a tennis ball... Using Coconut oil to lubricate it helps a lot.

Since you are done with the pessary, it would be a great time to really delve into the Whole Woman postural work. You've been here on the forum for years though I haven't reviewed any of your past postings. This is how we manage prolapse naturally and it is the reason this forum and the entire website exist. Have you tried it? - Surviving

This has been an on going problem for me - I have tried and tried to find this magical posture but it just doesn't happen. when I first joined the group I had wonderful thoughts of being able to manage my prolapse myself but it just didn't happen. I have tried and read the book and watched the DVD - nothing. I was walking around my family told me like a pregnant duck??? tummy stuck out and bum poked out.... I had the curve in my spine but that was it... I don't know how else I can find the posture...

No need to push your tummy and butt out. Relax your belly, open and lift the chest, the lumbar curve will take care of itself over time. WW posture is beautiful and feminine and graceful. Learn firebreathing. Prolapse management takes time and commitment and lots of big and little lifestyle changes too. If your family isn't supportive of your efforts, you can do it just fine without them. - Surviving