Pessary after hysterectomy

Submitted by Sammy on June 21, 2011 - 8:25am
Body: 

Appears the pessary topic isn't in hysterectomy forum (unless I missed it) so...
I have now had my 3,5 inch donut(bagel) in for a month. Last nite was probably the hardest. It is the streching of the vagina in 2 dimensions for 3.5 inches that is the problem I do use premarin (.5 gm 1x week) and I am very lubricated there. The relief from the very large sag (bladder, bowel pushing vagina out of my body is immense. Besides feeling the stretching in the 1 dimension, there is also a sensation of knowing it is there but is not too different from the dentures I wear- would sooner have my own teeth but compensate by accepting it is what it is. The amount in by bowel makes a huge difference. I love the comment on the pelvic floor being like a basket or pocket that we must ensure our abdominal contents stay IN the basket and not fall out... It is quite a change for me to adapt GOOD posture at all times....
I like to thing nipples away from navel- this kinda thing works for me - getting too much too soon. I know that when you understand things it is not complicated but some things - like just how a car works or how our muskulator skeletor system works just sits in the too complicated area of my head.
Feel perhaps the size of pessary I have is too large...Still dismayed that we need a uro-gyn to insert and care for this...
I hope to be able to put it in and out as desired, and develop understanding of all the environmental factors (including diet, posture, clothes, exercise, )that can help me manage the severe sag I have.

louiseds

June 21, 2011 - 10:17am

Yes Sammy, I can see what you are saying. Wouldn't it be great if you could give your vagina a rest from it whenever you wanted to? I feel sure the manufacturers could do that if there was an incentive to do so. Unfortunately their customers are not the women wearing the pessaries, but the doctors who prescribe them.

Perhaps women with pessaries need to write letters to their doctors, demanding more user friendly pessary designs, that can be removed and replaced readily by the woman? Do they really need to be as rigid as they are? After all, it is all like bags of jello in there. The manufacturers are not even going to think about this unless women ask them. The manufacturers never even speak to users. What sort of customer satisfaction is that?

"Tell me Madam, is there anything wrong with your pessary?"

"Um, er, um, well, um ... I have never worn one before. I guess it is OK."

Hardly an endorsement, is it?

Louise

Sammy

June 21, 2011 - 7:31pm

Thanks Louised
One lady on a forum here said that after $500 the pessary did not fit and she could not use it -- this is absurd.
My green shield at work covered a $300 foot prosthetic which I do not need near as much as the $100 pessary prosthetic which they do not cover..
I hope to speak to my doctor and write Mylex asking them to try harder regarding a more prolapse user friendly prosthetic- who knows who is paying attention....I also must e-mail our Medical Officer of Health and let her know that they have me going over 100 miles for pessary issues- we have many local doc and a new hospital rite here??

louiseds

June 21, 2011 - 8:38pm

Yes Sammy. Sometimes when we look at the absurdity of a situation from another angle it is apparent that really stupid decisions are made sometimes, without even being challenged by those affected by them. I can only encourage you to take some action. You may not see any results for many years. There are always those with vested interests who will stand in your way, but to do nothin' ain't gonna make it any easier for any woman in the future. You might even end up with a better pessary out of it. If another woman had taken action ten or twenty years ago you might have a better pessary today.

If we all take any action we can, life will become a little more uncomfortable for those who think they can laud it over the rest of us. We are all on this planet together.

Louise

louiseds

June 21, 2011 - 8:47pm

Hey Sammy

How about getting a Milex Pessary Users group up on Facebook, and start discussing the shortcomings of their pessaries with other women? Milex might close it down, but there are other ways ...

Cooper Surgical, who seem to be their distributors, don't seem to have any Forums for users. They only seem to want comments on their website.

BTW, only 7 people Like Milex on Facebook. ;-)

Louise

Sammy

August 25, 2011 - 1:41pm

Had my 3 month check with pessary- it is a 3 inch pessary not 3.5
I went to the head of the class haha and will see doctor again in aaout 6 months. Pessary was mostly not noticed during last 2 months..
I simply need to work at learning technique to make it a cone shape for insertion and removal. If I cannot- I need to call my GP
The fistula that is causing bleeding is a fistula and who knows?
Bleeding also happens as pessary if or as it is forced thru intriotis.
Not being at a physically demanding job is a big part of a comfortable life style for me with this life altering prolapse.
The urogynaecologist re-iterated that the surgery to correct the bleeding and the prolpse would be extremely complicated and best avoided....

louiseds

August 26, 2011 - 4:13am

Hi Sammy

Good to hear that you have made the pessary work. What is the fistula about. I don't think you haven't mentioned this before.

Louise

Amel

August 26, 2011 - 4:55am

Morning Louise
Hope all well.
You speak wise words about pessaries; am interested in why mine works. It's an unbleached super tampon from the health food shop and very lubricated; it goes in in a diagonal direction left and upwards as far as I can make it.
The one the doc prescribed is hard as wood (PVC) and round and big with a hole in the middle; it's impossible to bend. How did she come up with that and what is it supposed to do?!!!!!
When I get time I'm going to see her in September to ask plus my notes on the whole subject. Hope she has an hour or so to spare!
I've just bought a Mooncup to experiment with. It's silicone bendable and soft. Women have been wearing these for ages so it will be interesting to see if it's a better option.
I was a bit worried about the chopsticks you describes a while back. Would need a brave steady hand I think.
Amel

louiseds

August 26, 2011 - 8:13am

I really don't understand why pessaries have to be so rigid. It is all quite squishy in there. I had a donut pessary many years ago. I had to fold it to insert it, and I could barely hold it in its bent shape. I could only remove it in its flat form, which usually hurt! I am sure it could have been manufactured from a more flexible material that would have made it easier to insert and remove. Tell us how you go with the Moon cup. I think different members have tried them before for POPwioth not a lot of success, but I don't know why they were not successful. Maybe the real ones have a mumbo jumbo spell put on them or something?
;-)

Yes, the chopsticks were a bit of a worry, but a woman has to do what a woman has to do.

L

Sammy

August 28, 2011 - 6:08pm

Hi Louieeds
I have been amazed at how well my innards stay in place for the past 3 months with the donut. I do wear dentures and the vaginal prosthetic does not come to my awareness near as often as the mouth prosthetic haha.
Perhaps I used the wrong word(fistula)... there is some drainage from somewhere I believe due to the removed mesh and its attached complications.. the surgeon I believe said they left a drainage spot (I think he called it a fistula not sure) if necessary.. they think it may stop I hope it does.. I generally have showing of blood(pinkor brown) if i strain to lift push or pull or if I have a non-soft BM other than that, the drainage is likely in response to the pessary and is starting to appear normal-like to me.
I do not see surgeon for 6-7 months now and am to see my GP if I need help with pessary- he said I would not harm myself by getting it in and out but that it is hard to do. He did not have faith in the use of tampons for this purpose. I am to put my finger in the hole and try to make a cone as I pull it out and put it in. I am waiting a week to do this as each passage stretches things a little too much causing injury.

I hope to get to where I will use this occasionally not always... Rite now I don't know how the time weighted exposure of this will affect me but really feel I have had enough surgery... and am hoping posture will factor in to keep prolapse comfortable and liveable.(without pessay it affects my excretory organs too much - with it seems no problem)

louiseds

August 29, 2011 - 1:28am

OK, he probably did mean fistula. We become used to the word fistula being used in the context of a hole between the rectum and vagina or the bladder and vagina, as a labour injury, but I know that a surgical fistula is an artificially created orifice, eg a surgically created opening, deliberately kept open, which can be used to access inside the body, eg a tracheotomy hole. I would imagine this is what you have in your vagina to keep the drainage happening until it is ready to stop.

This may have implications for you hygiene-wise, as it could potentially be an avenue for infection to enter your pelvic cavity. I think it would be a good idea to contact the surgeon and find out exactly what he has done, so you know what you have going on in your vagina.

It is very easy to ignore all this information when you are getting over surgery, but as you are now actively managing your body yourself, it becomes relevant to know exactly what was done.

Louise

Sammy

August 29, 2011 - 11:06am

Other than removing mesh that was covered with a sheath by my blood probably createad by white blood cells,maybe granulamatous tissue) nothing was done-- the fact that there is still drainage is to be looked at with the issue that i was leaking probably a cup before this surgery- it was a mess, ruining sheets etc. I am getting more disrespectful of the first surgeon every day- he was so sure of the mesh procedure while I was so reticent- i feel the anger stewing inside me- I think I may/should have simply quit such a busy life I had and give my muscles a more healing environment- where was my counsel??

They were going to do all kinds of things (cervix amputation, mini arc, A& P repairs, sacrospinous fixation as well as some bladder check outs) but let me wake up after a very challenging job of mesh removal and a larger prolapse than I had before the first surgery.

louiseds

August 29, 2011 - 11:55pm

When I said it was important to know exactly what was done I meant whether or not you have an artificial drainage hole that is opens from the inside of your pelvic cavity into your vagina, ie is there a way that germs can get from your vagina into your pelvic cavity through the fistula, if that is what you have?

Louise

Sammy

August 30, 2011 - 9:31am

I believe it is a hole he said that they "left" so that drainage if necessary can occur. For my 1st visit after surgery he did tests on my i think white blood cell count to check for infection- there had been infection prior to their cleaning it out. My understanding initially was that the mesh was in a separated area from the pelvic cavity- i cannot get in there to take a look. I of course am concerned for infection -
There was no infe ction at that time and again the surgeon felt i was Ok.
Most o fthe time I barely notice the prosthetic and of course am sickened by the residual bleediness.

louiseds

August 30, 2011 - 9:54am

Hang in there Sammy. I didn't mean to alarm you. I can now see that you are aware of what is happening and your doctor does sound sensible.

Louise :-)

bobbielou

September 13, 2011 - 1:30pm

I've had POP for many years and had success using a Mylex ring pessary until I developed a moderate cyctocele. At the same time I devleoped IBS due to the stress of the unresolved cyctocele. I tried many shapes of Mylex and even tried two Mylex shapes at the same time, one above the other. Nothing was comfortable until with a corrected diet, the IBS slowly resolved. The donut Mylex was comfortable but the IBS symptoms would eject it. With the resolution of most of the IBS symptoms, I was able to return to the use of the Mylex ring. Usually I forget it's there.

bobbielou

September 13, 2011 - 2:09pm

From my experience, you do not need a Uro-gyn Dr. to insert, remove or clean a pessary. You do need an NP, RN, LPN or other medical technician to measure for its correct size. This person will order it and show you how to insert, remove and clean it. Once you are done healing from your surgery you can look for another provider. A good place to begin is a women's health clinic.

bobbielou

September 13, 2011 - 2:46pm

The mesh procedures looked to me to be so reasonable and effective. I hope you will be able to heal well and not blame yourself any longer. My understanding of prolapse it that it is a progressive condition under the best circumstances as we age. We're attempting to limit the effects of gravity.

Christine

September 13, 2011 - 7:48pm

Hi and welcome, Bobbielou,

Prolapse can only be considered progressive if we keep doing what we've been doing, so that the organs continue to be pushed backwards toward the vaginal opening.

If you begin to live in your natural posture, your "self-locking" pelvis will move your bladder and uterus forward, closing your vaginal walls so they are no longer subject to the forces of internal pressures.

Change your posture, change your prolapse!

:) Christine

louiseds

September 14, 2011 - 4:48am

Hi Bobbieloui

Gravity is real, and it is always there, always in the same direction.

The only way to stop gravity from making pelvic organ prolapse progressive is to change your posture so that gravity acts through your pelvic bones, rather than straight down your vagina. We do this by pulling up tall and relaxed, which makes a large lumbar curve and tilts the pelvis forward slightly so that the pelvic organs are tipped forwards to rest on the pubic bones and relaxed lower abdominal wall, rather than backwards and down the vagina. If you can get your bladder and uterus forward and relax your lower belly, it gets them away from the top of your vagina and allows your uterus to fold forwards on top of your bladder. Bladder and vagina are then supported on bone. These organs then press against the front of the vagina, as we inhale, using gravity to press the vagina closed, so they cannot go 'straight down the plughole'.

Confused? Keep reading. Use the Search box to look for keywords and call back with questions.

There is nothing wrong with using a well-fitted pessary but you may eventually be able to put your pessary into long term storage by making Wholewoman techniques a part of your everyday life.

Louise

Sammy

September 20, 2011 - 5:04pm

I have had pessary for about 4 months now. Urogyn said it would be very hard to remove and return by myself- I said everything is hard until u have done it 10000 times.
I tried and ok i can remove it sorta but because it is 3" it does tear me a bit... so I got my husband to make the donut as narrow as possible in the one direction. He removed it without too much ado.. I left it out for 2 days. While sitting and laying, I felt better, but as soon as I stood, the pressure and sensation from my vagina were just about intolerable.
so I asked hubbie to squeeze it one more time and re-insert, tellin g him I know it will be difficult. At first he declared it impossible bu then he changed the direction to straiht down and it popped rite in and is still in.
I do not like the way i sense it is stretching me but now that we got control of it at home instead of having to go to Toronto, I feel better
I hope this will lead to a smaller one with less stretchiness and some healing with the posture program.
the ring with support pessary is likely to not work for me long term as it does not touch as much of my vagina and thus is apt more to cause sores.
except for this site there has been minimal support for my condition and the first surgeion who messed me up with mesh really has no respect from me- I was a hard working older woman whom he counselled against her better judgement and got cut up badly because of his care less ways....

Timmy2

February 3, 2012 - 1:03pm

Pessaries are great. I was on the wrong link and posted "Light in the Tunnel" for anyone to read 'my story'.
Even in Canada (with our MSP) specialists are all too keen to do operations.
And if you read the research papers it is clear that the success rate is very low.
The old trad method of a pessary is great and I am so happy now I have a clinic to go to to have the tissues checked every three months. Most of the time I don't realise I have one in except when I remember the discomfort I used to have from the feeling of a kiwi hanging between my legs.

I am horrified to read of what women have to pay in the USA fo rthis care. I feel my tax money was well spent!