pessaries

Susan1, I am trying to get more info on pessaries also. ( I see that your post is under "Pregancy and Prolapse", are you pregnant?)

I had prolapse of bladder and uterus for about 5 years before I did anything about it (besides worry) until it protruded right out. After a friend had multiple prolapse surgeries, a nurse told her about pessaries, until then neither of us heard the word. I wanted to wait until she had hers in for about a year before I went to see about getting one myself, as I did not want surgery and end up like my friend.

Two years ago, I was fitted with a ring pessary. I believe it is "normal" to have several different sizes inserted before the correct one is found. I believe mine was the largest size in the ring catergory. (Are you familiar with the different types of pessaries? If not, google to find pictures.) All was fine until a few months ago, when I started to bleed. I was doing a lot of very heavy lifting and it seems that the pessary did a lot of damage inside. I am waiting to heal so in the meantime I have been without a pessary and was very afraid of getting worse....until I spoke with Christine, discovered this wonderful site, read many posts, asked for advice of the women on this site. Now I am very hopeful.... and wish that I had known about WW posture and had all the education I have picked up these last few weeks. From what I gather so far, it seems that with posture, fire breathing and the exercises things can either improve for some or at least stablize for others.

As you stated, I don't think my pessary was in the correct place either because before the bleeding, I was hanging out again..it felt as if the pessary was pushing to the side. I must say you are much braver than I...I never was able to take mine out. I had it cleaned every 3 months at the gyno's and was told to use Trimosan, which I found out has a pesticide component.

Wow....where did you get the idea to insert a wash cloth? I was told to insert a tampon during the day to keep things in. Since this site and the info I gathered, I only use the tampon when I leave the house for a few hours.

Of course, I would never TELL you what to do, but I would suggest that you read the book before you go back to see about the pessary, and to read as many posts as you can on this site so when you go to the doctor's you will be armed with a lot of questions. Maybe you will be one of the lucky ones that will get your parts to stay in.

Like you, I am going to the washroom more times than normal and also several times during the night. BTW, if you feel like you are sagging or uncomfortable after a meal at home, lie down for a bit.

I am hoping that someone that has worn a cube pessary will post some info. as it was suggested that it might benefit me. After looking it up online, that one concerns me too. I might decide to stay as is, and when the book finally arrives with the DVDs I will follow the program and hope to improve or at least stablize.

All the best to you.

I am happy that you have noticed an improvement!! Super! Wouldn't it be great if you were one of the lucky ones!

I never heard of sea sponges until I discovered this site. I got the book and the DVDs today so maybe I will learn about them through the resources plus I will also do a search on this site. BTW, where are they sold?

Even though I have difficulty sleeping on my back, I think I will try your pillow tip this eve, Thanks! (Sleep well tonight, suzanne1!!!)

Thanks suzanne1 for the info.! i will check their site online. As I said before, you are much braver than I! I am actually scared to try the sponges in case I get some infection.

Maybe someone who has had experience with them can answer your question about how often they have to be changed; however, if I ever do find out, I will post a note to you.

Actually, I did have a good sleep last night! :)

All the best!!

I phoned the number you gave, and found that the sponges should be removed each night and washed with mild soap and water but if you are sexually active, you can choose to leave it in as the sponge makes it more comfortable for SOME women. Every few days they should be cleaned in a stronger solution...apparently the info on the cleaning solutions is in the brochure that comes with the sponges.

The good news is that in 37 years of business, no one reported an infection. However, if the prolapse is severe the sponges might not be useful.

Hi, Suzannel. After reading "Saving the Whole Woman" a few years ago and lapsing on exercise and posture, I recently signed into the forum looking for information on the cube pessary. I think I got lazy on exercise and posture because the pessary worked well for me, but after using it for a couple of years it was easy to see I was going to have to get a larger one - and so on. I had been using a ring pessary and haven't used it for about six weeks until - confession time - today. I had to go shopping and it has felt so good to be supported today. I haven't taken it out yet, but I know that when I do I'll be feeling like peeing all night long. That's what the friction of walking and standing (mild as it is with lubricant) does for me. I'll end up sleeping on the couch tonight with pillows under my knees. Having to go larger (stretching) and lapsing in self-care and wanting to pee all night are three good reasons for me to look for another alternative.

I got a sponge and tried it once. It worked pretty well, but it was more irritating than the pessary. I still think if I could get it lubed enough and get somewhat used to it (without having to use it continually) it would be preferable to the harder and less conformable pessary. I'll appreciate hearing how you're managing to get used to using one.

Both the pessary and the sponge slip down to the vaginal opening. I haven't minded using my pessary this way. It never stayed in position upon the pubic bone from day one. It stayed in far enough so that I didn't feel it when sitting and it didn't interfere with peeing. The sponge, however, got wet when I went to the bathroom and I wouldn't want to take it in and out all day or leave it in pee-soaked....so I need to find some tricks for that.

No one here seems to have experience with the cube pessary. I'm not willing, and couldn't afford to if I wanted, to see a doctor for a fitting and prescription for something that may not be suitable.

I still think the very best option is to avoid using support that will stretch me any worse and keep up working at WW posture and exercise. I'm looking forward to better walking weather. I got used to being outdoors in the cold when I was a smoker (we didn't smoke in the house); but since I quit smoking, I rarely stay out in the cold....so I need warmer weather for walking (I know, whiney baby). From re-reading Christine's book and really "getting" her description of the heel to head action of walking, I'm sure it is the exercise I need most...as well as for other benefits (weight control, stamina, breath). It is also the easiest way for me to maintain posture - on the move.

Best wishes, Bebe

You are most welcome...I wanted to learn more about the sponges anyway so I phoned.

BTW, I tried sleeping with the pillow as you suggested but after a few hours of trying to fall alseep, my back hurt so I quit. I am in the process of reading the 2nd edition of the book and I think that is where I learned that if we sleep on our back, it is better not to use a pillow under the head. (Actually, the pillow I use is very low/flat so I think it is ok.) That got me thinking that perhaps using a pillow under the butt as you suggested might not be good for the prolapse since we are to get the bladder and uterus to the front of the pubic bone, and by using the pillow under the butt, it seems to me, they would be forced to the back. What do you think?

Thanks for your descriptive response. I know what you mean about the cube pessary. I saw pictures, too, and can't figure where it would go. After doing some reading here, I think the sponge is a better idea anyway...especially with the pessary stretching. I'll pay more attention to where the sponge is when I go to the bathroom. I will need some support when I start my garden. Working with a hoe seems to me to be the worse position - and with the added stress of working it. I love the payoff, though, of fresh-tasting (frozen) tomatoes for soup, green beans, and strawberries in the winter; fresh tomatoes and herbs in the summer; corn on the cob, asparagus, and lavender sachets. If I could grow my own clean tobacco and process it without addictive and damaging additives, I would still be smoking. (My garden is not that big!) I quit the first time when I had three kids in diapers and my husband said we could afford disposables if we gave up smoking. So we did, with the added benefit of getting rid of chapped hands. But I started smoking again after 15 years. No more. Congratulations to you too.

I am always surprised at how my cystocele doesn't bother me when walking in posture without the pessary or sponge.

There are a few things that cause that need-to-pee feeling and I know when I'm doing them. Sometimes I just want a cold fizzy can of Dr. Pepper, knowing I'll pay for it later. One of my mineral or herbal supplements causes it, but I haven't narrowed that down to the culprit yet. A couple of hours with my knees lifted to take the pressure off always works....even better than laying on my side.

It sounds like you follow through - so I'll be curious to know how that sponge behaves on your next cycle - along with others here who might be relieved if that's the answer. BTW, I used that method with a thermometer and charts for a year. How tiresome it was, but with my somewhat irregular periods was necessary. It gave me an extra year off between baby #3 and baby #4.

Thank you again for writing and may God bless you too. (How generously we're provided for day by day!)

I have used a 3 inch donut pessary for over a year and feel that it is just fine rather than the heaviness and dryness of having my cervix and bladder falling out the hole. It took many tries and a switch from the 3.25 to get good at this. After months, it is no more a nuisance than brushing my teeth. I wash it each nite and each morning before reinsertiion. The fact with the donut is that the pressures of the insert are born by more than a specific area. Water is my lubricant and I work still at my posture and diet, I am at the point of admiration for whomever designed the donut pessary it pops in , i twist it so that it lies like a donut on a saucer and am good to go all day. I vaguely feel it during the day and pop it out at bedtime. it is not perfect but is ok. My bowels and bladder are ok too but without the pessary cause me consternation

Suzannel, I just tried one of my Jade and Pear sponges yesterday. I started with the smaller one first and it worked like a charm!!! I initially was fitted by my GYN with the Gelhorn pessary which is next to impossible to be inserted and removed by anyone but the doctor. Then, I was told I had to return no longer than every 3 months to have it removed, cleaned, and reinserted. Not liking the sound of that, I decided to give the sponges a try. I followed the instructions, inserted it and left it in for only a few hours because I wanted to know sooner than later how difficult it would be to remove. It wasn't AT ALL. I just gave a little push, reached for it with my fingers and it glided right out. I proceeded to clean it, sqeeze out the excess water and left it on a paper towel (top and bottom) to air dry and put it back in this morning. I'm sure if you called Jade and Pearl, they'd be able to advise you on how long is safe to keep one in. For now, I've decided to keep it in during the day for normal activities but remove it at night before bed. I know it's not a cure but I'm SO glad to have found something to "manage" my uterine prolapse that doesn't require trips to the doctor!

Hi Veezvee

Whole Woman suggests that you clean your sponge overnight with peroxide, diluted appropriately, and rinsed thoroughly afterwards. It may eventually cause the sponge to break down, but it will clean it properly. Sponges are cheap, compared with antibiotics and the consequences of an infection.
Missing a night time H2O2 bath occasionally probably won't matter but if not cleaned regularly with something that will kill microbes it may develop a population of bugs that your vagina does not like. We don't want that to happen, do we?

Louise

Louise

Wondering if anyone else has this problem. I was fitted for a ring pessary by my local gyn that would not stay in. I went for a pessary fitting with my uro dr who tried a pessary with a knob and also a gellhorn pressary. I thought I had found the solution to my problem....until I had been on my feet about a minute. Urine started leaking out in a small stream that I couldn't stop. The dr explained to me that that happens sometimes because the prolapse has kinked the ureter tube and when the pessary straightened out the kink urine leakage can't be controlled. I was told my only options were to live with it as it is not life threatening or to have surgery. I am wondering if the sea sponges would work for me. I feel quite hopeless about my condition as I had a hysterectomy many years ago and feel there is really nothing that will help me. Any advice or suggestions will be so appreciated.

Been thinking about you, wishing I could offer something, and this question comes to mind. What kind of surgery is your doctor now recommending? I can see you've been trying to make an informed decision about it and wanting someone with similar experience to weigh in, so maybe you could be more specific.

I have used a ring pessary and only had the problem of leaking without sensation or uncontrollably when my bladder is full and I've been sitting too long (unaware of it). When I get up sometimes to go to the bathroom, I barely make it. Only once have I actually wet myself.....and I don't remember if the pessary was in or not. I'm careful to keep my bladder as empty as possible, though, especially when I'm out and about.

The gelhorn pessary would necessarily be worn differently than I wore my ring pessary....since I wore my ring pessary incorrectly, letting it flip and stay vertical because it wouldn't stay in the proper position. This way I was able to get by with a smaller pessary which supported my cystocele and let my vagina close rather than having an air space....but which also obviously widened my vagina. Considering that, I thought the sea sponge would be better. It didn't suit me, but that doesn't mean it wouldn't work for you. Others here have had success with it, I think.

I'm just adding these thoughts for you to consider and hoping you can find a way to avoid surgery if it isn't necessary or would worsen things for you. It still seems to me that WW posture would certainly help you and I encourage you to commit yourself to the effort. Daily the only reminder I need to be hopeful is the difference I can tell in myself when I am mindful of posture (standing, sitting, on the potty) and when I am not.

Hi Neveah, I am sure I have read about someone else here having the same problem with a pessary and urine leakage. I thought it was Daphne, but I have had a quick search and can't find the post I was thinking of. Perhaps whoever it is will respond to you. I hope you find some relief.

Bebe thanks so much for your response and curiousity for trying to search pessary leakage. I haven't been able to find the post yet either. I thought I would write my uro's diagnosis and maybe you would know more what my problem is.
1. ICS Stage II rectocele, cystocele and vaginal vault prolapse
2. Alternating constipation and fecal incontinence
3. Mixed urinary incontinence
4. Urogenital atrophy.
At my last appointment when I was fitted for a pessary and told none of them would work for me I was told if I wanted another appointment it would be for more testing and a consultation on my surgical options. So I don't know what kind of surgery. I am 75 and quite active when this condition allows it but am trying to avoid surgery at my age since I was told this is not life threatening. I have been through physical therapy teaching me kegals and use premarin estrogen cream now for urogenital atrophy. Any ideas, suggestions advise would be so appreciated as I have searched and searched and know this kind of surgery is certainly no sure fix. Again, thanks for the responses.

Bebe I forgot to ask you in my last post if you have had a hysterectomy? Thanks again.

No, I haven't had a hysterectomy. That's why I hesitated to advise you on anything. In fact, I wondered if it was insensitive of me to say I only needed to straighten up my posture to be reminded to have hope....since I haven't had surgery to further disturb the fascia like you have. I'm 62 with a diagnosis of a stage 3 cystocele and rectocele. My cervix and uterus seem to be staying in a pretty safe place right now. I found WW because I thought my worsening progress would eventually lead to a recommendation for surgery and hoped to avoid it. So far, so good. In my less hopeful moments over the past several years, I sort of depended on the idea that I could have bladder sling surgery eventually. Now I'm sure I won't....lawsuits already starting on that.... When I read the stories of women who have had complete uterine prolapse and are managing to take care of themselves, I am in awe of them and am encouraged to take responsibility for my health and not give myself over to a surgeon. I can't say what you should do; but if I had already had surgery and could find a way to get on without more surgeries, I would avoid it. It seems everything "they" do to fix things just add insult to injury. No matter what you decide, I wish you the best possible outcome.

Hi Bebe

I am not so sure that keeping the bladder as empty as possible when out and about is such a good idea. I find that I rarely have trouble finding a toilet and getting my panties down in time, when I am out and about. I do have this problem sometimes when I am at home. I have no idea why! I am pretty sure that trust and confidence have something to do with it, but often women with prolapse are low on confidence and trust in their body, so that might be hard.

The bladder is designed to fill right up, give the signal that it is time to empty, then empty completely or almost completely. Keeping the bladder empty is not allowing it to do this, and it can lead to the bladder thinking it is full, but it is not. It can also be part of a cycle of keep the bladder empty >don't drink as much > strain on the kidneys and lack of flushing, which can lead to inflammation in the urethra from strong urine and UTUs.

I think it is more important to be attentive to the signals your bladder is telling you, and ensure that you empty it every couple of hours. In my experience it is not so much the fullness of the bladder that causes problems with getting to the toilet in time. It is more that the sensation of wanting to empty it is so strong, or that the urethra cannot stay closed. The bladder doesn't have to be anywhere near full for this to happen.

With constipation and faecal incontinence it sounds possible that you have Irritable Bowel Syndrome (IBS). This can be helped with a change in diet. The problem is it is not a one size fits all diet. For some people with IBS more fibre and subsequently more liquid is prescribed. For others they find that is the worst thing they can do to themselves. It is probably wisest if you keep a food diary for a couple of weeks and mark down when you get constipated and when you experience faecal incontinence and then try to match what foods you have been eating to line up with these results. Diarrhoea of course means the food has rushed through your gut and the constipation is food that has slowed. Usually, insoluble fibre like breakfast cereal slows, whereas some fruits or sugary desserts will rush. Another clue lies in the stool itself. Stool that floats is more frequently fibre, stool that sinks is more frequently protein. These foods could have been eaten twelve hours prior for the diarrhoea or 48 hours prior for the constipation.

The urinary incontinence can be looked at again from the point of view of the foods and liquids which you consume. The Kegel exercises would have been for the stress incontinence i.e. the dribble of urine when you cough or exercise or laugh. (And you keep on laughing Nevaeh. Even in your difficulty here, I can see your smile.)

But you can also look at decreasing the amount of liquid that you are ingesting, and avoid drinking caffeinated beverages because they irritate the bladder. Spicy foods, carbonated beverages, alcohol and citrus also irritate the bladder and should be avoided….well maybe just limited at first and gauge how you are going.

I find pears, apples and berries do not irritate.

Urge urinary incontinence is caused by uninhibited contractions of the detrusor muscle. It is characterized by leaking of large amounts of urine in association with insufficient warning to get to the bathroom in time. You may have some underlying medical conditions such as diabetes or Parkinson which is causing this, but if not:
Urgency of urination happens when I have eaten something that creates this urgency; in my case simple things like salted corn chips, asparagus etc. Sometimes cold weather and sitting by a falling water fountain can encourage urgency, but I do tend to think there would in these cases be the underlying impetus which you possibly have not noticed until that moment.

By the way, Christine on one of these threads suggested a tsp. of raw, local honey in a small amount of water for bladder urgency.

Wholewoman posture will help cystocele and rectocele, but it is a long range plan for those older women like us depending on how long we have had it and the severity of the prolapse. So you are possibly looking at 2-3 years of human dedication. It is also important that the secret to comfortable urination is to look at avoiding the issues that create urgency and frequency as enumerated above. And also Wholewoman recommends that you be careful to empty your bladder completely at least once a day and half squat to urinate rather than sit on the toilet seat.

It would be worth your while to buy Christine’s book “Saving the Wholewoman” as you are intent on avoiding further surgery and then there is the Hers Foundation which you can google and you may be able to receive even more pertinent advice there as there are ladies there who have had hysterectomies also.

Best wishes, Fab

I do agree that to empty the bladder whenever the urge appears is the way to go for someone with uterine prolapse, and I should think that if the urinary urge is pulling the bladder down the vaginal canal then emptying would be a better proposition for someone with cystocoele as well. The pressure that is applied with the bladder’s urgency and /or frequency is I think best avoided to stop the possibility of worsening of the prolapse and the discomfort of a prolapsed organ at its extreme.

An empty bladder is a trouble free mind for some of us.

Louise mentions urinating every two hours. I like to be more flexible than that. I have gone regularly at one stage when at my worst and I went for my walks that I needed to go every ten minutes when I was on my feet. When I was seated I could hold on for hours. Naturally, it was painful to walk and something I needed to fix urgently. When fixed I can now go happily walking without urinating for two hours and longer.

As I explained to Nevaeh above, I looked at my diet. It’s nice to start with a bit of a road map, but also I needed a greater understanding of the vessel I was driving. Not so much its anatomy which could only mean so much to me not likely to ever see these things for real, but from a working principle.

It’s best to try this when you are not experiencing frequency or urgency. One way to get a handle on what is normal bladder capacity for you personally is to count when you first void in the morning. That first urination tends to be the longest one you will have all day. So count it. Just count, not seconds or anything like that, but just as a child showing you how well they can count would. You will probably reach 25 or something like that. Now this is usually your bladder’s absolute maximum bursting capacity. So you can probably think that good bladder capacity is around about a count of 20.

As you urinate during the day, you will find the urge to go will result in different streams which will last for different durations. Now if you go for a count of three you might think that is unnecessary and that you could have waited. When you are not having urgency or frequency then you would probably be right.

I don’t think you are going to be able to tell from the feel of the urge how much urine is actually ready to go, but more from the knowledge of what is normal for you if you have a reasonably static diet.

The point I wish to make however, if the pressure of urgency is pushing/pulling your bladder or uterus down, then I am of the opinion you do better to release that tension in the short term. Meanwhile, work as you are for the long term with WWposture, toilet habits and diet. That way the urgency and frequency will naturally decrease and the bladder will resume normal operation at least within the limits of the degree of its prolapsed condition.

Best wishes, Fab

Yes, Fab's right. It is much more variable than that, but you don't want to drink so little that you can go all day without a wee. Neither do you want to go every fifteen minutes during the day. Remember that the bladder also has volume, probably about the same as a baby's head when full. That is not to say that you should keep your bladder full, and use it all day as nature's pessary. Rather that allowing your bladder to fill is not bad for it.

You be the judge of how full is too full.

Oh yeah. Stay away from bladder irritant foods like those containing caffeine. If you like a coffee, go for an Arabica, rather than a Robusta (which is the species used for cheaper brewed coffees and instant coffees). Cola type drinks and energy drinks, beers, etc are also sources of caffeine.

Hi Nevaeh, I am 67 and struggled with a buldging bladder for years, gradually becoming worse. It got so bad that I couldnt walk anywhere without having to push it back in again. Charming!!
I finally plucked up courage to go to a Urogynae -an all women office. She was keen to do the mesh op, but I refused because that meant having half my uterus out. I also discovered that I had both bladder and uterus heading down south - both stage 3 of 4. Yikes.
Her PA fitted me with a ring pessary size 7 (after trying smaller sizes)- the kind that looks like a white flying saucer - but warned me it would probably fall out.
To my utter delight I found I could walk around like a normal person and really couldnt feel it - and it didnt fall out.
I have to use premarin cream 3 times a week due to tissue atrophy.
I went back after 2 weeks and was shown how to take it out and put it in again - not easy at first, but practice does make so much easier.
I need to pee more often and dare not put it off when I feel the need! But thats a small price to pay.
I have noticed in all the posts about pessaries that a lot of the time its which medical person you go to and whether they will listen to, and work WITH you. Make yourself heard - dont let the medical people tell you what you should do. You know your body best.
Try another pessary - maybe a different shape or a larger size. Keep on with the estrogen cream and please, please dont become discouraged. I know it can become disheartening, but persist. I promise you that the reward of having everything tucked back up again is so worth it.

I'll have to reread your posts a couple of times more and think about it. You both make sense to me and don't seem to be contradicting each other....seems the differences are in circumstances and I'll need to keep learning to be more alert to what's going on with me. There are some things I've grown accustomed to 'suffering' that I'm finding remedies for here. I've gotten used to things as they gradually worsen, adapting coping strategies subconsciously. I read about some of these things and think "I'm glad I don't have that" - then think again, "Oh, that's what that is!"

Today, Louise, after reading one of your posts somewhere, I found I could still touch the bottom of my kitchen sink when I'm standing upright as I need to. I can actually wash my dishes in good posture! I have to wear clogs around my kitchen to get enough height to work comfortably. Life is full of trade-offs.

Fab, my asparagus has come in and I LOVE it. I haven't noticed it causing urgency, but it does seem to make me urinate more freely. Husband, son, and I think asparagus must be powerful medicine of some sort because it smells so strongly! We love when it comes in and are kind of glad when it's season is over. Also, as for counting.....good idea and no need to explain how (obsessive-compulsives count everything).

I really appreciate the thoughtful time you both spent on your comments. Thank you again.

Bebe

I am so appreciative of everyone's helpful comments. Fab, I agree that there is more going on than prolapse. Years ago I had surgery for diverticulosis and adhesions. I have kept a food diary and have pinpointed several foods to avoid. Also, gave up coffee, wine, tea, soft drinks, etc a couple of years ago and that helped with frequency of urination. After searching I am totally confused about kegals helping or making matters worse or if it makes a difference if you have had a hysterectomy. I feel lucky that there is so much support and know a few years ago this was not the case. Thanks again.

I am 36 years old I have a prolapse cervix I got it while I was 3 months pregnant with my 1st child. I did physical therapy for a while but I don't feel like it worked for me so I got the pessary ring and it works great for me my only issue I have a strange smell now down there. I take it out every other day and wash it with an antibacterial soap like it says to do. I am afraid of the side affects that Trimo San jell because I want to have another child and it says not to use it 6 hours before you want to conceive . Can someone give me some advice on something that is natural to use to help with the smell.

Hi Rachel and welcome. You are right to be concerned about the Trimo San - this substance has been banned for veterinary use, but for some unearthly reason it's still OK for doctors to give this to women to put inside their bodies. It's a disgrace. If you have looked around the site at all, you will see we aren't big fans of pessaries here......they don't help prolapse and in the long run can make it worse. Better to learn natural and healthy ways to manage prolapse - that's what Whole Woman teaches. I don't have any suggestions for what to do about the smell. I've never used one and never will, but we have some members with pessary experience. - Surviving