Ring Pessary Questions - please help

Hi apismellifera, sorry I havne't used a pessary but I know there are a few here who have and found them successful.If you use the search box there are a lot of posts about pessaries. They work for some and not for others.Just thought that until someone else who does use them posts, you could start reading some of the posts.I know it takes awhile to sift through and find what you want. I also remember a few who were thinking of a pessary but then started to feel okay and then not want one.Personally I wouldn't tamper with a pessary while the area is sensitive and healing. You can read some of Csf's attempts at getting a pessary fitted and what distress she was in and now she's great. She's listed all the things she did that she thinks helped her, if you look up some of her recent posts.
If you could take the fear away and say to yourself that all is healing well and rest as much as you can, read some of the advice here in the posts,watch your posture and be careful how and where you sit.
I'll share with you that I am exactly as you describe yourself now in relation to position of cervix when squatting,but manage to carry on doing the things I need and like to do.Not saying it's perfect but Ive had a tough 2 years with other stuff so now I hope to focus more on my pop actively. Posture has by far been the one thing that has helped me the most.I have done some of the DVD exercise and the new yoga but had to stop for awhile with back problems to sort out first.
I have still been able to dance and bike, it starts with our head and how we deal with our pop in the beginning.We have all felt the same anguish and support each other.
I hope a pessary user offers you some advice soon, this is just to help you meantime. I wish you all the best whatever you decide to do.:-) and the best holiday ever!!! You can do it! xxx

Apis -

I was fitted for a pessary about a month ago and would not consider going a day without wearing it. My cervis was just inside the introitus and I could feel it in my vagina all the time. It felt like I had a tampon half in and half hanging out - in other words it was on my mind constantly. After doing internet research and reading up on pessaries, I realized I had nothing to lose. My doctor fitted me for one, and fortunately the first try was a perfect fit. I have read that sometimes women have to go back numerous times to get the correct fit. I had the nurse practitioner show me how to put it in and take it out so that I was comfortable doing so before I left the office. I take mine out every night and re-insert in the morning. Years ago I used a diaphram for birth control and the insertion part is similar. When I have the pessary in, I can't even feel it. The only thing I don't feel is my uterus moving around as though its going to slide right out of me. Mine is a ring pessary with support. It sounds like you are in quite a bit of distress, which is understandable. Hope this helps.

Marric

Hi Apis -

I am glad to hear you are going to try the pessary. When I did my internet research, I found that most women that have used them had success. Just remember that the proper fit is most important. Apparently there are ring pessaries with support and without. The rings with support are filled in with silicone in the middle and have small holes within the filling (if that makes sense). If you go to this link it will show pictures of the different types of pesaaries including the type that I use. - http://coe.ucsf.edu/wcc/print_pessaries.html

My prayers are with you. Please let me know how it goes on Friday.

Marric

Check out this page for info about which pessaries are for what. http://www.aafp.org/afp/20000501/2719.html

Louise :-)

I was fitted for a gellhorn pessary 4 months ago and everything seemed fine except that it hurt so much to put in and take out. My doctor switched me a month ago to a ring pessary with support which inserted with no discomfort. This worked out really well until recently when it feels like my prolapse (bladder) has fallen. I checked this out and it seems that the pessary is right where it should be. Can the prolapse escape from the ring pessary....or do I have a new prolapse? Could I have vaginal vault prolapse. I'm a little confused as to what that is.
Can anyone help?

Your prolapse can escape from the pessary. Someone was on here describing that very thing recently. Let’s hope that is all it is and not another prolapse. If you can’t get to see your doctor, it is probably wisest to take the pessary out anyway until you know what is happening. I know Bebe and 123butterfly are currently on forum and have experience with pessaries. You could check their posts in the meanwhile. Hopefully, they will spot you. Mostly, it is only women who have had a hysterectomy who need to worry about a vaginal vault prolapse.
That's not a stupid question by the way.

Hi Hummingbird,
I don't have any experience with a ring pessary, but I have a cube pessary. Most of the time it really supports me a lot, but sometimes (I take it out for the night) my prolapse escapes from it. Then I have to turn it a bit round or even insert it again. So this could probably be your problem, too. Perhaps you just have to change its position a bit? Hope this helps.
Butterfly

(I was listening to Seals & Croft today on the way to the store. Just an aside in case that means anything to you, Hummmmminnnnggggbirrr...rrd.) I have a ring pessary with support for help with my cystocele and (though I hear it not's supposed to help with it but does) my rectocele. I bought "Saving the Whole Woman" a few years ago and lapsed on commitment to posture and doing the First Aid video exercises because the pessary did help. Shame on me. When my cystocele began to bypass it and escape, I returned to WW to try and renew my commitment and learn to live without the pessary. If you looked at my posts, you've seen that I've worn it "sideways" and that my expectation is that it will just cause more stretching and will need to be replaced by bigger and bigger pessaries. I rarely use it any more and because I'm not used to wearing it, the friction bothers me (makes me sensitive and causes a little bleeding). I thought I would use it this spring when I began to garden, but I'm getting along okay without it so far. My condition is changing (as is usual) and on occasion I return to the pessary, actually more for my rectocele (and relief from hemorroids, too, taking off some of the pressure). So I can say that Butterfly's (also lovely name) advice to reinsert can help. Or you can get yourself back into position somewhat by jiggling. You'll want to research that.

Butterfly, I'll look at your posts and hope to find something about your cube pessary. I'm curious and would like help making comparisons with the ring pessary, though at this point it would take a lot to convince me to go for another one of any kind. Never say never, though.

Seconding Fab, there are no stupid questions. We tend to fear the worst about our conditions. I went straightaway to thinking I'd just have it all taken out or sewed shut but decided rather to keep myself intact as much as possible, avoiding the surgery-train (once it starts, it's hard to get off) and keeping the hub of support (the uterus). What women have to say here has convinced me that even if it all eventually prolapses, I'll be able to deal with it. But, more importantly, I'm convinced that with commitment it is possible to slow, halt, maybe even reverse things happening on the slippery slope.

I hope my pessary comments in the above post didn't confuse or discourage you. You and I don't seem to have much in common in our condition or in our current lifestyle. We do have this in common, though: having children close together (my four were born between November of 1983 and November of 1987). There's a lot of lifting, kneeling, sprinting, bending involved in taking care of young children. I was fortunate in that my prolapse (mostly cystocele, some rectocele) came on slowly, and I didn't begin to learn about it or deal with it until the last several years. My doctor spoke to my husband (not to me) after our third child was born to advise that we have no more children for a while, so I suppose he could see at least potential problems for me. I am not sorry that I got pregnant and had that last one.

We're all experiencing so much of the same things in our fears and discomforts and our small victories, but we're also all different and changing physically. I don't want to go against the advice of the more knowledgeable (in both the Whole Woman experience and in anatomical and medical information), so I wouldn't try to convince you that pessaries generally work for rectocele. It really doesn't even make sense that they would. With my personal construction, eating and bowel habits and lifestyle, the pessary provides enough support to take off some pressure and gives me overall down-there relief when I resort to using it.

You offered to answer questions about the cube. I mentioned in other posts that I have used my ring pessary vertically rather than horizontally. It wouldn't stay up and I didn't want a bigger one. I meant to use it vertically so that my vagina would be closed (without an air space). I wondered if a cube pessary would stay in place better. Oh, I've just answered my own question, I think. It seems that since I want to support a cystocele and my cervix seems to be in a pretty good place, a cube pessary probably wouldn't prevent the escape any better than the ring with support. Does that make sense?

hi girls sorry to jump.in on ur post but i have a question...can ring pessaries be used for 2-3 grade bladder prolapse?
im in the uk n have just been diagnosed with bladder prolapse...i went to a gp who didnt know anything about prolapse so i saw a gyna who was the rudest most unsympathetic woman iv ever met. i asked for a pessary as im goin on holiday with my 10 month old baby this thurs n i just cant function with.this prolapse hanging out..im getting more stomach pain n pain in my sides...she said i cant have a pessary cz theyr only used for uterine prolapses and she "thinks" my uterus "might" be ok? x

you didn't confuse me ;-).
Wow, four kids in four years. Not bad :-). How did you manage this? I'm so often knocked out with my 2 littles and one bigger...
In Germany the Drs seem to know cube pessarys only. There's a forum, pretty similar to this (they just believe in the wrong posture...) and all the women there, who are having a pessary, have a cube pessary. So I can only tell my experience with that one. There are two different types: one made of silicon and with holes in it and one, that's not so soft (not of silicon) and without holes. I have the one with holes.
For an uterine prolapse our Drs fit in a small one and you have to insert it as high as possible. For cysto- and rectocele they fit in a bigger one, placed just a bit over the pelvic floor muscle. (That's the answer to Kam's question)
The cube creates a vacuum (it needs a bit experience to take it out, you have to turn it round itself and then squeeze it) and so it's held up high. I don't know, if it stays better in than a ring pessary, but most of the time I don't have problems with my pessary staying in place. So if you have some more questions, just ask, I hope I can help.
And I hope, someday I will need it just like you only when I'm working hard. Last week I tried a few days without the cube and just stayed in posture. It worked better than I have thought. But then I had to insert it for going - without my husband - to the playground. Since then I'm wearing it again, because I'm always afraid not to get through the day :-(. Shame on me, I'm such a scaredy cat...

Don't worry Butterfly, you'll get there. One of the biggest lessons I've taken away from this work, is not to fear the bulge. It gives you constant feedback and reminds you to work on posture and visualize those organs moving forward. - Surviving

Thanks for your description of the cube. I certainly understand the sense of security that using the pessary gives you. You said when you didn't use it and stayed in posture that worked better than you thought, so the more you develop the habit of WW posture - the more secure you can feel with that. And Surviving's right about not fearing the bulge. While on the one hand we have to be vigilant about posture, on the other we can't let a continuous consciousness of the bulge take over our lives. Before I read Saving the Whole Woman and got some understanding of how I'm made, I was in fear of my insides sliding out and having a messy crisis and a medical emergency. Sorry to be so graphic, but that's how I felt. It's just not likely to happen.

Do you have a helpful husband who is sometimes able to go to the playground with you? That's how I made it with four so young and close in age. It was a strange blessing that my husband suffered from a work injury and was off work (but compensated) during the critical year that babies two and three were born. Finally after giving birth to baby number four, it felt so much easier just not being always pregnant! We've had a pretty simple lifestyle, not a lot of social obligations, no grand estate to keep up...just making a reasonably clean and safe haven for the kids to grow in.

for your heartening words!
I know, I shouldn't fear the bulge... I'm waiting for the STWW book and as soon as it'll be arrived, I'll start again not using the pessary. That's my plan :-). I know exactly the feeling you described, Bebe (fear of my inside is coming out) and without the pessary I have also the constant urge to pee when I stand or walk (not when sitting or laying down) and that drives me crazy and takes my will to go on... But I won't let this happen anymore. Promised :-).

My husband is very helpful. When he's at home he cooks, plays with the children etc. He is the best :-). But he has to go to work, so I'm often alone with my kids.
However I now know I'm not alone and have someone to talk to, tell my fears and ask my questions. Thanks for that :-). No more discourage ;-).

Hi to all the ladies who are looking at pessaries as an aid for managing prolapse.

These Forums are full of women's accounts of using pessaries. They are sometimes useful, most often for primary cystocele. A pessary may change the configuration and position of your organs. It will hold tissue back somewhat if positioned where the bulge is.

If you have had hysterectomy you might or might not have sufficient length of vagina to accommodate a pessary high enough to help.

Most rectoceles in women who have had no surgical pelvic repairs are low in the vagina, which is why they are so irritating in the vulva, and why the rectum kind of bunches up right at the bottom and won't allow complete emptying.

Most cystoceles tend to be higher. If you use a pessary high in the vagina it may hold the bladder back, but this often allows the rectum to come forward to fill the space in the vagina left by the bladder.

This is why we talk about mildly prolapsed organs being nature's pessary. Together they prevent each other from coming too far into the vagina. Prolapse means falling back or falling down. There is nothing wrong with the organs. They just get where we don't want them to be. ;-) This happens because the organs are more mobile after a pregnancy, after an extended period of constipation, and as a result of the menopausal transition which lessens the strength of connective tissue. Hence facial wrinkles! Yes, you get wrinkles on the inside too.

If you still think you want to try a pessary, find someone who fits pessaries regularly, and be prepared to go back several times until you get one that does the job you want it to do. You may or may not succeed. Depending on where you are on the planet, your health care system may or may not pay up the total of costs incurred in getting it right. Check before you embark on this journey, what you can get free or get a rebate on. Pessaries, except for sponges and home made ones, are only available from a doctor. Sometimes the fitting is done by an Assistant. Be polite, and be assertive when beingfitted. If you don't like the person's attitude, or you think they are putting you down or they are not not caring for you, chances are that they are not going to do the job properly. I suggest that you make a formal complaint and go somewhere else, so the next woman doesn't have to put up with unprofessional treatment. You are paying, either through your taxes or through your pay packet. Your body deserves a break.

Sponges for vaginal use can be purchased in many places. Jade and Pearl on the internet seem to be a popular supplier. They are quite inexpensive and easy to trim to size if necessary. They can be cleaned overnight in hydrogen pyroxide. Ask your pharmacist about appropriate dilution. The Jade and Pearl sponges come with instructions. You may need a lubricant if the sponge feels scratchy, or if you have a dry vagina from nursing or the menopause process.

Don't expect the earth from your pessary, but it might be a useful tool in your toolbox. Some women use them for many years successfully. Others simply cannot make them work.

Louise