New to this: So many questions: so little time (cystocele)

Hi Joan,

Wow! I can't imagine wearing a donut pessary for a full year, but I will now certainly add you to our list of women who have had success with them.

The sling is not going to correct your cystocele. It will hold the neck of your bladder at a higher angle to correct any incontinence, which you don't mention experiencing. Many women believe there is a surgery that holds the bladder itself in a sling, which there is not.

Yes, it is possible for a major portion of the bladder and uterus to bulge outside the vagina. To my knowledge, we have no women here with that degree of prolapse, nor women whose prolapse has worsened after beginning the postural work.

It is the shape of the spine that pushes the organs forward and keeps them more horizontally positioned within the pelvis, rather than vertical where they can fall down. I just have no way of knowing if this will absolutely work for you, Joan. All I can say is that women are stabilizing their cystoceles left and right with this work, and also realizing that managing prolapse in this way far outweighs the many post-surgical problems that occur, including subsequent cystocele.

If you keep your appt. with the surgeon, send him to wholewoman.com!

:-)Christine

>
>Would having a pessary put in help, hinder, or make no
>difference in doing the exercises, posturing, etc.? After one
>year with it in, I rather like not having it.
>
>Joan

I too am interested in the answer to that question. I just got my donut pessary and am thrilled with it. But I probably have more severe prolapse than you do. I was going to begin the posturing/exercises also. I am sure it won't hurt, and it will still help, but I am interested in Christine's answer to whether it will make any kind of other difference.

I read the comment that a pessary caused rectocele, and I also have discovered only in a couple of short days that my pessary can be positioned differently within me. So my conclusion is that there are right ways and wrong ways to wear a pessary, and there must be ways to avoid the negative results such as it blocking stool. Once yesterday I felt I had to defecate but it felt to me the pessary was "blocking" something so I removed it to do my business. But the other times I have gone and the pessary actually made it easier to get the stool out. So I think there were slight positioning differences, and also perhaps differences in the hardness or shape of the stool. For this issue, I intend to actively manage my stools and not allow the pessary to do more damage to my tissues.

As for your pessary having been in place a year, I too am shocked because all the information I've read admonishes doctors to keep such patients on regular followup. They are to inspect your tissues for erosion, infection, ulcers, etc. And they should do that. But then you could look at it another way; think about all the artificial, plastic things they surgically implant into people and leave forever. Heart valves, shunts in brains, pins in bones, and so on. You can think of a pessary as a permanant implant that simply didn't need surgery because you've got the handy vaginal opening. I know, it's not the same; the pessary is routed to the outside and so infection is possible, and it can move and exert pressure and so damage is possible, but you can just think of the concept of implanting an inert object as really not an unhealthy or bad thing. We do it all the time.

Anneh

No message

I think the pessary is a very individual choice, since it seems to work much better for some women than others. It's interesting that Joan wore a pessary for an entire year for a newly diagnosed cystocele and still this was not enough to affect any real change in her condition once the devise was removed.

It is my unshaken belief that the best we can do once prolapse shows up is to draw the entire musculoskeletal system up and over the pubic bone, affecting the placement of the organs to a greater or lesser extent - depending upon the structure of the woman to begin with. I don't believe wearing the pessary while exercising or doing the postural work will have any negative effect, and if it makes you feel better and more in alignment - great! For me, it just pushes my bowel and bladder around in odd ways and makes me leak urine. There is the longer term issue of holding the upper vagina open to intraabdominal pressure, which could indeed force the rectum against the back vaginal wall. Just keep an eye on it. The last time I removed my pessary (three years ago?) I had to dig it out from a bunch of tissue that was surrounding it from the back, something that was very different and worth noticing. I never put it back in and did not go on to develop a permanent rectocele.

As I have always maintained throughout the surgery/no surgery debate, I think we need to keep in mind the woman who has sustained an unusual amount of damage through obstetric practices versus the one for whom the organs come down slowly over time. Surgery to correct real and serious damage may be preferable to overwhelming symptoms that will not resolve in these ways. These are the finer points of the issue that can only be ironed out over time.

Christine

Hi all

I look at it this way. You can try postural changes, pessaries, exercises etc first, then opt for surgery if you have no success with christine's tricks.

If you opt for surgery first up, you cannot go back to the body you had before and try the alternatives on an unaltered body.

That is why I am giving all Christine's suggestions a fair go. It is only a few months difference if you do go for the surgery after trying Christine's tricks. I know which I choose as a first option!! And I have experienced significant improvement with Christine's tricks, so surgery is now officially off the agenda for the time being, I hope for ever.

Good luck with your decision making.