problems with pessaries

Body: 

So I am over 60, newly divorced, have had prolapse start not long after the birth of my child and now my bladder is also bulging. I have no sypmtoms though, no discomfort except for embarassment of the situation if I were to strike up a relationship. none now So I decided to go to a specialist and see about surgery. When mentioning concern of surgery as I have heard a few women talk about their problems with mesh and prolonged pain afterwards. The Dr. confirmed that this can happen.. even when surgery goes very well - pain afterwards. So we decided to go try the pessarie route.. I have tried 3 different types of pessaries, none have stayed in for long.. am doing kegel exercises as well. My question I guess is do other women have difficulty getting a pessarie to fit and stay in? as I said I have no discomfort from my falled organs but Dr has urged that things could get worse and that pessarie is good to use for now.
What do any of you think about that.. no bothering symptoms.. I think I would rather do without, but also not crazy on things getting worse and having surgery and problems with mesh etc.

Dear Snowrabbit,
I am glad to hear that you do not have any bothering symptoms at this time. I am also glad you are trying to get more information about the condition many of us share. I am 62 years old and trying to manage my prolapse. Prolapse does not go away. However, you may be able to stabilize it, reverse it somewhat and make it manageable. Many women continue to have a satisfying sex life with prolapse. Many women also find it difficult to use pessaries. Whole Woman suggests using only the thin round one if you do use one. It would need to be placed high and vertically between the 2 vaginal walls. The upper part of the vagina is wider and the lower part is narrower. The positioning avoids creating a space in the vagina which could impact intraabdominal pressure and cause other problems down the line. Some women really have had good success with a pessary, many have not. My choice was to read Christine Kent's book and to try the posture and exercises she teaches. I have found that slowly but surely my symptoms have improved. I would urge you to further explore the Whole Woman website. You are not alone in coping with pelvic organ prolapse. You are not alone in wanting to find ways other than surgery to stabilize your condition. Good luck and stay in touch.
WholeWomanPA

Hi snowrabbit,
I am so pleased you haven't gone down the surgical route. Considering you have no troublesome symptoms that seems a fairly extreme option, with potentially long term negative consequences.
Re pessaries: Many women report problems with pessary use, for example tending to stretch the vaginal passage by putting in and taking out pessary and by the actual pessary in place and discomfort when pessary in place.. According to Christine's 'Saving the WW' book, thin pessaries such as the ring-with-support appear to suit women with cystocele or anterior prolapse best, with the pessary lying more vertically. This can lift the bladder slightly, improve comfort levels and allow the vagina to flatten almost considerably.
However I am wondering, with no symptoms, whether you need to use a pessary. If you follow the ww posture, exercises, diet and life-style, then your condition will almost certainly improve.
I also wonder whether your partner would notice anything at all about prolapse, especially if you're without symptoms. The pelvic organs are remarkably mobile and exist within a fluid environment. My impression from the forum is that it the women concerned who are concerned about sexual/intimate contact, rather than their partners. My impression is that unless the partners are told, they would most likely not even be aware of any problems. However, as with the whole ww approach, as with every aspect of life, ww posture can influence which positions are most suitable for prolpase recovery. A whole new area to explore!
I do recommend Christine's book and dvd's. The 1st dvd '1st aid for prolapse' explains the prolpase issues v. clearly.
All the best.
wholewomanuk

Hi there Snowrabbit - Concerned with this statement: "I have no discomfort but doctor has urged that things could get worse and that pessary is good to use for now." I realize these are your words, but it sounds like the doctor is suggesting that the pessary can help prevent things from getting worse. I've never used one myself, but these Whole Women have explained things well. A pessary is for occasional use to relieve symptoms. It isn't going to reverse your condition and could ultimately aggravate it.

WholewomanUK and WholeWomanPA have given you very good answers re the pessary. Your posture, and how you use it when doing things like lifting and emptying your bowel, is the most important factor in keeping your pelvic organs inside you. These two things generate a lot of intraabdominal pressure. Intraabdominal pressure is also caused by almost anything we do, including breathing. If your lumbar spine is straight intraabdominal pressure will cause your pelvic organs to move into your vaginal space. A good lumbar curve will 'hide' them from intraabdominal pressure, by putting a bend in your torso. They will be around the corner, out of harm's way.

Re new relationships, a relationship is just that. A relationship. It is between minds, hearts and bodies. Just remember that your body is more than simply a vagina. Men don't really notice much difference during coitus when a woman has prolapse. In all other ways you are the same as any other woman, and remember that many other women of our age also have prolapse. Go for it. Enjoy what life has in store for you.

Louise