new pessary

Good potty news is crucial and good on you. It is also good that you are finding the pessary helpful. I understand your dilemma when your work requires you to be on your feet all day and lifting babies. I found I could control my prolapse more when I had a stationary job, but I am an active person and after many years of that, I yearned for work that required me to be walking on my feet all day. This was before I discovered WWposture. I can’t say it made my prolapse worse, but I certainly did not receive the relief that sitting down provided, and lifting (according to approach and weight) could quickly undo any improvements I did make.

Actually, on baby lifting you could be a good resource on the “how” for young mums especially, apart from other day to day things, if you had the time.

Now that you have had time to master WWposture a little, then the addition of the pessary should hopefully prove added support so that you can remain on your feet with your prolapse in a better place, but please don’t forget WWposture for it is working silently all the time to strengthen muscles and hopefully to the extent that when you are in a position to be less demanding of your body, you won’t need the pessary.

For at age 66 with many years of severe prolapse I can honestly state that things have improved much for me, so if an old girl like me after years of neglect can, etc etc.

Christine talks about pessaries in “Saving the wholewoman” p 115. I think you will connect with what she has to say.

Best wishes, and well done brave lady, Fab

Having not worn a pessary, from what I can make out Christine says that the flipping vertically of the pessary is it conforming to the natural axis of the vagina and that a thin pessary such as the ring-with-support will allow the vagina to flatten completely, and this is a better situation to be in rather than where the pessary holds the upper vagina open and pressures the rectum.

Maybe, you could edge one side in first and then the second side, rather than all in and then let go?

Sorry I have no knowledge here.
cheers, Fab

Hi Angee,
I have seen several Drs. to try and get a pessary fitted that would work for me and I am afraid that none that were tried worked. One Dr. said that the ones he tried flipped up because of the weight of my prolapse {Uterus} and that made me pee all the time so had it out. It sounds like you are having the same problem with it flipping although you are not getting the bladder problem from having it in.
Hope you find some relief soon, does it have a knob on it? If so they have to be turned after inserting it.
Daphne

Hi Angee

Are you sure you are putting it in the right way around. I know that it does my head in, doing a self-exam, and trying to figure out whether I am feeling the back or front vaginal wall.

If you have the folded pessary in your fingers, are you sure that you are putting it in the right way around, so that it unfolds in the correct direction? It may be designed so that the bladder pressing onto the fold will make it go flat, whereas if it is unfolding in the wrong direction the bladder may push the bend outwards and leave it bent. Just a thought.

Hi Angee,
After trying exercises for years, I finally gave into a pessary at age 58. What a relief it is. I wonder why I didn't do it sooner. I guess I think exercises can fix most things. I am using the same ring as you have.

I am having the exact same problem as you are. If it could just stay horizontal it would be perfect. I went back to my doctor, who is so patient. She showed me different versions, but I choose the next size up ring. It seemed fine in the office, but later in the day it also went vertical. Since it was bigger it hurt later in the day. It must have been hitting the back wall. I think it hit a nerve once in awhile. It also hurt when I removed it because of the larger size springing open.

I went back to the small size, which is fine until later in the day when the parts seem to be heavier and it starts its journey down. I usually end up taking mine out about 6:30 or 7:30. Always a relief, but I wouldn't do without it now.

When I go into the office they do an ultrasound to see if my bladder is empty. With the pessary I can totally empty it now, which is so great.

Also, I asked if there was an up or down to the ring and she said no. I usually hold it so the curved parts is up and slips in. That is easiest for me. Turning it a quarter turn is awkward. I try to get my finger in one of the large holes and pull that around. It usually works. You can tell if it turned it the little hole is where the bigger one started out.

I'll be interested to see if you find something that works in a different way. When I go back I may try another one.

duplicate post

Hi jh - can you elaborate on how you tried exercises for a year? Do you mean that you tried WW posture for a year? This is way more than an exercise program, it's a change that you make every waking moment of your day. - Surviving

I was fitted for a ring pessary 2 months ago. Before I left, my UroGyn had me insert it to make sure I was doing it correctly. The need to do 1/4 turn of the pessary after insertion depends on where the knob is located when folded. One of my pessaries folds so the knob is on the side and another folds so the knob is along the fold line and enters the vagina last. The one with the knob on the side when folded needs the 1/4 turn so it fits on the pubic bone.

I know when it is in well and when it is not. It almost pops in place. I only use it a few hours a day while exercising. It just makes me feel more secure and takes away that bulging feeling. It will slip, however. I'm sure that is because the vaginal walls are no longer strong. I have Grade 1.5-2 prolapse of everything! I am 47 and still get my period, so I don't have a lot of tissue irritation.

My doctor said if it is properly inserted you won't know it is there. I find that comical based on the size of the thing. But, I don't think about it when I have it placed well so I guess she is kind of right. After a few hours I want it to come out because I do start to notice.

Personally, I would call and make a quick appointment to be instructed on proper use and/or fitted for another. I have had 4 different rings placed before we settled on this one. I kept the 3rd one because it did work fine but is a size smaller than my current one. If the MD isn't available, then see if they have a nurse practitioner to help.

I first noticed the slight prolapse in 2008. My doctor told me to do kegels, which didn't work. I do yoga and the warrior poses really helped pop the bladder back in place. I'm still working on the WW posture. I'm always working on my posture. I do the Habit DVD faithfully, in addition to yoga and tai chi to help strengthen my entire core. December 2012 I finally gave in to the pessary. It dropped so much by early evening I couldn't void anymore. It is so nice to wear jeans again (they used to make me bleed a little) and to do floor yoga that used to press on my bladder. I really wanted the posture and the exercises to work. I still continue to do them, hoping.

I was told to be sure to take out my ring with support before having sex. I can see where it would hurt if you didn't.

Hi Angee

I am sorry to hear that your initial consultation was cut short by someone else's emergency. These things happen sometimes. I think they owe you a freebie for not finishing the first consultation before they dashed out. so, do go back and explore it further (and hope for no emergencies).

As a general comment, there are quite a few different types of ring pessaries, and I have now learned that there are several types of ring with support! All ring pessaries will eventually end up vertical, because the vagina is a flattened tube, except at the top where it opens out to be kind of H or X shaped, because of where the thickened sections of fascia that attach it to its surroundings to stabilise its position, are joined to the vagina. Not very good grammar. Sorry.

It would be helpful when talking about your pessary to have a look at a site like http://www.sayco.net.au/Sayco_pessaries.html to identify the type of pessary you have. Another site is http://www.aafp.org/afp/2000/0501/p2719.html , which lists different manufacturers as well. It is useful to know about different types so that you can talk in an informed way to the doctor who fits it. There are many different types and subtypes, some of which may be more effective than others. The most common ones are the ring types or the donut types. Ring types are usually more useful for primary cystocele, while the donut types are generally more useful for women who have had hysterectomy, because they occupy more volume, ie they are more like nature's pessary (bladder + uterus + rectum tethered together) It is more difficult to get improvement in prolapse where rectocele is a major factor because a rectocele is usually low in the vagina, and difficult to hold back. If a woman can eliminate constipation and use Whole Woman techniques to reposition her bladder and uterus, and drag the rectum up and in with them, then the rectocele may cease to be present for most of the time.

However, if the bladder and uterus move forward and up, and the rectum follows, there is little point in having a pessary at all! ;-)

If you look carefully at the diagrams that show how they sit it is easy to see how they would slip down, and it is easy to see how changing the posture so that the pelvis is tilted more forward, changes the orientation of the organs, *and* the pessary.

Louise

I had read Christine's book before I got my pessary and already figured I was going to be using it vertically. Then my idea was to get one as small as possible to support the cystocele without slipping down too far and to not stretch me more than necessary. When mine slipped before I left the doctor's office, I kept my mouth shut and said it was just fine. I did not want him back in there trying to make something bigger work! I've used the same size for nearly three years and, because of the unavoidable stretching, have been considering another type. Really, that's why I'm back to trying to stick to the WW program again. I believe ultimately it will work better than getting larger and larger pessaries. On one hand, the pessary has worked better and for a longer time than I thought it would. On the other hand, if I had stuck to the program in the first place, I would have been in way better shape by now.

My experience has been similar in wanting to take it out in the early evening and the accompanying relief. If I'm not ready to take it out and it feels too heavy, I just lie down for a few minutes. It has helped with better emptying my bladder, and it has given me enough support to feel more secure while I'm working. Many days I don't use it all so that when I do use it there is some irritation. Still, I'd rather have some irritation than total dependence.

There is always a trade off, whatever decision we make.

"On the other hand, if I had stuck to the program in the first place, I would have been in way better shape by now. "

Maybe? Maybe not? All this thinking is a way for you to cope with what has happened to your body, to integrate it, and to make decisions on how you will proceed from here. We can only deal with what is in front of us at any one time, and with the information and tools we have available to use.

Whether the decision taken at the time was good or less than wise, doesn't matter now. All that matters is that you find out what you can, do what you can, and on the basis of that, realise that you are doing the best you can for your body. Give yourself a pat on the back.

BTW, that late in the day heaviness is our body giving us a sign to slow up. A little lie down late in the afternoon can be a lifesaver, (as long as we leave out the bit about the Bex).