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03-02-2014 01:12 AM
O/P I so share in your frustration. I badly want the pessary to work in order to avoid surgery.
My problem is the same as silverandgold, uterine prolapse, but like you I have probably tried every pessary in the inventory and they won't stay in for but a few minutes - and I have been fitted with various sizes. The only one that stays in for me is the one with the knob and that even came out once when I had a BM. But the problem with that one for me was the knob seemed to irritate the v@gina. Like you I have no problem inserting and removing them myself, however they want you to keep them in and not constantly remove them, probably because they damage or irritate the tissues too much. About six mos. ago I started having some incontinence if I didn't get to the bathroom as soon as I felt the urge. Do you have stress or urge incontinence, or both?
I consulted with the urogyn a few weeks ago and surgery does not sound promising for me at this time. I have asthma and cough frequently (which was a major contributor to my prolapse) so my concern was blowing all the surgical repair apart post surgery when I cough. The urogyn said that would be a concern. Plus like someone said above, and the urogyn confirmed, 20-25% of the repairs don't "take" the first time or further repair in needed after 1 year. So I am between a rock and a hard place. When I lose my patience with this, I plan to go back to the NP that does the pessary fitting and try again. I am hoping they will come out with some new and improved pessary. I have strong pelvic floor muscles and I do kegels, but my prolapse still progressed to the advanced stage.
The way my gyn explained it to me was that sometimes the bladder just needs to be tacked up if it isn't sagging badly, and a sling is not needed. But I don't know if that means that maybe later a sling might be needed. She said the mesh sling is made of nylon. But it seems like in your case kegels/exercises would really help and maybe you wouldn't need surgery. Wow, those pessaries sure are expensive. The ones I have taken home didn't cost me anything as they were covered by my medical plan.
Consult with a urogyn and see what they say. Good luck and keep us posted.
03-02-2014 02:23 AM
On 3/1/2014 noseycat said:My gynecologist tried either 2 or 3 pessarys on me and they were all very uncomfortable and I could not wear any of them. I just went ahead and had the hysterectomy and that ended all of my prolapse problems. I just wish I had done it sooner.
Everybody is different, but this seems to me to be the logical answer to the problem
I had a hyst years ago for fibroids so I know what's involved. They took my ovaries as well due to cysts, but if it's done for prolapse, the ovaries could stay so there would be no hormone loss.
I guess I don't know if child bearing is an issue, but I would think that with a prolapse, that would not be recommended anyway
03-02-2014 02:53 AM
I worry about this problem also as I have a large fibroid and feel pressure alot of the time. How did you ladies know you had a prolapse problem. I am hoping that my fibroid shrinks when I reach menopause which should be any time now that I am 53 years old. But as of now it is still large.
03-02-2014 03:41 AM
On 3/1/2014 dsky said:I worry about this problem also as I have a large fibroid and feel pressure alot of the time. How did you ladies know you had a prolapse problem. I am hoping that my fibroid shrinks when I reach menopause which should be any time now that I am 53 years old. But as of now it is still large.
If you have uterine prolapse it slips down the v. and in the later stages it actually protrudes out the opening and in some women that have weak pelvic floor muscles, it actually falls out. My gyn said that the uterus pulls the bladder down as well. If only the bladder is sagging then the symptom is incontinence.
03-02-2014 04:44 AM
03-02-2014 12:17 PM
My Mom had one for about 16 years until she passed away. She never inserted it herself or removed it herself. she went to her gyn once in 6 months for removal and cleaning and reinsertion. Occasionally, she would have some minor bleeding, then he would refit her for a new one. All in all it was a very positive experience for her, saved her from a hysterectomy which she did not want.
03-02-2014 12:19 PM
Can one have relations with the pessary in? Does it help that?
03-02-2014 12:27 PM
On 3/1/2014 dsky said:I worry about this problem also as I have a large fibroid and feel pressure alot of the time. How did you ladies know you had a prolapse problem. I am hoping that my fibroid shrinks when I reach menopause which should be any time now that I am 53 years old. But as of now it is still large.
I knew I had a uterine prolapse after my son was born. He is 25 yrs old now, but was a large baby 8 lb 15 oz & I had a vaginal delivery. But at first I did Kegel exercises & they worked well for awhile, but gradually at my gyn checkups, my dr would say the prolapse was getting worse. As you get older & estrogen levels fall, the prolapse tends to worsen. But, it was a condition, not a disease. I went to the uro-gynecologist he recommended & of course, this dr was all about a hysterectomy & major pelvic floor repair surgery - & using mesh which has many issues (another topic for another day). Without the uterus in place, nothing to hold the bladder in place. Anyway, I told him I didn't want surgery as he also said I couldn't lift more than 5 lbs for about 6-8 wks, because then the pelvic floor repair could be undone, I may need more procedures, etc. Also, he wanted to do an abdominal hysterectomy as I am small boned & he said not a candidate for the DaVinci procedure or a vaginal hysterectomy since he'd need the room to work on the pelvic floor muscles. Needless to say, I did a wealth of research (I was 53 at the time), work full time am very active & leading a sedentary lifestyle is not realistic hoping not to 'undo the surgical repair'. I opted for the pessary and it was the best thing I could've done.
03-02-2014 12:35 PM
On 3/2/2014 Milfy said:Can one have relations with the pessary in? Does it help that?
There are many different pessaries depending on the cause of the problem, your age, your lifestyle etc. I have a pessary for uterine prolapse, but I can take it out & put it back in whenever I want. You have to take it out for sexual relations and should take it out at least once a wk to cleanse with mild soap & water. Some older women have pessaries that a dr must insert & it remains in place til next visit etc. I don't even know I have mine in which is the way it should be.
03-02-2014 12:51 PM
Thanks for being so candid with me. I appreciate it.
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