What Is A Pessary And Do I Need One?

What Is A Pessary And Do I Need One?

If you have incontinence, or a pelvic organ prolapse, you’ve likely heard the term “pessary” tossed around at some point.  Pelvic organ prolapse is a condition in which your pelvic floor becomes weak or compromised – sometimes due to age, sometimes due to trauma (like childbirth), causing one or more of your pelvic organs to collapse into the vagina. Pelvic organ prolapse can be mild, or severe, and symptoms can vary greatly depending on the severity. Some women may not even realize they have a prolapse until later in life.  Symptoms can include pressure or a feeling of heaviness in the vagina, incontinence, or even pain.

While some women can see big improvements in their condition with physical therapy, the condition cannot truly be “fixed” without surgery.  But, it is possible to manage pelvic organ prolapse by using a pessary. 

A pessary is a medical device, typically made out of silicone that is placed in the vagina and is used to support the pelvic floor, and the bladder, uterus and rectum.  Pessaries are not a one-size-fits all type of device. Everyone is different so your doctor will usually fit you for one that works for you. This may take a few tries, so don’t get discouraged if the first one you try doesn’t feel quite right.  Just be open with your doctor and work with them until you get the right fit.

Once you’ve found the right fit, your doctor will train you on how to insert and remove the device.  You’ll also learn how to care for your pessary, which will require weekly or biweekly cleansing.   

Pessaries can be a great solution for women with pelvic organ prolapse, or bladder incontinence, who don’t want to consider surgery (or are not quite ready for surgery yet).  It works by “holding up” the organs that may have collapsed into the vagina, relieving many of the side effects of a prolapse, such as the feeling of pressure or heaviness in the vagina, or incontinence.   

If you think you may be a good candidate for a pessary, talk to your doctor. They can review the pros and cons and help get you fitted for one.  It’s a great option for those experiencing symptoms of pelvic organ prolapse, and can provide great relief without undergoing surgery.

 

Life After Leaving The Closet

Six months ago I announced that I was ‘coming out of the closet’ regarding my health issue with Pelvic Organ Prolapse. Today I’m back to share how that decision has improved my life.

After dealing with POP symptoms for what seemed like an eternity, I finally decided to seek answers to my questions concerning this health condition. It took a fair amount of courage to face the fact that I needed help. It wasn’t an easy decision by any means because I tried to tell myself it was just part of the aging process and I would just have to ‘deal with it’ the best I could.

I’m here to tell you, that isn’t the case. No woman needs to suffer in silence or hide their health issues in a closet. I totally understand how reluctant some women are to talk about or be treated for this health issue. I grew up in the era when women’s health issues weren’t openly discussed among peers, but were generally relegated to a dark closet. However, times have changed and although some may not know it, there is hope and help for those who suffer with this malady. New treatment options occur on a daily basis that allows women to control, improve and repair this cryptic health condition. It’s time to openly discuss women’s health issues.

Although I tried to keep up with a daily exercise program prior to surgery, it became difficult because of the pressure and pain I was experiencing. Because of this I gained an extra 15 pounds in a very short period of time. It was a very depressing time for me. But, after the brief recovery from surgery in January I was once again able to exercise and follow a simple diet that resulted in my losing 22 pounds by mid-March.

My life today is one-hundred percent better than it was prior to my surgery. I can go for walks, out to dinner, and shopping without having to worry about what might happen.  If you suffer from Pelvic Organ Prolapse I encourage you to not hide in a closet or allow it define how you live your life. Take charge of your health. After all, there is a better life after leaving the closet!

Betty Heath

Did you miss Betty's original article about her surgery? Read it here!


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About The Author:  Betty Heath lives in Colorado with her husband. She is “retired from work, but not from living”, and has a weekly column called “As I See It”, which appears each Sunday in the Longmont Times-Call, owned by the Denver Post. She enjoys writing, cooking, gardening, and quilting. Betty also volunteers in the St. Vrain Valley School District, helping students learn how to write from their heart. For the past six years, she and her husband have volunteered as Santa and Mrs. Claus for the Holiday Festival in the Carbon Valley. You can read more from Betty at her blog, The Rejoicing Soul.

Prolapse After Pregnancy – It’s Not Your Fault.

Prolapse After Pregnancy - It's Not Your Fault.

Around 6 weeks postpartum, I had expected to feel a bit more like myself.  I had avoided exploring anything in the vaginal area for fear of what I would find, but had felt a general heaviness since I had given birth.  Not knowing for sure if this was normal, I made an appointment with my doctor to get checked out. 

Upon examination, my doctor confirmed that I had a prolapsed bladder.  His tone was nonchalant, as if it was totally normal and something that just happened sometimes. 

I was completely shocked. What had gone wrong?  And why did I never hear that this was a possibility?  I immediately started blaming myself.  Why had I not done more kegels during my pregnancy?  Why didn’t I do more research to know that something like this could happen?  Did the decision to use a vacuum during the last bit of pushing influence this?  What could I have done to prevent this?

But the truth is, some women really are just more susceptible to prolapse.  While a prolapse can occur for many reasons, some women have more of a genetic risk for the condition due to the strength of the connective tissues.  It’s not your fault. 

That being said, there are some things that may help you either avoid a prolapse, or at least improve your symptoms if you have one.

How to improve symptoms of pelvic organ prolapse

  • Maintain a normal weight.  If you are overweight, you are more susceptible to a prolapse due to increased pressure inside the abdomen. 
  • Avoid constipation.  Becoming constipated can cause you to strain during bowel movements, increasing the chance of a prolapse.  Ensure you are eating a high fiber diet and drink plenty of water every day.
  • Keep active.  A regular exercise plan keeps your weight in check, and also helps promote healthy bowels.  Be sure to include your pelvic muscles in your daily workout routine too.
  • Avoid extra pressure inside the abdomen.  Things like lifting heavy objects, and chronic coughing, create persistent pressure, which can increase the likelihood of developing a prolapse, or making your symptoms worse if you have one.  Stay healthy and avoid strenuous lifting. 

Whatever you do though, don’t blame yourself for developing a prolapse.  Instead, use that energy to find out what you can do to improve your symptoms and treat the condition.  Talk to your doctor about your options, and find a qualified physical therapist to help you learn how to strengthen your muscles to improve symptoms.

ASK THE EXPERT: Is It Safe To Have Sex With A Vaginal Prolapse?

Is it Safe To Have Sex With A Vaginal Prolapse?

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: Is it safe to have sex if you have a vaginal prolapse?

Answer: Yes! A prolapse occurs when a woman’s vaginal wall weakens and collapses, causing the uterus, rectum or bladder to fall into the vagina. However, in most cases, it is completely fine to have sex as long as the woman feels comfortable.  And, having sex when you have a prolapse will not cause any harm to the bladder, rectum or uterus, nor will it make the prolapse worse.

Some women with a prolapsed organ may feel some slight discomfort during sex. Using lubricant can help, as well as ensuring your pelvic floor is completely relaxed before you begin. Trying other positions may also alleviate any pain you are experiencing too. Talk with your partner about what feels best for you.

Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Contact us!

What Is Bladder Prolapse And Why Does It Happen?

What Is Bladder Prolapse?

Bladder prolapse is when your bladder is no longer being held up in its appropriate location in your body by the muscles around it. For some women, bladder prolapse can feel like a heaviness above their vagina, and for others, the bladder is actually resting or ‘leaning’ on the vagina. The condition can be very mild (some women may not even realize they have it), or they can be very severe. If left untreated, many women may see an increase in symptoms such as incontinence or pain as they get older.

Prolapse can occur for many different reasons. The most prevalent is in direct result of pregnancy and childbirth. During pregnancy and childbirth, the women’s organs are shifted around in their abdomen and are often pushed to make room for the baby.  The pelvic floor, which typically holds up those organs, is now helping keep a growing baby hoisted healthfully above the pelvic bones and the reproductive organs. Childbirth exacerbates the pressure and trauma those organs and the pelvic floor withstand because of the sheer force needed to birth a child. This all results in the pelvic floor being very weak and overworked.

When the floor can’t withstand any more weight and pressure, the organs it supports begin to prolapse.

There are many options for treating a prolapse. Physical Therapy can do wonders for women with this condition. In addition, management tools, such as pessaries, can help ease many of the physical symptoms of pelvic organ prolapse. And, if none of these options do the trick for you, there are surgical procedures that can help correct the issue (read about this woman's journey to healing her pelvic organ prolapse.)

If you think you may be experiencing this and want to learn more, go here for more detailed explanation and suggested treatment options