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.

 

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

Pessaries And Non-Surgical Options For Prolapse Treatment

Pessaries and Non-surgical options for prolapse treatment

I always wanted a large family.  After giving birth to and raising 4 children, I think I’ve pretty much fulfilled that dream.  My family is everything that I expected it would be.  What I never expected, however, was to have a prolapsed bladder.

I discovered it when I turned 63.  I had a feeling of heaviness “down there” for a while, but didn’t really think anything of it. I experienced a few accidents in the months before my birthday but thought they were just that – accidents. I was wrong. I went to the doctor for my usual check up, tried to explain what I was experiencing, and he told me I may have a prolapse. Prolapse is when the muscles supporting your bladder, rectum and uterus weaken. This weakening can cause your organs to fall into or through the opening of the vagina. This can happen to any woman with or without vaginal childbirth, but women who have had strain on their vaginal muscles (ahem, birthing 4 children) are at greater risk. After an examination, my doctor diagnosed me with a cystocele, or a prolapsed bladder.

At first I was horrified – the thought of an organ protruding, even slightly, sounded appalling.  What would this mean?  How would it affect my day-to-day life? Would things progress to a level greater than what I was already experiencing? ? 

Luckily for me, my prolapse is mild.  My doctor told me that as long as my symptoms were not causing me much harm, surgery was likely not necessary.  Some pelvic organ prolapse (POP) will improve on its own through watchful waiting, although my doctor said it is not possible to identify whose POP will improve with time. A common treatment option for those who do not want or need surgery is a pessary.

Pessaries are silicon devices that come in a variety of shapes and sizes and are placed in the vagina to provide support to the pelvic organs. Because each woman is different, the pessaries need to be fitted to the individual.  I decided to give it a try and was fitted three different times before the final size was decided.  I’ve had it in for 3 months so far and it is comfortable and seems to be treating the feeling of heaviness I had been experiencing very well.  It does require some upkeep and needs to be removed and cleaned on a regular basis, however this is easy to do and even if you have trouble, you can have the pessary removed and regularly cleaned by your provider. 

In addition to my pessary, my doctor also prescribed a vaginal estrogen.  This helps lubricate the area and reduce the risk of irritation or ulceration.  It also reduces the risk of getting a urinary tract infection.

Never in a million years did I think this would happen to me – I didn’t even really know it was possible to be honest. But thanks to my pessary, I’m able to easily manage my symptoms and live my life the way I want to.