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Pessary ring - any advice on pros and cons ?

Posted , 5 users are following.

lynne1945
lynne1945

hello, I am new to this group, although active on the Lichen Sclerosus one. My gynaecologist last week suggested my slight prolapsed bladder should be dealt with by a plastic ring. I hate the idea of this but I guess at age 70 I am not going to get on any hospital list in the public sector. 

I need to do something as my LS is enough to cope with without having urine leaking onto me which is beginning to happen. I wash every time I pee with soda bicarbonate rinses to prevent this burning. The prolapse is visible on standing but not on lying down.

So, the pessary ring? Any one had it and is it generally successful and would anyone recommend it? I have had anterior and posterior repairs in my 50s, I would prefer that again (obviously I would need to go private) but then my general health isn't all that amazing so it's maybe a risk.

thanks in advance ...

 

1 like, 15 replies

15 Replies

  • nannylin
    nannylin lynne1945

    Posted

    Hi Lynne I am 61 with LS and had a total pelvic floor repair in May. My gynaecologist said it was not possible for me to have pessary ring due to LS so surgery was the only answer. This was all done vaginally and my LS has been worse since the surgery. I am hoping it will settle. I am guessing you are in the USA or Canada so your health system is different but I think I would push for surgery again rather than a ring unless it is dangerous for you to be put under ( maybe it could be done with a spinal block ? Good luck
    • lynne1945
      lynne1945 nannylin

      Posted

      Thanks Nannylin

      Well, that's given me something to think about! I don't like the thought of the LS being aggravated. Actually I am in NZ, my gynaecologist (hospital visit, so free, but no frills if you know what I mean) who is treating me for my LS didn't even hesitate when advising the pessary ring and now I am torn. I don't think she's the one for me somehow, we had no rapport, she brushed my questions aside and was annoyed I had gone armed with these questions I had got from on line sites such as this. 

      I already plan to go out of town to another city an hour away to seek a dermatologist specialising in vulval health, so I think another gyn doctor may be in order for the bladder thing. 

      My general health was pretty good but my system has been knocked about by being diagnosed with 3 chronic health conditions including LS in the last year and my anxiety and depression taking its toll to my overall detriment. Trying to overcome that!! 

      Thanks so much for your input, and hope your LS soon settles down!

    • lynne1945
      lynne1945 nannylin

      Posted

      Hi Nannylin

      i am wondering how your LS is now? You are the only person who seems to be in same boat as me as regards LS and bladder prolapse. That is, contemplating surgery as appossed to a pessary while having active LS. I have been doing lots of research and there is available now a keyhole surgery Technique, but not sure if available in NZ .. I will try and find out soon. The idea of vaginal surgery makes my toes curl and an abdominal wall cut just seems extreme, at my age anyway. 

      wishing you well

      Lynne 

    • nannylin
      nannylin lynne1945

      Posted

      Hi Lynne what I forgot to mention is I also have Lichen Planus which affects the inside of my vagina. It's like I have been burnt it very sore and red raw, walking is very painful. The surgery seemed to affect that (although not at the beginning) and I think I have fused more but I put that down to being less mobile for a few weeks. I am keeping an eye on it as I am worried in case I fuse and can't pee. I've got an appointment with my dermatologist in a couple of weeks so will see what she thinks ( she takes photos so can compare to see the changes) I think any stressful situation affects LS & LP so I was half expecting problems even though the surgery didn't worry me. Our bodies react in a way we have no control over. I also have Crohn's disease which is an autoimmune condition so it's all a juggling act. I wish you well x
  • kathleen61417
    kathleen61417 lynne1945

    Posted

    I to suffer from LS, but not at the moment. I also had a ring for Cystocele and rectocele, but suffered infections. I was duped into having a TVT for cystocele and presumably the rectocele was stitched but unfortunatley the Specialist cannot even tell me how he repaired it as my records on this surgery were sent off site and went up in flames the next year. I will advise against having polypropylene mesh surgery as my health has suffered a lot since and in much pain. I too am 70 and it looks like I am going to be faced with serious surgery in trying to remove it. In England there are only two specialists who have experiance in removing mesh, so don't be fobbed off with a mesh TVT or similar. I think being sterilised caused me to end up with cystocele and rectocele. What they do not inform you are problems that can be caused by some types of surgery in the UK.
    • lynne1945
      lynne1945 kathleen61417

      Posted

      Kathleen, I am so sorry to hear about your troubles with the mesh! I have never even heard of it, but then I am on the beginning of my journey to find out the approach I may need in the time to come. I have pretty much ruled out the pessary ring due to nobody liking it and all that in and out and cleaning and infection risks. Ouch! 

      Surgery isn't to be taken lightly at my age. My prolapse is small but will worsen and I already get dragging aches in the afternoons. Am trying some pelvic floor exercises but no physio so have no idea if doing it right! 

      Thanks for your reply, I do hope things work out for you soon! 

      I think MY problems started when I had babies that weighed 9 and 10 pounds 40 years ago. 

    • kathleen61417
      kathleen61417 lynne1945

      Posted

      My poor Mother as I weighed in at 10 pounds. They might call it a sling or a hammock, but they are the same thing and made of polypropylene mesh and think of the chemicals they have used in making it. They fix it in place  by using skewers which they insert blindly up through the groin and end up with a hole either side of the abdomen. Just imagine the harm they do in an area rich with nerves. Some models are placed slightly in different positions. The problem is they cannot easily be removed so remember to ask if the surgeon is experianced in removing the mesh they put in if it causes harm. If too you have an autoimmune condition  ones body is bound to suffer as plastic is an intruder made from chemicals. This mesh can also stick to internal organs and impossible to remove.

      There have also been legal cases in USA regarding problems caused by this mesh and one of these patients has now died. Scotland has managed to get this type of surgery suspended. Don't be fobbed off by Doctors. I believe there are such things as Kegal exercises.

      Bare this in mind too that companies use bribes to get Doctors to use their products be it drugs or medical devices. Go for the exercises its far safer.

    • lynne1945
      lynne1945 kathleen61417

      Posted

      oh Kathleen! Rest assured I would never go near the procedure you describe, that's terrible what you have had to bear.

      I really have had enough procedures already in my life to this area, next time I come back I want to be a man! Or do I, maybe not! :-)

      I had a cone biopsy for stage 3 precancer at age 31 which removed most of my cervix, then 6 months later a hysterectomy. Then two repairs in my 40s and 50s, one was a double repair, anterior and posterior. I wonder now if all this fiddling about with my down belows  has given me the propensity for the  

      lichen sclerosus....

      It's pretty painful right now and the thought of any more anything is depressing, but the pessary no, and the mesh definitely no. 

      Thanks for all your feed back.

    • kathleen61417
      kathleen61417 lynne1945

      Posted

      I  think you are right that surgery in that area leads to Lichen Sclerosus, as I know somebody else who got this after mesh removal. Did the Specialist by any chance say that he did not know the cause of Lichen Sclerosus. Now we do at least know, but they would want to conceal it.

      You have been through a lot.

      If I end up having mesh removal I will clearly become incontinent but I will not go through further surgery. At our age surgery may not always go well. I would sooner wear padding.

      Men do indeed have things easy.

  • nickie54687
    nickie54687 lynne1945

    Posted

    Hi Lynne,

    I am 71 and am 10 weeks post hysterectomy with anterior and posterial repairs.  I do not however have LS.  You asked about a pessary.  I would highly recommend against it.  My sister was not allowed to have surgery and had a pessary inserted.  It worked but she had constant infections.  After one year, she had it removed.  She said she preferred a diaper (she uses a pad!) to having a pessary.  I am in Canada and I think our health systems are similar.  I would certainly go for the second surgery - done vaginally.  It's not without pain but the gains are great.  I would definitely recommend you get only a uro-gynacologist to do the surgery though.  They need far more training, are normaly more available post-op since they don't have patients of their own usually, and so if something crops up, you can ask right away.  Have to say though, that my only complaint is that they don't tell you what might occur after so for instance, I had dreadful constipation which I didn't know is common plus leakage which I had never had. before. Both cleared up after about 4-5 weeks but this forum gave me my sanity.  We are all here for each other.  Having blathered on, I would say it's only my personal opinion and you need to think what is best for your own case - in conjunction with a doctor with whom you have a good rapport. I still have issues and am seeing the surgeon for the 3rd time next Thursday.  But with all that, I would do it again in the blink of an eye.  I have a life again.

    I also suffered from a clinical depression some 38 years ago but it still feels like yesterday.  I got help with that and dealing with the accompanying physical issues I was having at the time went a long way to helping as well.  It took 3 kinds of medication before the depression started to lift but you can't just hope it will go away.  You need help with that as well.  I have had no recurrence of depression since.

    I will say prayers for you - many of us keep each other in our prayers.  I hope this doesn't offend you.

    Good luck in any decision you take and keep us posted.  We do care.

    Nickie

    • lynne1945
      lynne1945 nickie54687

      Posted

      Hi Nickie and thanks for your support. Funny thing, your post says it's been here three days but it actually only arrived a few hours ago so I wasn't being rude not replying 😀 it was held up for some reason.

      I have definitely decided against the pessary. And because of my LS I couldnt bear the thought of the vaginal route at the moment! Am doing exercises and crossing fingers it doesn't get worse. Yes, bowels and the non functioning of them is the biggest issue with prolapse I am sure, before and after procedures. I have been constipated all my life and having to take all sorts of stuff and even my IBS was of the constipated type and not the other sort! My poor lower regions have been put under a lot of strain and my babies were big as well! 

      I'm so glad your op was successful and your problems after resolved. It does give me hope that my age isn't against me as we are the same, and you coped! Am not sure if our not very big city would support a uro/gynaecologist specialist. I will see.

      I don't mind at all your prayers and it wouldn't at all ever offend me! Makes me feel very supported and I thank you.

      ps I am getting help with the mental health issue, it was all too overwhelming to deal with alone (I have a lovely husband but he can't really help, feeling as helpless as me about the recent health woes)  and I have excellent people here who help me including a nurse and counsellor, and today I went to a naturopath and spent a lovely hour there and came away with all sorts of supplements including iodine and colloidal minerals as my energy levels are almost nil. Stress and anxiety are debilitating.

      thanks again Nickie and get well soon x

    • nickie54687
      nickie54687 lynne1945

      Posted

      Hi Lynne,

      For some reason, I got a notification that my reply was being "examined" for suitability - that's why the time delay in your getting it.  I am so happy you are addressing all your issues including getting outside assistance with the mental heath issue.  It takes time to overcome but is much more debilitating than anything else we are dealing with - been there, done that.  I think this reference was why my reply was held up!  In some areas of the world, the mere mention of this disability is one of weakness and not illness.  How very wrong.  But all attitudes take time to change.

      I am sorry to hear that there may not be a uro/gynaecologist in your city.  These are the only surgeons I would trust to attach a mesh properly - did much research before surgery.   We only have a few in a city of a million people but it would be nice if you could find one.  At 71, we are not old.  I work in a retirement home where the average age is 88 - and there are 192 residents!  At least there, I am the "kid" at the desk.....

      I must say if your prolapse is bearable, I don't blame you in your decision not to have anything more done vaginally.  Enough already for you I guess.  It is too bad because before and after the surgery is night and day.  I do still have one issue being looked at by my surgeon on Thursday and it may lead to further surgery (absolutely nothing to do with the mesh by the way).  But if so, I have every confidence it will be successful.

      I am happy you appear to be more upbeat now than when you first posted.  I do know I would have gone mad without the support of  others on these sites.

      Take care and I will continue to keep you in my prayers.  Feel well.

      Nickie

  • karen41728
    karen41728 lynne1945

    Posted

    Hi Lynne

    Did you have colposcopy years ago for precancer just thought I saw it somewhere

    Only I did and now have lichen planus both in mouth and vagina I think there connected

    • lynne1945
      lynne1945 karen41728

      Posted

      Hi Karen

      I had a cone biopsy 40 years ago, I had stage three pre cancer and most of my cervix was removed. I don't have LP and I seemed to recover well from it and have had yearly Pap smears to vaginal vault every year since. But funnily enough, I do, in retrospect, date my first problems with LS back to after I had prolapse repairs done vaginally about 15 years ago, where I felt as though the surgeon had scraped me or burned me on the labia near vaginal entrance. It always irritated at times over the years and latterly has worsened. It took several GPs and gynaes not diagnosing it till a year ago when LS was found to be the cause. It's still the major symptom I have, that lesion, plus the disappearing of architecture and burning of my whole labia. You could well be right about the connection. All that fiddling about with babies and repairing prolapses and having Pap smears and so on. Next time I want to be a man! 

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