I don't know how pertinent my experience is to this case. I have a prolapse of the uterus and bladder, with the vaginal wall bulging out of the vagina. A pessary was working well to hold things up, but was causing a sore and some bleeding. After taking a vacation to let things heal, I found it more difficult to insert the pessary, and it would frequently come out while I was doing exercise walking, which is my favorite form of exercise. As a result, I have not been using the pessary most of the time. Without it, I am uncomfortable and have had some episodes of incontinence. If I have to go to an appointment, I insert it and it seems that it will stay in for normal moving around, not the sustained walking that one does for exercise. Without the pessary, I often feel a tremendous pressure on my urethra, as if I must urinate, but I may not be able to produce anything, even if I push up, as the doc tells me to do. This tremendous pressure causes a sensation like nerve alarm, which can extend to my arms and legs at times. Pushing things up sometimes causes bleeding too. I will become 83 next month, and the procedure that has been recommended for me is called colpocleisis. Total colpocleisis is for women without a uterus. LeFort is the procedure for women with a uterus. It closes the vaginal canal and can be performed at the same time as a sling procedure to address incontinence. It's recommended for older women who are not sexually active. The main problem I have now is to figure out who is the best urogynecologist to do this procedure. So far, I have seen two urogyns from the National Center for Advanced Pelvic Surgery. There is also a woman who is the head of obstetrics and gynecology at the Johns Hopkins Bayview Medical Center in Baltimore, whom I saw interviewed online about this issue, and there is a local urogyn who just performed a procedure, including hysterectomy, at a local hospital on a former neighbor of mine. I haven't seen the latter two yet, but I am running out of time.