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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.

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Replies to "I don't know how pertinent my experience is to this case. I have a prolapse of..."


I can understand your urgency and assume you have researched what is involved with this procedure including the recovery time. My concern is that if you decide to undergo the surgery that you can no longer have Pap smears or that the cervix and uterus cannot be accessed for routine screening.

I have been using a pessary for about 5 years (age 80) for the last stage of prolapse. My UroGyn said I must use a vaginal estrogen cream for vaginal atrophy. Has anyone told you that you had vaginal atrophy? It makes removal and insertion of the pessary easier with no irritation. I tried several types and sizes until I found a type that was comfortable and large enough so that it didn’t fall out. I use the cream twice a week and also use a vaginal jelly for insertion and all is well so far.

I don’t know of anyone who has had the surgery but just wanted to share my experience in the event something was overlooked at the time you started with the pessary. Let us know what you decide.
Bladder incontinence is so common and we shouldn’t have to live that way.

FL Mary