Ring pessary questions

[relaxingathome]

I saw my consultant yesterday and have been fitted with a ring pessary for uterine descent, if it helps( which fingers crossed it seems to be as symtoms have reduced) I will be reviewed in 3 months re further management.

If the pessary helps I can either continue with the pessary or have a hysterectomy.

My questions and concerns are as follows
Can I use a mooncup with a pessary in situ?
Can I have sex with the pessary in situ?- I am not currently in a relationship, so this is hypothetical but would be anxious about a new partner discovering the ring iyswim.
I also have anterior wall laxity and am concerned that a hysterectomy could make this worse.

You poor thing. Sympathies. After giving birth to DD 15 months ago I was left with a cystocele, rectocele, uterine prolapse, detached pelvic floor, and damage to the coccyx and pelvis. Five weeks ago I had one lot of surgery and am due a second later this year. You have my utmost sympathies. In my case we never really considered a ring pessary because we wanted to go for a permanent repair, rather than just symptom management. I never tried one, so I can't speak from experience. However, when we were talking through the pros and cons of a pessary, my consultant said that I could have sex with it in. He didn't say anything about a mooncup - I suppose you could just try and see. The worst that would happen I guess is that things might be a bit messy .

As to needing a hysterectomy if it doesn't work, I would strongly recommend that you seek a second and even a third opinion. I saw 3 surgeons before deciding on who was going to do it and what it was going to be. They were all generally along the same lines, but one said she would consent me for hysterectomy, whilst the guy I went with said this was not an option because of my age and that I may still want to have another baby. He has hoiked it up by tightening the ligaments front and back. If this fails, there is still the option of mesh suspension, with hysterectomy as a very last option.

As for the anterior wall prolapse worsening, I think that once you have any prolapse mended, there is the risk that any other prolapsing area will get worse, because it's no longer being held back by the tissue that was keeping it in place. In my case, my rectocele has definitely worsened since my cystocele and uterine prolapse were mended. We always knew this was likely and I'll be having the surgery to correct this later in the year.

I'm so sorry you are oging through this. Do join us on the rectocele thread in general health - there's lots of us there who are going through similar htings and there may be someone who has expereince of pessary rings. I'll find the link and post it.
X

Here we go:
www.mumsnet.com/Talk/general_health/1372271-Rectocele-Repairs-continued

Thanks for the reply, I work in a medical profession and know my surgeon is very highly regarded and would not operate unless necessary.
I have been sterilised, so having more children is not a question that would stop the hysterectomy, however I am under 40 so may be an issue.
I am aware that I can have sex, but am concerned that in a new relationship it may be less well tolerated than in a long established one where the prolapse and subsequent treatment are part of the history iyswim.

The hysterectomy would only be a choice option if the pessary does work, if it doesn't reduce symptoms then a hysterectomy wouldn't either.
Not sure what the plan would be in that case

Thanks, will c/p my questions across

Most of the sources I have come across say that you can wear a ring pessary during intercourse if you feel comfortable.

www.webmd.com/urinary-incontinence-oab/vaginal-pessaries

Looking at this review paper (note section on clinical implications), it seems that individual women really have to see how they get on with living with a pessary.

www.medscape.com/viewarticle/499503

Thanks for the reply, sadly I cannot see the second link

This is more of the same answer for youreally- I had a repair almost 20 years ago for uterine, cystocele and minor rectocele. It was classed as "minor" prolapse but I wanted it fixed and was covered by insurance, so had it done privately- I too saw several drs- incl. 3 gynaes- who all had a differnt opinion- 2 said I didn't need anything doing at all despite my feeling a bulging feeling all day.

I was told that any subsequent work would be harder as they had taken quite a bit of tissue away - especially from the anterior wall- and that a hysterect. might cause a vault prolapse.
I know now that this is something they try to guard against, by the type of repair they do.

I'd still recommend you ask around for other opinions as IME they only do a hysterect. as a last resort and unless there are other reasons not to try a repair, then they usually offer that first.

Good luck whatever you do.