Is your pessary a mistake?
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- čas přidán 21. 09. 2023
- If you failed, this was where you ended up...
But is how we use pessaries changing?
Does earlier fitting give your tissues & your nervous system a break?
Can we think of them as temporary orthotics or are pessaries for life?
What do YOU think?
carriepagliano.com
Dr. Carrie Pagliano has been a dynamic leader in clinical care and education in the areas of women’s/pelvic health and orthopedics for nearly 20 years. Dr. Pagliano received her Masters in Physical Therapy from the University of the Sciences in Philadelphia in 1999 and Doctor of Physical Therapy from the University of St. Augustine for Health Sciences in 2007. Dr. Pagliano is a double Board Certified Clinical Specialist in Orthopaedics and Women’s Health and holds Manual Therapy Certification from the University of St. Augustine for Health Sciences. Dr. Pagliano is the founder of Carrie Pagliano PT, LLC. For over 10 years she was the program lead/founder for the Pelvic Physical Therapy clinical program/physical therapy residency at MedStar Georgetown University Hospital in Washington, DC.
I didn't hear of a pessary until a few months ago when my sister got one as she waited for the procedure to get a hysterectomy. Im 69. In last four years I have not seen a doctor on a regular basis. I looked on the internet as to why I had fullness feeling in the uteres area. I was surprised to find prolapse is common for women that went through child birth. I don't remember a doctor ever mentioning anything about this condition as being something to watch for. I bought myself a belt that holds the pelvic floor and that helped a lot for more than a year. After hearing about the pessary I made a doctor appointment and got one before a 3 week long road trip that I came back from just days ago. Wow! I'm so thankful for this device. It has been a big relief regarding the ease of it and not having to fumble with velcro closure tabs that were losing their grip. I didn't bother with it during the trip other than to use a cream a few days each week. ( I cleaned it after I got home) I plan to use indefinitely but not sure of negative side effect the pharmaceutical cream may have after a long period of time. I prefer not to have a hysterectomy.
I'm 64, had stage 2 prolapse in August, 2023 and Kagel made the leakage worse so I stopped doing it right away. It had gotten worse to stage 3 in early 2024 so I decided to try the ring pessary. It was a god sent and gave me all the support I needed. I didn't feel a thing and was able to get back to normal right away for the most part. I first tried a smaller size and it fell out in two days. I tried to put it back in myself but wasn't able to push it in deep enough while keeping it folded. Then I was re-fitted with a larger size and this one has been staying in pretty well. I requested to schedule a cleaning/refitting every three month as I couldn't do it myself.
The pain, discomfort, and leakage before using the pessary stopped me from doing anything that requires standing for as short as 3~5 minutes and it was horrible. I thought about going for surgery as soon as possible and the pessary saved me. I still want to fully enjoy my go-go retirement years.
Glad you found something that worked for you!
The doctor put it in. I can take it out but can get it in. It is to difficult to get in even though it is folded in half using lubricant.
Some people have an issue with it for sure
I have had a pessary for about 10 years…ring type…first one was larger but was causing abrasions so my gym switched me to a smaller one. No more leaking when I walk, dance, play tennis, cough. It is a godsend and I highly recommend his device. My attempts at kegels don’t work and I sometimes have mild infections after removing or inserting. Don’t have a prolapse. I have difficulty getting it out myself but I use a dental floss string to help me get it out. I am 78 …are you suggesting that I can get along without it at some point?
Yes using it only sometimes is better for me because the weak back wall….
Makes sense
my uterus is down n out. i have a pessary for 20 yrs. i can do anything. i take off clean it, put gel on it n i put it back in. i rather have a pessary than surgery.
why PT fitting the pessary not an OBGYN?
This is a newer option. Easier to get appointments & less barriers to access.
MY 88 YR OLD MOM HAS HAD A PESSARY IN FOR 6 YEARS WITHOUT HAVING IT TAKEN OUT. SHE HAS BEEN BLEEDING FOR OVER 2 YRS STRAIGHT. I HAVE FOUND HER 6 SPECIALISTS, AND NOT UNTIL I GOT HER INTO A SMART FEMALE OB/GYN DID ANYBODY MENTION THEY SAW THIS PESSARY WAY UP INSIDE HER. SHE WAS TOLD SHE CAN'T HAVE SURGERY ON IT OR IT WOULD CAUSE A COMPLETE PROLAPSE. SHE HAS BEEN AND OUT OF HOSPITALS AND MEDICAL CARE FOR THE LAST 2 YRS. SHE GAS HAD MANY TESTS, XRAYS, SCANS, AND EVEN SURGERIES WITHOUT ANY DOCTOR SEEING THIS PESSARY.
WHAT WOULD YOU SUGGEST DR.CARRIE?
😢
I think your mom is lucky to have you advocating for her & needs providers who will help her make the safest choices for the best quality of life!
Omg that is just insane. Someone needs to get it out of her
I was fitted January 26 and it was good for a couple of days. I was so happy to feel so comfortable guess what? Ive been bleeding super irritated and now it feels like the prolapse is coming back down a little. I only feel comfortable laying down😢
Definitely worth a recheck & fitting. Super important that the tissues aren't irritated and also in good health. Shouldn't be uncomfortable at all.
Thank you so much for your support. I went to my gyno she checked it and said it was twisted I guess by itself or a movement that I made have no idea. She examined me and said I had an infection and irrigated the area, put me on a vaginal cream and antibiotics. Im reschedule fir tomorrow 16th but have decided not to use it again. My prolapse has gotten worse. Supper upset and frustrated
She also mentioned that my urethra is not looking normal and referred me to a specialist. Im 73 and not looking forward to getting older. Thank you for your video.
I have my third pessarium now. First was out in 40 meters walk and 2 stair steps. The second managed to stay in for 50 meters and a full stair. The second I have taken home. After a few days I tried to insert the pessarium myself at home. It stayed in for several hours. Walking and cycling no problem. Peeing was fine, but with pooping the pessarium came out. Shit. But the support was just fine.
The first two were with disks with supporten membrane and holes. Then the gynaecologist fitted me a third, a simple ring. It felt unpleasant, with pressure all over the pelvic area. We agreed to give it a bit more time. After a few hours I took it out. Immediately the headache was gone. Actually, today I have inserted it again. Unpleasant. I try to keep it in for the 8 hours. Luckily I still have the second pessarium.
Getting a good pessary fitting can be challenging. Sounds like you have a provider who's willing to work with you
I often wonder if the cube with its suction can actually make my prolapse worse?
Any pessary needs to meet specific prolapse issues. No we'll fitting pessary should be making anything worse
@@carriepaglianopt thanks!
I was fitted last Friday. I hope ot works im super doubful.
Why are you doubtful?
I was bleeding had to remove it and now my urethra is messed up.
@@marissagonzalez7195 wow! What kind of pessary? How are you doing now?
The round one falls out right away the tubular one I can't get out properly
May need a re-fit or a different kind
My pessary was a mistake😢 made me bleed therefore gave me infection. Today Im worse.
Sorry. Sounds like the tissues may not have been in good shape or the pessary wasn't fit well
I can’t because my back wall is so bad. I have hEDS and it presses against rectum. I’ve tried quite a few. Even the sponge does it :(
Typically cube only works with mid level rectocele, not a low one.
@@carriepaglianopt mines very low. Ugh. Will PFPT help reverse it at all? I also have hEDS
Doctor insert 78mm ring pessery it came out when i went toilet.same as with 80mm..
I have blader and 2nd degree uterous prolapea
Hi - I also have a 2nd degree prolapse and my Pessary also fell out in the toilet.
Sounds like it wasn't fitting
Yes it was.not.fitted properly and was some small in size..
now i used 80mm and senior doctor fit it and check properly...now 3months after it is perfect and life is perfect easy mashaAllah..
What is a pessary anyway?
Medical device inserted to support organs in the context of pelvic organ prolapse
@@carriepaglianoptor urinary leakage
DM on what platform?
@carriepagliano on IG
I hate a pesisary.
I'm sorry to hear that.
It’s sad to see women are getting the cube, which is supposed to be removed nightly, and they are being told it can be left in for days or weeeks
Correct, it needs to be removed for cleaning. Education regarding proper care is paramount!
@@carriepaglianopt I’m in a group on FB called pessaries and pelvic organ prolapse. You would probably be appalled at how many women are fitted with a pessary and leave with no instructions to insert and remove it, and some get it placed and their providers don’t have them come on for 3 months to get it checked. The first pessary! There are at least 2 women now in horrible pain. Can’t remove the pessary on their own and have to wait weeks to get into their providers! It’s a travesty!
This is a good idea as an option for younger bodies, however, after hysterectomy, post menopausal with a subsequent prolapse, this would not help 🫤
Have you tried?
@naturegirl4074 I tried a pessary, no go. I now use a sea sponge; with no way to strengthen the vaginal tissue itself after lising elasticity, I don't see how this would work. Curious as to your thoughts.
First conversation here would be hormones and pressure management. The architecture of the "neighborhood" changes when you remove parts. Makes it more challenging. Wasn't a concern years ago when that was our primary option but definitely a point for discussion these days
@@StarreSierens I also have trouble with pessaries and I do have recurrent prolapse as well. I used the sea sponge for a while. Are you using it estrogen cream topically? I feel like this is helped the tissue. I also have a Eds so it’s complicated
@naturegirl4074 I use vaginal estrogen 2x/wk. I feel a difference the next day after, but seriously can't tell if it helps, other than my Urogyn telling me my tissues look healthy.