Posts Tagged ‘pessary’

Treating urinary incontinence-Don’t Be Pampered by Pampers

September 24, 2014

Many women experience incontinence after childbirth. Fortunately, most women have a temporary problem that usually subsides with time. However, there some women that have a persistent problem that lasts for a longer period of time.

After nine months of pregnancy and a rollercoaster of experiences with a changing body, it’s easy to chalk up bladder leaks after delivery to one more outcome of childbirth. While that’s true for many women, other conditions could be responsible for urinary incontinence —the inability to control the release of urine from one’s bladder —if a woman is having difficulties controlling urination two months post pregnancy or more.

The problem is common and nothing to be embarrassed about since many new moms experience urinary incontinence after baby’s arrival.

The condition is caused by the stretching and tearing of supporting structures including ligaments, tendons, nerves and muscles, resulting in a weakened pelvic floor. The extent of the stretching or tearing varies in each person. Incontinence often resolves itself within a couple months after delivering the baby when the structures have repaired themselves naturally.

According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age, although women over age 50 are the most likely to develop the condition. In many cases, UI is often temporary—such as during or after pregnancy for a short while — or results from an underlying medical condition.

The most common form of incontinence in women post pregnancy is stress incontinence, which consists of losing urine when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Another common form of urinary incontinence post pregnancy is known as urge incontinence —described as an intense urge to urinate, followed by an involuntary loss of urine. Many women will experience a mixture of both forms, which medical professionals refer to as mixed incontinence.

Urinary incontinence can affect a woman in many different ways. It’s more than just an awkward issue that makes it hard to not leak urine. The impact of incontinence on a woman’s personal life can be distressing. Women often avoid going out because they are embarrassed by their frequent bathroom usage. The problem can greatly affect a woman’s sex life, especially when suffering from stress incontinence. Many patients will talk to providers about the changes in relationships that take place in their intimate lives as a result of urinary incontinence.

Women with incontinence have to rearrange their lives. They have to buy pads, which can be expensive. It can irritate their skin. They are all emotionally challenging things to deal with especially after just having a baby. It has added to the stress of having a baby in general.

There are several different ways to treat urinary incontinence.

The most important thing is to allow the muscles to repair themselves. While some cases of urinary incontinence will disappear a few weeks after a woman gives birth, women should seek medical treatment if they are still experiencing leakage after two months.

Pelvic floor exercises, commonly known as Kegal exercises, can often improve urinary incontinence. The exercises strengthen the urinary sphincter and the muscles that help control urination. A physical therapist or professional recommended by a physician can provide insight on whether a patient is properly contracting muscles to help improve the condition.

I also recommend keeping a bladder diary for those dealing with urinary incontinence, which can help normalize fluid intake. Often times women, out of wanting to remain hydrated, can drink several liters more than is necessary causing their bladders to remain over filled. A bladder diary can help to realize this problem, she says.

Another option available to treat urinary incontinence is what’s known as a vaginal pessary. The device can be put in the vagina to support the structures that help prevent urinary continence. The device can serve as a bridge to allow activities like walks and hikes while a woman rehabilitates her muscles.

It takes only one baby for the problem to occur, and the subject of urinary incontinence should not be taboo. I suggest that women ask their physicians about the problem

Bottom line: Urinary incontinence is common after childbirth. Most women will have the problem resolve without any treatment. If the problem persists after several months, then medical attention is recommended.

When Something Is Coming Out “Down There”-Use of A Pessary To Treat Vaginal Prolapse

January 30, 2014

As women reach menopause, many women experience changes in the vagina which include incontinence of urine and pelvic organ prolapse where organs and tissues start coming out of the vagina. For mild problems of incontinence, Kegel exercises can help control the problem. For more extensive prolapse surgery is often necessary. For women who can’t have surgery or wish not to take the surgical option, a pessary is an alternative. This blog will discuss a vaginal pessary and how it can help women with urinary incontinence and vaginal prolapse.

A vaginal pessary is a removable device placed into the vagina. It is designed to support areas of pelvic organ prolapse.

There are a variety of pessaries available, made of rubber, plastic, or silicone-based material. Among common types of pessaries are the inflatable, the doughnut, and the Gellhorn

Your physician will fit your pessary to hold the pelvic organs in position without causing discomfort. Pessaries come in a variety of sizes and should be fitted carefully.

What To Expect After Treatment
Your pessary will be fitted in your health professional’s office. You may need to experiment with different kinds of pessaries to find one that feels right for you. Your health professional will teach you how to remove, clean, and reinsert the pessary on a regular schedule. The cleaning schedule is determined by the type of pelvic organ prolapse and the specific brand of pessary. If it is hard for you to remove and replace your pessary, you can have it done regularly at your doctor’s office.

Why It Is Done
Pessaries are used as a nonsurgical approach to the treatment of pelvic organ prolapse. They are frequently used to treat uterine prolapse in young women during pregnancy. In this instance, the pessary holds the uterus in the correct position before it enlarges and becomes trapped in the vaginal canal.

Pessaries are also used when symptoms of pelvic organ prolapse are mild or when childbearing is not complete. They can be used in women who have other serious chronic health problems, such as heart or lung disease, that make a surgical procedure more dangerous.

Pessaries are sometimes used to see what the effect of surgery for pelvic organ prolapse will be on urinary symptoms. This is called a “pessary test.” If you have a problem with incontinence with a pessary inserted, a separate surgery to fix the incontinence problem may be done at the same time as a prolapse surgery

How Well It Works
Pessaries do not cure pelvic organ prolapse but help manage and slow the progression of prolapse by adding support to the vagina and increasing tightness of the tissues and muscles of the pelvis. Symptoms improve in many women who use a pessary, and for some women symptoms go away.1

Risks
Possible complications from wearing a pessary include:

· Open sores in the vaginal wall.
· Bleeding.
· Wearing away of the vaginal wall. In severe cases, an opening (fistula) can form between the vagina and the rectum.
· Bulging of the rectum against the vaginal wall (rectocele formation).
Complications can be minimized by having a pessary that fits correctly and that does not put too much pressure on the wall of the vagina. Your pessary should be checked frequently by your health professional until both of you are satisfied with the fit.

In post menopausal women, estrogen (cream, ring, or tablets) is sometimes used with a pessary to help with irritation caused by the pessary.

Follow your health professional’s instructions for cleaning your pessary, because regular cleaning reduces the risk of complications. The cleaning schedule is determined by the type of pelvic organ prolapse and the specific brand of pessary.

What To Think About
Pessaries often are an effective tool for managing pelvic organ prolapse without surgery. They may be the best choice if you are a young woman who has not finished having children, if you have been told that surgery would be risky for you, or if you do not wish to have surgery for other reasons.

A pessary may not be a good choice after having a hysterectomy. This is because the walls of the vagina are no longer held in place by the uterus and cervix. Women with severe prolapse following a hysterectomy may have difficulty keeping the pessary in place.

Many women can have sexual intercourse with their pessary in place. But you cannot insert a diaphragm (a round rubber device used as a barrier method of birth control) while wearing a pessary. If you have not reached menopause, you may want to discuss birth control with your doctor.

Bottom Line: Incontinence and prolapse are common concerns of many middle age, post-menopausal women. Certainly medications are a first line of treatment. For women who do not respond to medication and do not want to have surgery, a pessary is treatment option.

Losing Your Urine When You Cough Or Sneeze-Treating Incontinence With a Pessary

December 27, 2012

Pessary For Treating Mild Stress Incontinence

Pessary For Treating Mild Stress Incontinence


Stress urinary incontinence or loss of urine with coughing, sneezing, or even bending over to put on your shoes affects millions of American women. Often times a woman is looking for a treatment that does not involve medication or surgery. For certain women a vaginal pessary is an option. A pessary is a removable device placed into the vagina. It is designed to support areas of the pelvis such as occurs with pelvic organ prolapse.
There are a variety of pessaries available, made of rubber, plastic, or silicone-based material. Among common types of pessaries are the inflatable , the doughnut, and the Gellhorn.

Frequent Urination: Causes and Treatments
Gotta go all the time? The technical name for your problem is frequent urination or overactive bladder. In most people the bladder is able to store urine until it is convenient to go to the toilet, typically four to eight times a day. Needing to go more than eight times a day or waking up in the night to go to the bathroom could mean you’re drinking too much and/or too close to bedtime. Or it could signal a health problem.

Why It Is Done
Pessaries are used as a nonsurgical approach to the treatment of pelvic organ prolapse. They are frequently used to treat uterine prolapse in young women during pregnancy. In this instance, the pessary holds the uterus in the correct position before it enlarges and becomes trapped in the vaginal canal.
Pessaries are also used when symptoms of pelvic organ prolapse are mild or when childbearing is not complete. They can be used in women who have other serious chronic health problems, such as heart or lung disease, that make a surgical procedure more dangerous.

Pessaries are sometimes used to see what the effect of surgery for pelvic organ prolapse will be on urinary symptoms. This is called a “pessary test.” If you have a problem with incontinence with a pessary inserted, a separate surgery to fix the incontinence problem may be done at the same time as a prolapse surgery
How Well It Works
Pessaries do not cure pelvic organ prolapse but help manage and slow the progression of prolapse by adding support to the vagina and increasing tightness of the tissues and muscles of the pelvis. Symptoms improve in many women who use a pessary, and for some women symptoms go away.

You will need to see a doctor to be fitted for a pessary which will hold the pelvic organs in position without causing discomfort. Pessaries come in a variety of sizes and should be fitted carefully.

What To Expect After Treatment
Your pessary will be fitted in your doctor’s office. You may need to experiment with different kinds of pessaries to find one that feels right. The pessary needs to be remove, clean, and reinsert the pessary on a regular schedule. Most often this is done by the doctor or his\her staff but some women prefer to do this themselves. The cleaning schedule is determined by the type of pelvic organ prolapse and the specific brand of pessary.

Risks
Possible complications from wearing a pessary include:
• Open sores in the vaginal wall.
• Bleeding.
• Wearing away of the vaginal wall. In severe cases, an opening can form between the vagina and the rectum.
• Bulging of the rectum against the vaginal wall (rectocele formation).

Complications can be minimized by having a pessary that fits correctly and that does not put too much pressure on the wall of the vagina.
In post menopausal women, estrogen (cream, ring, or tablets) is sometimes used with a pessary to help with irritation caused by the pessary.
What To Think About

Pessaries often are an effective tool for managing pelvic organ prolapse without surgery. They may be the best choice if you are a young woman who has not finished having children, if you have been told that surgery would be risky for you, or if you do not wish to have surgery for other reasons.
A pessary may not be a good choice after having a hysterectomy. This is because the walls of the vagina are no longer held in place by the uterus and cervix. Women with severe prolapse following a hysterectomy may have difficulty keeping the pessary in place.
Many women can have sexual intercourse with their pessary in place. But you cannot insert a diaphragm (a round rubber device used as a barrier method of birth control) while wearing a pessary. If you have not reached menopause, you may want to discuss birth control with your doctor.


Bottom Line: Stress incontinence is common condition affecting millions of American women. The treatment with a pessary is an option that does not require the use of medication or surgery.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women's health

New book on women’s health

Raising Up the Dropped Bladder

March 17, 2010

There are nearly 14 million American women who suffer from urinary incontinence or the involuntary loss of urine.  One of the most common causes is a dropped bladder.  Dropped bladder is a general term to describe a condition known as Pelvic Organ Prolapse (POP).  POP means that one of the pelvic organs – the bladder, the uterus, the intestines or the rectum has fallen down into the vagina. POP ranges in severity from very mild (i.e. prolapse that can only be felt by your doctor on examination) to severe where one or more of the pelvic organs actually protrude through the vaginal opening and can be easily felt by the woman on self examination. When the POP is severe you can actually see it; it looks like a red ball protruding from the vagina.

Causes of POP?

POP is caused by a weakening of the muscles that normally hold the pelvic organs in place. Childbirth (labor and delivery) is the most common cause of weakening of these muscles. The aging process itself, particularly in women who do a lot of heavy lifting, may be another cause.  Excessive weight and chronic coughing are also causes of POP.

What are the Symptoms of POP?

The most common symptom of POP is a feeling of pressure or fullness in the lower abdomen, vaginal or rectal area accompanied by urinary incontinence.  In severe cases you may actually see the POP protruding from the vagina and, if so, it may get irritated and cause a discharge or even bleeding. With more severe degrees of POP it may be difficult to urinate, causing you to have to push or strain.  Rarely the POP can block the kidneys causing kidney failure. Fortunately, when the POP is repaired the kidneys usually return to normal, provided that the condition is caught early enough.

Treatment for POP

For the overwhelming majority of patients with POP treatment is completely elective-meaning that if your symptoms bothersome enough, you will want to have it fixed.   At the present time there are only two treatment options: a pessary or surgery.

A pessary is a device that is usually made out of a plastic and is usually in the shape of a donut or ring. It is placed in the vagina, like a tampon, to hold the pelvic organs in place. Pessaries come in many different sizes and shapes and need to be fitted by your doctor to the size and shape of your vagina. Pessaries are quite safe, although in some patients they seem to be associated with recurring bladder infections. If a pessary works for you, and it is comfortable, it can be a lifetime treatment. It can be left in place for several months at a time and may be changed by doctor or a nurse. They are not, however, effective in all patients.

If a pessary is not effective, then surgery is the other option.  There are operations that are done through the vagina and operations that are done through the abdomen.  There are now procedures that can be done on one- day stay or outpatient basis under a local anesthetic where a tape or sling is placed below the urethra that elevates the urethra and the base of the bladder which immediately corrects the incontinence.  Most patients can return to all of their activities in 1-2 days after the procedure.  They cannot do heavy lifting, have intercourse, or use douches for 4-6 weeks after the surgery.

So if you are considering surgery, be sure that you do your homework and learn a lot about the different surgical possibilities, and the potential risks and benefits of the procedure.  If you think you have a dropped bladder contact your urologist or gynecologist for an evaluation and to learn what treatment options are available to you.  Remember help is available and you don’t have to depend on Depends!