Cube pessary

[HashtagNell]

Hi, folks. I'm nearly 70 and in the UK, fairly fit and well except for vaginal prolapse which started to be a significant problem just over a week ago. It is difficult to get to see a GP in our local surgery because they are so understaffed. However, I did get an appointment. It wasn't very helpful. I'm not even sure the GP was convinced there was a problem, but he examined me in the morning, lying down. At that time of day the bulge is less obvious!

He talked a lot about vaginal atrophy, offered me oestrogen cream, but it wasn't clear to me it would be useful. He said if the atrophy wasn't bothering me (basically if I wasn't active sexually, which I'm not) I didn't need to do anything about it. He suggested, as usual, stepping up the pelvic floor exercises. If that didn't work after a few months, the 'next step' was to refer me to a physio for specialist help with the exercises.

I went home unreassured. A week later I was so unhappy I paid to see a gynaecologist privately, first time in my life. It was expensive but I just wanted to talk to someone without being rushed, and by now I'd thought of a lot more questions and done a lot more reading. To cut a long story short, I had a good consultation, very reassuring, and opted to try a cube pessary together with the PF exercise for at least six months and see how I got on. I wasn't ready to discuss surgery yet. I can't remember whether she said my prolapse was stage 2, but it is: it just protrudes from the vagina but doesn't actually hang down. It's uncomfortable when walking.

I inserted the cube myself, under her supervision. She confirmed it was fitting well. Later that night getting it out again was harder. Mini panic but I managed it. I don't know how I'm going to get on with this beast though and would love to hear from anybody else who has used one. I don't think I'll use it every day but walking is definitely easier when wearing it, and I do walk every day, so we'll see. I just don't know how well I will manage putting it in and taking it out.. It is really uncomfortable, and the sensation of the little pink tail protruding is odd. Anybody else try one of these? Can it really become like second nature??

The trouble with seeing an expensive private consultant is that they don't, charming as they are, say 'Just pick up the phone if you feel worried'. 'Drop me a line for a chat.' 'Let me know how it goes.' You know if you go back, you need your credit card. 😱

[cufflady1]

Hi,

I'm 92 and in excellent health other than a recent bladder prolapse. I live in the US and an OBGYN is readily available, here, and covered by insurance. I was first fitted with a cube pessary but it didn't work for me and am now using a round one. I don't understand why you're taking it out every night. My Dr. inserts it and I go back every 3 months to have it removed and cleaned and she inserts it again. I could learn to do it myself but prefer to have her do it so I know it's in properly. Did the Dr. actually tell you to remove it every night? That makes no sense, to me, as all. I guess countries have different points of view on this problem, but here in the States the pessary is removed every three months and the patient is examined to be sure there are no other problems. I wish you good luck.

[HashtagNell in reply to cufflady1]

Cufflady, thank you so much for replying. I really appreciate it. There must be different practice in our different countries, I don't know why. But maybe the cube pessary is also slightly different? Goodness knows. Either way, it was explained to me that the cube was intended for daily (or occasional) use, whereas a ring was fitted and then replaced and removed by a health practitioner at intervals. There were at least two other types, but I liked the sound of the cube from what I was told. But I don't think I can use it. It is too hard to remove it, and both times I've done it, I notice a pinky brown mucus on it, quite a lot of it, which I don't think is a good sign for me. Must be slight bleeding somewhere. What a performance I had tonight getting it out on my second try! It gets so complicated at times inhabiting a human body. I'm not sure I can face it again (Oh, I mean putting the cube in and out, not inhabiting the body. 😜)

[cufflady1 in reply to HashtagNell]

You seem to be having the same trouble I had with the cube. I had a brownish discharge as well and also some bleeding. The Dr. said it was irritating me and had caused some damage. She had to cauterize me and that's when she inserted the round pessary which is much softer. I have had no problems since. Please have your Dr. check, the bleeding is definitely a sign that the pessary is not right for you. Also I think the pessary shapes are universal and the manufacturers send them all over the world. Good luck.

[Lurcher-lady in reply to cufflady1]

cube pessarirs do need to be removed at night, unlike ting or gellhorn ones as they are space fillers.

[Alisandra]

Do you know what the round pessary is called please? It's not one I've heard of in the UK. I too have tried the cube and gave up it was so uncomfortable.

[HashtagNell in reply to Alisandra]

There are six sizes. Mine was size 2 which is second up, so quite small. However, I suspect it's too big.

[Alisandra]

By round do you mean a ring pessary or is it solid round?

[HashtagNell in reply to Alisandra]

Several round types are in use in the UK, ring, Gellhorn and shelf. My gynaecologist had round ones beside her too. But I liked the sound of one I could control myself. Except I can't.

[Alisandra in reply to HashtagNell]

Yes we have those, but I am interested in if there is anything spherical (3D) rather than cuboid, sounds more comfortable rather than sharp edges. Thanks for your help.

[Jasparswim]

When I saw my GP and Gynaecologist I started off by showing them photos I had taken on my phone of my prolapse and said this is what I'm dealing with, how can you help me? The photos were taken whilst placing phone on toilet seat lid with me squatting over and clearly showed a true extent of the damage to bladder, vagina and bowel and what gravity does, and the lump hanging out of my vagina. It helps identify how far down your bladder, womb or bowel has really dropped. When you are examined you are lying down and the full extent of the prolapse due to gravity is not seen, so these photos show the reality. It helped on both occasions and I continue to keep a daily diary of photos for me to see as well.

[HashtagNell in reply to Jasparswim]

Good idea. Brave of you, too, I feel.

[Spanielgirl]

Hello, I'm so sorry to hear of your draining dilemma, it can easily take over your life. I've posted on here before as have others on the benefits of using natural sea sponges. I have successfully used sponges with coconut oil as a lubricant for the past 2 years. It becomes a way of life, it works and no medical intervention is needed. You can be in control of your own body. It's worth giving it some thought. I hope you can regain control of your life and feel more comfortable. Good luck and best wishes.

[HashtagNell in reply to Spanielgirl]

Have found one of your entries about this now and had a look at the website selling the sponges. So when I'm ready, that's where I'll start.

[HashtagNell]

Thanks, Spanielgirl. I did read about the sea sponges earlier, but went through so much to get this cube that is giving me so much trouble, I wasn't get at the stage of ready to try other things. But it does sound good. I will go back and read again about this. Have you got a thread somewhere on this site about them?

[MOLLYMILO007]

Hi there I feel your pain...I'm 63 I managed a bladder prolapse for 10 years sometimes very distressing but I researched alot I bought a kegal 8 pelvic floor exerciser it's a probe u put in and lie down and let the electrical pulses strengthen your pelvic floor ...look at kegal 8 on the Internet..not cheap but they are fabulous also take colegan and vit d daily ..would u consider hrt as thar will boost your estrogen as lack of estrogen is the main reason for a prolspse ...sorry if I sound like a know all...lol but after 10 years of managing it quite well I feel I have the knowledge...I did have a prolspse repair as I had to come off my hrt which affected my prolapse ..I paid private 6.500..but well worth it...the quality of life you gey back..but the nhs do it also may be worth getting your gp to refer you to get on the list ..the recovery isn't great but after 12 weeks u will find your a new woman lol..Good luck and message me if u want more info.....jeanette x

[HashtagNell in reply to MOLLYMILO007]

Thank you, Molly Mil. I really appreciate your sharing. I'm probably just at the beginning of all this. I am trying estrogen locally (vaginal tablets) to improve the 'atrophy'. I think that's as far with HRT as I would go, for other reasons that I won't go into here. I haven't (yet) seriously considered the Kegel exerciser because I've just expended so much on the gynaecologist and the cube. I don't want to throw money at it because my resources are so limited. But I may come to this yet. I also think I may have surgery yet but right now I really don't want to if I can avoid it. So I guess, I'm learning to live with it, and looking at options, and discovering what my own body (which has been good to me up to now) can actually do yet.

[gymkat]

I haven’t gone down the GP pessary route (yet) but after the PF surgery (which failed after 9 months approx) I found this forum. I read about the sea sponge option, I ended up buying natural sea sponges from amazon and cleaning via the method on the ‘sea pearl’website. I have managed well for 2-3 years using these. I have got worse recently, so I’m paying attention to see if I should try a pessary from GP. I have also used the Kegal 8 which is really worth the cost. It’s made a noticeable difference. I use the vaginal cream as well which does help but short lived relief. I would recommend trying the sea sponge option as it’s natural, removable and economical. The ones I buy are sold as baby sponges, you trim them down to size and use like the cube I guess. They lift the prolapse up so you can get on with your day.

[HashtagNell in reply to gymkat]

Gymkat, could I ask a question about the sponges please? I've bought two and they've arrived. They looked so small in the online picture but now I look at them in relation to me, they look huge. I know sponges are spongy, so I expect they would squash. But the question is, how do you work out what would be the right size to start with? These two are about 10 cm in width and quite substantial in density and roundness. They have little threads attached, for help with removal, but I find it hard to believe the slender thread would do much to move that sponge once it was firmly ensconsed!

[gymkat in reply to HashtagNell]

It depends how dense they are. Once it’s wet you will get a better idea how pliable it is. You can trim bits off, yes -usually the shape goes awry - but it still does what’s necessary. When they are new and dry they do look huge but soften so much when wet. You definitely need to squish it to insert it, but once in you barely feel it… but if you do, trim off a bit more, until it’s comfortable. Good luck!

[HashtagNell in reply to gymkat]

Thank you! 😚

[HashtagNell]

Thanks Gymkat, that's really helpful to me. I'm going to give these sea sponges a try. I am SO sorry that surgery didn't last longer for you. What a bummer! I see from reading around, that some women have two or three goes at surgery and think it's worth it. I'm not psychologically ready for that. But I'm also nearly seventy. I might not last long enough to need surgery. I go to funerals of friends every year.

I got my cube pessary through a consultant (that I paid for, a lot), not GP, who didn't get me far. I haven't given up on the cube yet, but I have deferred using it for a while, and I suspect I might need a size smaller. For PV exercises, I am finding the NHS app Squeezy helpful, though I scoffed at first. But actually it does make the regular practice seem easier and more simple to accommodate into ordinary life.

Most of all, I am tremendously relieved to know there are other women taking a practical approach, not panicking, and just getting on with the day, as you so reassuringly put it. That's all we really need to aim for. And sharing experience is so helpful. Thank you! x

[Jasparswim]

I've declined pelvic exercises physio as I've been doing them myself and found all necessary exercises being shown on you tube and tik tok. I've declined having a pessary fitted....it's too messy and sounds horrific causing more problems. I've opted for repair surgery on my anterior prolapse and posterior prolapse together. I saw a gynae through NHS at private hospital as the local maternity hospital must be too busy. Brilliant for me. I had to wait 6 weeks after GP examination to have appointment with Gynaecologist. Week later I've had a call to get pre op assessment again at hospital with nurse. Been told a week later I will get a call with op date. No waiting list 😲 . RESULT !!! I will have outpatient surgery with General anesthetic and go home after. Each op separately is only 30 mins and it's 6 weeks recovery with no exercises or lifting anything. I'm looking at the bigger picture and figure get it done now whilst I'm fit and healthy...not later when my condition has got worse from using pessaries etc and loads and loads of appointments. Ask your GP to refer you to a Gynaecologist and don't be fobbed off. If I was an animal at the vets I would be operated on straight away.....so here goes. Fingers crossed I can go back to swimming and walking exercises in a few month. Don't be afraid of surgery.....

[Pelvicblues in reply to Jasparswim]

Jasparswim I have level 3 bladder and level 2 uterine prolapse that I have consulted with a Uro-gynocolgist about here in USA and the surgery that he proposed involves removing my uterus and supporting upper vaginal wall with a mesh material that he swears is not at all like the mesh used in past causing many problems. I'm curious to hear about your upcoming surgery repair - are they planning to remove your uterus or was it previous removed? How do they support the prolapsed areas, do they use stitches only? Thanks in advance for your help and wishing you all the best with your surgery and recovery.

[Jasparswim in reply to Pelvicblues]

They don't use mesh over here because of the problems it's caused lots of women. They use stitches. Not planning on removing any organs either. It's an outpatients appointment so no hospital stay unless they have to do other stuff. It's called an Colporrhaphy in medical terms. I've been advised not to lift anything heavy after the op and to be careful in the future. As long as I can do my swimming and continue walking that suits me. Will give the cycling a miss from now on. Thanks for you kind thoughts.

[Pelvicblues in reply to Jasparswim]

Thank you for your prompt response and giving me the name of your procedure, with that I can do internet search for more details. I really appreciate your help!🙂🙏

[Jasparswim in reply to Pelvicblues]

I have level 2 bladder prolapse, level 1 uterus and level 3 bowel prolapse...

[MOLLYMILO007 in reply to Pelvicblues]

Hi sorry to jump.on your thread but in the uk they don't use mesh ..I asked my consultant prior to surgery...I must admit he didn't remove my uterus as he said no.need in my case amd your uterus supports your bowel and bladder so I was lucky there...give yourself 3 months plus to recover ...Good luck u will be fine x

[HashtagNell]

Good luck, Jasparswim!

[Jasparswim in reply to HashtagNell]

My pre op assessment is in 19th April....so all happening quickly 😯😊

[Spanielgirl]

Hello I've just caught up on the amazing response to your Cube pessary post. Healthunlocked is a great way to share and give support to others in similar situations. Great to see that Gymncat has shared natural sea sponges with you and that you've bought some. Don't despair it's all a bit hit and miss to start off with and needs a bit of fine tuning but it's definitely worth persevering. Just thought I'd let you know that I've found a cheaper option, by buying a large natural sea sponge from Amazon and managed to cut 3 out of it and sew a dental floss loop into it. If you want any more information don't hesitate to message me. Take care x

[HashtagNell in reply to Spanielgirl]

That does sound a useful option for future reference. I'm on day two with natural sea sponges, and it's a great relief to me that it's not painful, or all that difficult, to put them either in or out. However, I'm not clear in my mind how the sponge, when inserted, should ideally lie.

Is the aim to get it to lie across the cervix at the top of the vagina, or should I be trying to allow it to expand lengthwise? The reason for me asking is because I know the idea is to trim the sponge to get to your ideal size, but I can't tell what I'm aiming for.

What IS an ideal size? Am I aiming for a rectangular shape or a round one? Am I aiming for a fit at the top, or a tampon-type fit?

If it goes in and doesn't fall out, does that mean it is fitting okay? I find through this whole prolapse thing I seem to have lost confidence. To tell the truth, I feel a bit pathetic! But I'll get past that.

I keep thinking about my mum (now dead seven years) who had a vaginal prolapse, same as me, same age as me more or less, and never even mentioned it. She was fitted with a ring, which she only mentioned much later when she had a hysterectomy because the ring was no longer working, she said. She had never even conceded anything was wrong. It was all 'women's stuff' and not to be discussed, even with women.

😱

[Pelvicblues in reply to HashtagNell]

In regards to the comments in your last paragraph about your mother having same prolapse issues I think that even today with online support groups like this, too many women in the world suffer in silence. I know I certainly never heard of any of the prolapse issues from any of the older female relatives (mother, grandmothers, etc) or even the female doctors that have been involved in my healthcare over the past 40yrs. I certainly understand why women are reluctant to speak of these things but our healthcare providers, especially the gynecologists should talk to their patients about the risk, ways to prevent, and what to be aware of in case it should happen.

A couple generations ago it was normal for women to give birth to a dozen or more children and I suspect they many of them must have been dealing with the same issues. I know when my bladder prolapse happened I was freaked out but at least I had the internet available to help me figure out what was going on, nobody had that 40 yrs ago. As women I encourage anyone with daughters or nieces to talk to them about it and perhaps they will be better informed than most of us.

It ain't easy being a woman in this world - strength, healing and peace to us all!

[Spanielgirl in reply to HashtagNell]

Great news about the sponges! We all have different opinions on how to deal with this mind blowing dilemma, but all I can say from my experience is perseverance will pay off. It's all a matter of making the best of a bad job without medical intervention!Ok the practicalities of the sponges. The aim is to insert the sponge so it does the job of holding everything in place. You've probably got the hang of it now but in the early days it's dealing with the unknown and seriously a question of what have I done to deserve this !Wet the sponge and roll it into a tampon shape Coconut oil makes the process of insertion easier. I use natural organic virgin oil and put small balls in the fridge to harden. If the sponge is too big , you'll know because it feels uncomfortable, easy just trim with scissors. The sponge will mould to you, sometimes it slips down and you need to re insert. I always remove in the evening, when gravity isn't dragging everything down, rinse in natural soap and leave to dry. I've stopped using tea tree oil for regularly soaking the sponges in and the life of a sponge is now definitely longer.

I thought I had a lot of street cred/ life skills at my age, but this situation weirdly blew my mind and I thought why hadn't someone told me about this. I'm sorry to hear of the loss of your Mum, they were heroes, they/some like my Mum were married to controlling old dinosaurs, they suffered in silence and ignorance. I care for my 94 yr old Mother, 1 of 10 children, later stage Alzheimer's. Did she ever talk about any of this No !

To end this, Id just to like to say, it will get better. It's an inconvenience, it's pain but it becomes a way of life. I'm anti any medical intervention, my Mum is a record breaker in the Alzheimer's journey, she is amazingly on no medication and I'm lucky to say I'm not, and so grateful for discovering natural sea sponges .

2 yrs ago, I never thought I'd continue to be a carer, walk my dogs, let alone work them on last shooting season, but I'm doing everything. You can do the same, believe in yourself and stay positive. Take care x

[HashtagNell]

You are an inspiration, bless you. I really don't want medical intervention either, if I can possibly avoid it. So I'm on day four of sponges and maybe, just maybe, getting the hang of this. I put it in much as you describe -- haven't tried oil yet but have been using one of the water-based lubricants which wasn't bad -- but I have some olive oil ready and I'll experiment until I get the thing that works best for me. I insert it carefully and and as far in as I can, but it seems to work its way down again first thing (maybe my bowels doing something), and I have to push it back into place an hour or so later, after which everything seems to stay in place until the end of the day. I feel the sponge is friendly and on my side, and the cube definitely was hard and hostile. I love the sound of those dogs, and I see your avatar name was no accident! 😘

[Rosetortoi]

It's great that you have found something that works for you. I have a cube myself and it is the first size along 3 different sizes here offered in the UK. They go up a little larger as your needs require. I bathe most evenings in a warm bath, and that helps me to retrieve and clean the cube ready for the following morning. My gynae did say it was ok to leave it a couple of days as more permanent pessaries will be left up to 6 months. It's always good to know you are not on your own. And at this stage of our experience we can use something effectively that allows us to get on with our daily wants and needs. I do have a friend who has the second size larger cube. She did use it for a while, but now she no longer uses it because she felt confident enough to manage without and makes herself comfortable with a slim pad. So it's really up to what our different individual needs are and of course our preferences. I wish you well.

[HashtagNell in reply to Rosetortoi]

That's really interesting. Thanks so much for sharing your experience Rosetortoi. This site is such an education!

[EndoJaz]

hi, I’ve just had an anterior repair for my bladder prolapse which happened after my hysterectomy 6 yrs ago. 2 weeks post op, feels a bit swollen down there but too scared to see if the bulge is gone. I waited just over a Yr on the nhs list and was terrified but it wasn’t too bad. Just hope it has worked. My understanding is that the worse they get the harder the surgery so mine was stage 2/3 as told different at appts. They key is no more heavy lifting over 5kg. X

[HashtagNell in reply to EndoJaz]

Dear EndoJaz, thanks so much for sharing your experience. I know precisely what you mean by being too scared to look. But I think two weeks after your op is still early days, and if it feels a bit swollen it probably is post-op swelling. Give it time. I do hope it all works out well. How complicated our bodies are! And do post again a couple of months down the line so we learn how it has gone, and how you are feeling. Meanwhile, every possible scrap of luck and best wishes. x

[Knowledgehunter]

Hello HashtagNell. It's quite the journey isn't it? But don't despair. I have a cube that was recently fitted. At first it felt most peculiar and uncomfortable. I was given number 2 . I was also sent home with size 1 to try if 2 didn't feel right. I removed 2 and tried 1 but it felt too small. So I reinserted 2 and now after a few days it feels ok. The little loop that you pull to remove it I am aware of but getting used to. I also use a oestrogen cream with it. I think perseverance is the key. One wonderful effect is that I no longer get up and down all night to urinate. I am sleeping at last and all pressure is gone. My practitioner said I can leave it in for 5 days or so before I remove it and clean it. So my experience is positive so far. I am hopeful and think if targeted exercises are also used there could be a good outcome. I hope you find a happy solution .

[HashtagNell]

Ah, this takes me back. I'm glad to report that a couple of years after starting this thread, I am much better. I couldn't use the cube, it was impossible for me and I gave up in the first two days. Too stressful by half!

But I did use sponges successfully for a quite a while, and religiously did the pelvic floor exercises with NHS Squeezy app (I still do them) and oestrogen pessaries.

Somehow the exercises gradually altered the situation, though this took at least six months before I felt any benefit. Now the prolapse (though it hasn't vanished and I can feel it more by evening) became much less uncomfortable. I no longer use a pessary, though I have sponges put by just in case, and I am perfectly comfortable walking and exercising again. When I went on holiday in March, I didn't even pack the sponges.

So I guess I am lucky for the moment. I don't suppose it will last forever, but then neither will I.

I think each of us is a little different, but this group was enormously helpful to me and I learned a lot. That prolapse changed my life, but happily not for the worse in the end.

Good luck with your own situation. x