Pessaries Various types of pessaries and their uses, ask your doctor for information.

We thank you for helping raise the awareness about pelvic organ prolapse and how to help women obtain a better quality of life. To find out where your nearest women’s health clinic is, or if you require brochures for your clinic, please contact us. C&G Medicare Ltd is an approved NHS supplier.

C&G Medicare, Williams House, 11-15 Columbus Walk, Cardiff, CF10 4BY T: 0871 218 1233 E: info@candgmedicare.comYou can also download more information at: www.pelvicorganprolapsesupport.org and www.candgmedicare.com

Experiencing Pelvic Organ Prolapse?You are not alone.1 in 5 women may have one or more symptoms of pelvic organ prolapse, yet very few speak about it!Many women feel isolated and don’t know how to explain what they feel physically or emotionally.

“ Pelvic Organ Prolapse is seldom life threatening but it is always life altering” Sherrie Palm APOPS founder

Association for Pelvic Organ Prolapse Supportsponsored by C&G Medicare Ltd

www.pelvicorganprolapsesupport.org and www.candgmedicare.com

Type

Uses

Insertion/removal

Removal for intercourse

IncoStress Slight cystocele, Rectocele, Stress Incontinence Bladder neck and urethra support

Easy Yes

Ring Mild uterine prolapse and mild incontinence Easy/Medium

Not needed

Donut Moderate uterine prolapse Medium Yes

Thick Ring Mild uterine prolapse without severe incontinence Yes

Urethra ring Urinary stress incontinence Medium Not needed

Urethra Bowl Urinary stress incontinence with severe descensus Medium Yes

Ring with support Mild uterine prolapse Medium Yes

Incontinence dish Urinary stress incontinence Medium Yes

Dish with support Urinary stress incontinence with mild prolapse and mild cystocele Medium Yes

Gellhorn Moderate uterine prolapse Difficult Yes

Club Moderate to severe uterine prolapse Difficult Yes

Inflatable Moderate to severe uterine prolapse. Also multiple prolapses Easy Yes

Cube Moderate to severe uterine prolapse (good if patient is unable to support a ring)

Medium Yes

Tandem (custom made) Moderate to severe uterine prolapse (supports cystocele & lower rectocele also)

Medium Yes

Gehrung with or w/o knob Moderate to severe cystocele. Mild to severe uterine prolapse. Mild rectocele (depending on where in bowel)

Difficult Not needed

Hodge with or w/o support Urinary stress incontinence for the woman who has a small vaginal introitus

Medium Not needed

Mar-land with/out support Moderate uterine prolapse, a cystocele or rectocele Medium Not needed

Bowl or Sieve Bowl Mild vaginal vault and uterine prolapse Difficult Not needed

Oval Mild uterine and cystocele Difficult Yes

T Pessary B and R type Mild cystocele, enterocele and rectocele as well as urinary stress incontinence

Easy Yes

Cramer Urinary stress incontinence Medium Not needed

Cerclage (2 types) Used to treat pregnant women with an incompetent cervix Medium Not needed

Shaatz Mild uterine prolapse complicated by a mild cystocele Medium/ difficult

Yes

Smith or Risser Designed for patient with shallow pubic notch Used for retroverted uterus in pregnancy Urinary stress incontinence and mild cystocele

Difficult Not needed

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What is pelvic organ prolapse (POP)?The pelvic floor is a structure of ligaments and connective tissues which supports the bladder, urethra (tube which lets urine flow from the bladder out of the body) uterus (womb), cervix, vagina and bowel.One or more of these organs can descend into another organ; this is a pelvic organ prolapse.There are different stages of POP, in stage 1 you may be symptom free, to stage 4 where the organ protrudes outside the body. It is crucial you see your doctor if you suspect you are experiencing any symptoms of POP.

Who is affected by pelvic organ prolapse?Pelvic Organ Prolapse is so common that it can affect any woman regardless of age, however the natural production of oestrogen and collagen decreases with age and makes it difficult for the pelvic floor muscles to retain sufficient strength to support the organs.Women who’ve had a difficult and/or multiple deliveries are at risk of POP. This contributes to stretching and weakening of the pelvic floor muscle tone.Other factors may be obesity, diabetes, connective tissue disorders, hereditary pelvic floor issues, weakening of the pelvic floor through previous surgery.Those who repeatedly lift heavy weights, experience chronic constipation or chronic coughing increase their risk as the pelvic floor is being constantly forced downwards.

Pelvic Organ Prolapse can affect women of ALL agesAsk yourself:Do you feel like your insides are falling out?Do you experience painful sex?Is inserting a tampon painful or difficult?Do you feel you are sitting on a golf ball?Do you have pelvic pain?Are you experiencing incontinence from either front and/ or back side?Do you feel you are unable to completely empty your bowels?

If you answered yes to any of these please speak to your doctor about pelvic organ prolapse. Ask your physiotherapist for correct pelvic floor exercise training (kegels). It’s crucial you exercise the pelvic floor correctly.

IT’S NEVER TOO LATE TO START PELVIC FLOOR EXERCISES!Pelvic floor exercises are of value as a preventative measure, additionally they can reduce symptoms.

PessariesPVC and silicone pessaries are available on prescription from your healthcare practitioner. Other pessaries are available without prescription. Contact us for a full list available.Pessaries should be fitted by a pelvic floor specialist. Some pessaries are removed, cleaned, and reinserted daily at home, others are inspected every few months by your healthcare practitioner.

What are the symptoms?• Pain or heavy presssure in pelvic/vaginal/rectal area.• Difficulty initiating or completing urine/bowel movements.• Urine or bowel incontinence.• Recurrent bladder infections.• Pelvic/back pain.• Painful intercourse.• Lack of sensation during intercourse.

Is surgery my only option?No there are pessaries that can support the pelvic organ prolapse but your doctor will be the best person to advise you. Physiotherapy is also recommended with both.

Can I get a pelvic organ prolapse after a hysterectomy?It is possible, without the uterus (womb) there is less support in the pelvic area.

Can diet control POP?Diet plays an important role in self-treatment, particularly with a rectocele.

I’m afraid to tell my partner that having sex causes so much pain, it doesn’t feel comfortable.This is a common reaction. Talk to your partner. If he had a hernia or swollen testicle how would he tell you? Think of POP as a female hernia and take it step by step TOGETHER.

What are the different types of pelvic organ prolapse (internal pelvic organ hernia)?Cystocele – (dropped bladder) is descent of the bladder into the vaginal wall.Urethrocele – drop of the urethra usually collapsed by the pressure from the bladder.Rectocele – The large intestine (rectum) forms a ‘pocket’ and bulges into the back wall of the vagina.Enterocele – The small intestine pushes into the upper part of the vagina.Uterine prolapse – The uterus (womb) descends into the vagina.

Weak muscle structure is a factor of pelvic organ prolapse.

Do men experience POP?No, they can experience abdominal hernias or/and inguinal hernia in the groin.

Recommended reading to help you understand more about POP.

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