Jacqueline
Jacqueline developed pelvic organ prolapse after a radical hysterectomy. She treats the condition with a vaginal ring pessary, which she describes as “perfect”. Jacqueline is hesitant about mesh surgery and is keeping it as a “last resort”.
Jacqueline is a 66 year old White British woman. She is married and has two adult children. She is enjoying retirement.
Conditions: pelvic organ prolapse, urinary urgency
More about me...
Jacqueline began to feel that “something wasn’t quite right” with her pelvic organs around six years ago. She experienced urinary urgency and felt a noticeable bulge in her vagina. Jacqueline’s GP diagnosed her with pelvic organ prolapse and instructed her to do more pelvic floor exercises. Although she followed this advice, Jacqueline’s condition did not improve. Looking back, Jacqueline believes that the doctor “dismissed” the severity of her problems and feels “let down” by the care she received.
Jacqueline went to a different GP several years later who told her she had a “very bad prolapse” that would not be helped by pelvic floor exercises. The doctor suggested that her prolapse was likely because of a radical hysterectomy she had in 1999 to remove fibroids (non-cancerous growths that develop in or around the uterus). Jacqueline was referred to a gynaecologist, who recommended a mesh repair. Jacqueline had heard about the “horror stories” around vaginal mesh so she chose to try “everything else” first.
For the last three years, Jacqueline has been successfully managing her prolapse with a vaginal ring pessary. Jacqueline described the insertion and removal as “uncomfortable” but not painful. She finds that “it’s perfect” and “it suits me down to the ground”.
At her doctor’s recommendation, Jacqueline is also on the waiting list for vaginal mesh. Around six months after her consultation, she received a letter scheduling a surgery. Jacqueline chose to stay on the waiting list instead of having the surgery. Her nurse has encouraged her to “carry on as you want to”, which Jacqueline plans to do until the pessary stops working for her. Jacqueline feels that “as it stands at the moment, [I’m] quite happy to do what I’m doing”.
Jacqueline’s choice to avoid a vaginal mesh procedure for her prolapse was partially informed by her prior experience with surgical mesh for a hernia repair. Over time, the mesh used in her hernia repair became “quite lumpy” and she can now “feel it very, very pronounced”. Jacqueline is concerned that vaginal mesh would have similar complications and considers it a “last resort”.
Jacqueline feels fortunate that the second GP she saw took the time to examine her and “took on board how [prolapse] was affecting my life”. Using a pessary has made Jacqueline feel “far more comfortable”; she generally “doesn’t even know it’s there”. Jacqueline emphasises the need for women to not let themselves be “fobbed off” by physicians and to “find the right GP, push it”. Currently, Jacqueline finds that pelvic organ prolapse doesn’t affect her everyday life. She wants other women to know that pelvic organ prolapse is “not the end of the world” and that “it can be resolved”.
After the advice Jacqueline was given didn’t help her, it was several years before she felt it was worthwhile going back to her GP again to ask for help about her prolapse.
After the advice Jacqueline was given didn’t help her, it was several years before she felt it was worthwhile going back to her GP again to ask for help about her prolapse.
So, having had a radical hysterectomy back in 1999, everything was going along marvellously, yes, I did have to have a hernia repair afterwards. But it had no problem at all. But became aware probably about sort of six, eight years ago that something wasn’t quite right. Went to my local GP who diagnosed a prolapse and basically sort of said, “Oh well, just go home, do pelvic floor exercises for three months and see how it goes.” Well, I did that having done that for I don’t know how many years before anyway. Went back after three months and she said, “Oh yes, it looks to be improving. Just keep going.” And that’s how it went. So, yes, I did, but progressively, you know, yes, it was affecting my bladder, you know, there was like I need to go to the loo and I need to go to the loo now, different stuff like that. So I went back probably about three years ago now, and saw another GP and she examined me and she said, “[mm] You’ve got a very bad prolapse. Nothing on this earth is going to help it you know, just by yourself doing sort of yeah, pelvic floor or anything like that. I’ll refer you.”
Jacqueline describes the process of having a pessary inserted. She considered the process to be “painlessly intrusive”.
Jacqueline describes the process of having a pessary inserted. She considered the process to be “painlessly intrusive”.
So, yes, it’s a case of you know, lie back, open your legs. It’s just I assume they obviously squeeze it together so that it’s not just you know, try to insert a ring, but squeeze it slightly and obviously yes, it goes in. You’re asked to take a breath, but keep breathing deep breaths. I think the very first time I had it changed it was a case of, “Well have you done it then?” Because it was so…painlessly intrusive. It was you know, it was just incredible. But, yeah, you know, it’s uncomfortable. It’s not the nicest thing. But, equally, it does what I want it to do and you know, after the first one’s fitted they always advise to sort of go for a little walk, blah, blah, blah. Go to the loo. Walk around for half an hour just in case it’s not the right size. My first one did actually dislodge after 10 days, so I did go back and have a larger one fitted. But again, that was fine.