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John
Reply with quote  #1 
My mother has a tried a few pessary devices with no luck, they end up coming out a day or two after being placed.

Today the doctor said he could try one more but after that he doesn't think they will work.

Now he is talking surgery, a vaginal hysterectomy and also  a vaginal vault supsension and an anterior and posterior repair.

The thing is she is 79 and has many health problems, she diabetic, biploar, uses a walker, had a knee replacement a few years that didn't go well.

This doctor can only do a portion of this surgery so  it means going elsewhere.

Does anyone have any experience with this and the surgery with a woman that old?

Thanks.
lizzie42
Reply with quote  #2 

I'm not familiar with this at all, but it does seem to me that at her age, at the very least a second opinion is in order.  Then, of course, she has to balance her symptoms against the risks.  Perhaps someone else will have more direct information.

Never Get Away
Reply with quote  #3 
john,

Absolutely get a second opinion, as this surgery was described to me by a top surgeon as delicate as stitching a sheer silk stocking.



Kim D
Reply with quote  #4 
Hello John,  it's sounds like your mother has Dx of prolapse uterus 2nd  to rectocele  and cystocele which in not uncommon of her age or women that has had large babies or mult births.  The sx you describe are fairly common ones to fix her medical problems.  There's risk with any surgery ( just read all the lovely ones on the surgery consent forms).  There for please get a 2nd opinion and even a 3rd if 1st and 2nd don't agree.  Your mother will need a cardiac and pulmonary clearance first before any surgery will take place.  Her recovery will depend on her will to follow the rehab instructions, biggest risks are going to be bleeding, infection, pneumonia and her blood sugars might be out of norm. Plus the plumbing will be backed up for awhile ( bladder and rectum).  Here's another suggestion to look at ......quality vs quantity...how much of this medical problem interferes with her quality of life?  Do you or any other family member have DPOA?  Does she have a living will or a DNR? 

Kim D
Reply with quote  #5 
I forgot to add about the "Dr only is able to do  portion of the surgery"  What he might be saying he can only do 1 out of the surgeries but will have to consult with other specialists to do the others all at the same time.  If they cannot do that, MAJOR RED FLAG and get that 2nd opinion.


Only Girl
Reply with quote  #6 

Hi John, DM has had a pessary for years, they get old and we get a new one, the problem is her health now, they say dementia and incontinence is a issue at her OB/GYN so guess who changes and cleans the darn thing? Me, oh well, getting off the subject, when mom had her surgery "the total woman", it was called by the surgeon ( cystacele and rectacele) it failed as it does in 75%-80% of the cases per a good friend of mine and a great surgeon himself. So, do I think she needs surgery? I can't say but I can say the surgery is almost always a waste of time and money and it is hard on the elderly. Has she been properly fitted for this device? Maybe she needs a larger one or perhaps a different type? I hope this helps some.

John
Reply with quote  #7 

Thank you all for responding. I am very uncomfortable with this.

My mother is not in the best health but she gets around with her walker. This sounds like a lot to go through.

One of you made  a comment comparing it to a silk stocking. That sounds about right.

The gynocologist wants to try one more pessary and then refer us to this surgeon. He did say to make an appt. and see what they come up with(the surgeon) before proceding.

I think to put a 79 yr old diabetic with various health issues under the knife is very  risky and from  what he described doing sounds incredibly invasive.

This all started because she was getting urinary tract infections and that is when this gynocologist suggested the pessary because the bladder was leaning on the uteris.

 
OhDear
Reply with quote  #8 

Could someone explain what a pessary is, why it is needed and what it does?

I've heard the name of the device but nothing else.


Never Get Away
Reply with quote  #9 
John,

I was the one to whom a surgeon likened the operation to stitching a silk stocking.

 Unfortunately, the females in my family have a long history of UTI's, and in our search for help we have found that D-mannose powder does work. My 89 year old mother used the powder 3X a day for a week for a UTI and now uses a pinch daily in water. Check out the extensive positive reviews on Amazon, I purchased D-mannose from iherb.com, but it can be obtained from the Vitamin Shoppe.

You of course should talk to your mom's doctor first, but I can see no downside in trying something like this. I am a big believer in taking the smallest steps first.

John
Reply with quote  #10 
Me to, me to  Never Get Away in regards to small steps.

So when I heard surgery, I was not happy. When we started with this doctor( who I like) he explained it might take several attempts before finding the right pessary.

He didn't like the idea of surgery given her age and state of health when we started and seemed against it.

Now he is willing to try one more device and then I guess he  is done with her.

Aside form the ususal risks of surgery I don't want to see the quality of life go downhill because they screw up or complications arise.

My mother uses a walker and wears pull ups, but she gets around and the bathroom issues are under control.

A bad vibe came over me when he started discussing this.
Janice
Reply with quote  #11 
 
My Diabetic MIL had this surgery TWICE, and it failed TWICE. Just my opinion, but if it were me, I would see a Urologist before I did anything else. Get their opinion first. It's not an easy surgery.
Only Girl
Reply with quote  #12 

Hi John and all: To Oh Dear, a pessary is a rubber device inserted into the vaginal area, in this case it seems to be to push the bladder off the female reproductive organs to prevent infections, however in DM's case the rubber ring (as it is) is used to push mothers bladder and rectum back into place as she suffers from both a prolapsed bladder as well as a prolapsed rectum (she had both a hysterectomy as well as large babies and several babies to boot), not a pretty sight to have to glove up and physically push DM's insides back inside of her where they should be, but we manage.

john
Reply with quote  #13 
Only Girl, so you have had luck with your mother and the pessary? Other than taking it out( I' m not doing that...LOL) for cleaning.

Did it take several attempts to get the right fit?

Our problem has been 6 different devices and none stay in.

He is only willing to try one more. So I don't know if they can't find one or this doctor is just giving up.

My mother would leave the office and they would stay in for a couple of days, the last one before yesterday came out the same day, hours after we left the office.

Yesterday they had  her go to the bathroom in the office, and it came out, I think that is when he threw up his hands.

I am going to have to do more research, I don't like the surgery option.  Someone on here said their relative had two surgeries and they didn't work.

WTP of puttting a 79 yr old woman through that unless it is going to work.


I am glad I come on this board, we are lay people, but I don't think the doctors tell you everything.

They make it seem like surgery is the answer, I want to know every possible problem, rate of sucess, how age and health factors in before doing everything.

Don't need her coming out of this worse than she is going in.
Only Girl
Reply with quote  #14 

Hi John (laughing at the statement that you wont change the thing) I dont blame you for not wanting to clean it, real icky for a female, even more gross for a male......yes, mom has had the device for years, her surgeries were in 1995, they didn't work, she went through several trial and error stages in fitting, they need to be sized, maybe the Dr is not placing it in correctly? Without sounding biased, I would find a female OB/GYN, she would be gentle and patient in fitting the thing, if the guy is already tossing his arms up with despair....your mother deserves a gentle, patient doctor. These things are alot like a diaphragm that prevents pregnancy, they fold in half to be inserted and once in place they spring open and look like a ring. Some of the devices are thicker as well as larger, ranging in size from 2 inches up to four or even five inches in diameter is my guess? Maybe the guy has it in sideways????

Only Girl
Reply with quote  #15 

John, just re-read your post, maybe he doesn't have in in far enough if it comes out that easily? It shouldn't "just slip out" like that???

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