21: Pessaries with Kristen Parise and Dr. Maureen Macdonald

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In this engaging episode of The Hole Shebang Podcast, Dr. Maureen Macdonald hosts an insightful conversation with Kristen Parise, a pelvic health physiotherapist specializing in women's health issues, particularly pelvic organ prolapse and pessaries. Pelvic organ prolapse, a common condition affecting up to 50% of women, involves the descent of pelvic organs due to weakened support structures. Kristen emphasizes that this condition is prevalent but often unaddressed, partly due to a lack of awareness and conversation.

 

The discussion starts with a detailed introduction to vaginal pessaries, devices used to support pelvic organs, much like how a knee brace supports a weakened knee. Pessaries are presented as a versatile solution for women of all ages, from those in their twenties postpartum to women over 100 years old. Kristen highlights their effectiveness not only in managing symptoms but also in potentially preventing further progression of prolapse by providing necessary structural support.

 

Kristen and Maureen explore the anatomy and function of the pelvic floor, emphasizing its vulnerability to gravity and life's physical demands. They discuss how prolapse can manifest differently in women, with varying symptoms such as the sensation of heaviness, urinary difficulties, and bowel issues. Kristen explains the grading of prolapse severity and underscores that even minor prolapse can significantly impact a woman's quality of life, making day-to-day activities challenging.

 

The podcast delves into the assessment process for pelvic floor health, demystifying what might seem an intimidating experience. Kristen describes a comprehensive approach that includes lying and standing assessments to understand the true extent of prolapse and ensure effective treatment planning. Emphasizing a holistic approach, Kristen talks about collaborating with other healthcare professionals to provide well-rounded support for women, acknowledging the role of teamwork in optimal pelvic health management.

 

Preventive measures are also a critical component of the conversation. Kristen advocates for early education and pelvic floor health awareness, suggesting that pelvic health assessments should be as routine as annual physicals, especially before childbirth. Proper understanding and strengthening of the pelvic floor, managing constipation, maintaining healthy weight, and mindful physical activity are recommended to minimize the risk of prolapse.

 

Another key point of discussion is the innovation in pessary design. Kristen shares her excitement about new developments in custom pessaries, which offer more comfortable, personalized fits compared to standard models. This innovation provides hope for those who previously struggled with standard pessary discomfort.

 

Overall, this episode is a valuable resource for anyone seeking to understand pelvic organ prolapse better and explores the role of pessaries as a supportive, effective solution. The key takeaway is clear: there is hope and help available, and conversations like these are the first step in lifting the veil on women’s pelvic health issues.