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My mom is 84 with fairly far advanced dementia. I’ve recently taken her to a specialist for the uterine prolapse, but the doctor recommended “potty training” and putting lotion on to keep from any breakdown. Did not recommend any kind of actual relief from the prolapse, said she did not recommend surgery unless it was affecting her kidney in some way. Anyone else deal with this? I can see it’s physically bothering her at times. Thanks for any suggestions!

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? Potty training? You don't mean pelvic floor exercises, do you? - tricky for an older lady with dementia, I'd have thought, but not the worst idea.

Putting lotion on *what*?

The pessaries seem to be the treatment of choice, we have a handful of clients who use them successfully.

I'd take your mother to a different doctor to get measured and fitted, though (make sure they're careful to get the right size for her).
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Ambrianne Mar 2022
“On *what*?” Bahahahahaha!!! Thanks for the giggle.
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My mom got a prolapsed uterus a couple of years back and ended up w/a pessary. She’s now moderate/severe dementia and has to get the pessary changed every few months. I try to not have her go out for doctor stuff unless it is totally necessary. Pessary replacement appts suuuuuuck but fall into that category - the pessary really does the trick for her, I can only imagine how hideous a prolapsed uterus would feel! :P

Pessary option is totally worth looking into. Mild caveat my mom’s physical pain tolerance has been and is like 11 out o 10, it’s unbelievable what she sails through!

Good luck!
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A pessary has made all the difference for my mom. She goes to see the urologist every three months to ensure she’s still locked and loaded, and that has been all there is to it.
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I second exploring the idea of using a pessary, there are some that can stay in place for months at a time.
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It’s already been noted in previous answers but a pessary was a game changer for my 78 yo mother with Parkinson’s. She also has an e-string now which supplies estrogen for 3 months. I take her every 3 months to her uro/gyn to have the pessary removed and cleaned and the eString replaced at the same time. We have had little to no issues with either. Since taking these steps she has gone from having literally a constant UTI to having 1-2 a year. (Note: she also takes Hiprex 2x daily per her infectious disease doc)
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Ask for a referral to a gynecologist. She may benefit from a pessary - a small device that is inserted into the vagina to keep organs in place. As for surgery, if allowed, she would benefit from a hysterectomy via the vagina. Ask if they could do spinal anesthesia with conscious sedation for the surgery. She would not be "fully asleep" as with general anesthesia but would be drowsy and not feel a thing.
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I would see a urologist or other specialist,perhaps gyne. I think "potty training" is a bit bizarre. Urgency and frequency is a common side effect with aging in any case with the thinning of the mucous membranes of the urethra. When there is the added pressure of a prolapse uterus I think "potty training" is a bit of a silly idea. Check with the specialist. Hysterectomies are commonly done vaginally these days, and it may be worth considering that with minimal anesthesia; always that is a concern with age. This isn't going to be comfortable no matter WHAT otherwise. She joins the ranks of the famous such as Queen Victoria. She had a dreadfully prolapsed uterus it was found after her death.
I wish you luck. I know if you go up to the search spyglass on the aqua line above we have had the question; I am uncertain if other OPs came back to us to say what was done or how it went. I wish you luck.
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I agree with the pessary option as she most likely is not even a surgical candidate at this point and you don't want to put her through a surgery if it is not necessary now anyway. My strong suggestion is that you seek consult from a clinician that is well versed on fitting them as many gynecologist don't do it often, if at all, and may only have a few sizes available. The fitting is an art and the last thing you want is one that is too small and falls out everytime she toilets or is too large and creates vaginal erosion to the thinned and dry tissue. She most likely will need some vaginal estrogen supplementation to avoid that. Any Urogyn is well trained to do this as well as some women's health ARNP's. The first thing I would ask any clinician is if they like using pessaries and if the answer is no then look on. The next question is how often and/or how many pessaries have they fitted. If fitted well she won't even know she is wearing and it can be removed and cleaned by either a caretaker that knows how or a simple in office procedure approx every 2-3 months.
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TheresaG: Imho, I believe that your mother's specialist, whether a urologist or a gynecologist was off target/incorrect when he recommended potty training (possible pelvic floor exercises) and the application of lotion. The pessary seems to be the method of choice/option to correct uterine prolapse. Seek another specialist.
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Cover99 Apr 2022
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i had a uterine prolapse after the birth of two children, resulting in a hysterectomy at age 36. Here is my insight. The prolapse is painful and feels like a heavy weight inside dragging down the organs. Also the backs of the legs become sore. It helped me to lie down and put my feet up several times a day when possible. A heating pad on the backs of the legs and buttocks relieved the pain there. Also sleeping with legs elevated might help. Then, I had to have a bladder sling installed several years ago. I was fortunate to find a pelvic floor specialist to diagnose, treat and operate. Look for a board certified urologist/gynecologist who has advanced skills, not just an ordinary one. I’ve been to urologists who didn’t understand the problem, and the average GP or internist is clueless. Good luck!
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