Mumsnet has not checked the qualifications of anyone posting here. If you have any medical concerns we suggest you consult your GP.

Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc part 7

(1001 Posts)
gottagetthroughthis Fri 19-Oct-12 00:38:09

This is thread 7 of a long-running series of posts from ladies suffering from pelvic prolapses to support each other through the process of diagnosis, repair and recovery.

Here are the previous threads:
Thread 1
Thread 2
Thread 3
Thread 5
Thread 6

Info from BBC Health

What is a pelvic prolapse?

As the muscles, ligaments and supporting tissues in the pelvis become weaker, they are less able to hold in the organs of the pelvis such as the womb (uterus) or bladder.

Gravity pulls these organs down and, in the more severe cases, may appear through the entrance to the vagina.

A variety of problems can occur, depending on where the weakness lies and which organs are able to descend, but in every case there is some degree of prolapse of the vaginal wall, which begins to invert (rather like a sock turning inside out).
Prolapse of the womb or uterus is the most common prolapse, affecting as many as one in eight older women to some degree
Prolapse of the bladder, known as a cystocele, is less common.
Prolapse of the urethra (the tube that carries urine out of the bladder) is known as a urethrocele.
Prolapse of the intestines is quite rare, and known as an enterocele or rectocele.

Symptoms

Symptoms depend on which tissues descend, and how severe the prolapse is.

They may include:
A sense of heaviness or pressure in the pelvis.
The appearance of a bulge of tissue in the genital area, which can be quite alarming, and is often red and sore.
Urinary problems, such as having to urinate more frequently, feeling the need urgently, being incontinent (losing control of the bladder) or, conversely, being unable to pass urine when you need to.
Pain in the pelvis or lower back.
Sexual problems, including pain and decreased libido.
Constipation.
Vaginal discharge or bleeding.

Treatment and recovery

Once a prolapse has developed, surgery to fix the affected organs is usually the only way to cure it effectively.

However, another option is to use a device known as a vaginal ring pessary. This is rather like a contraceptive diaphragm or cervical cap. It's made of silicone or latex, and placed in the vagina to push back the prolapsed organs and hold them in place. Many women happily manage their prolapse this way.

cardamomginger Wed 30-Jan-13 19:30:19

Hi Mangled.

You poor thing. I think you have to go back to your GP and go and see the gynae again. I wouldn't say anything at the consultation about having been lax about PFE's - if you admit to that that may just make them tell you to go away and start doing them again, and I think they need to take what you are saying more seriously than that. BTW - was the gynae you saw a specialist uro-gynae who does pelvic floor reconstruction? This is who you should be seeing, not just a general gynae clinic. Ditto the physio - this should be a specialist women's health physio.

This hasn't happened to me, so I am not speaking from experience, but urine can leak out of your vagina if you have a fistula - a small hole between the urethra and the vagina. But it might not be that. If you have nerve damage down there it can sometimes be hard to work out exactly where things are coming out of.

Did you have any scans or tests to assess the anal sphincter or how the rectum? If you have faecal continence problems, I would have thought that this would be sensible.

You can have surgery if you haven't completed your family yet - it just means that you need ELCS (and probably an early one). Of course, that might not be what you'd want. But wanting more kids doesn't automatically mean no surgery.

And of course, you might not need surgery. I've unfortunately had quite a lot of procedures done and am heading for operation number 3 next month. But, I'm thinking about my own rectal problems that I still have that are not dissimilar to your's. In my case the anal sphincter is intact, but my muscle tone is rubbish. I;m having another test tomorrow to rule out any high rectocele that can't be felt on normal examination, but my surgeon is talking about even more precise PFE's involving a biofeedback thingy. I don't know any more about it than that - there was no point asking any more questions about it until after tomorrow's scan and after my surgery. But just to say, that there may well be options to help that are not surgical. And if PFE's have helped you in the past, then that it a really good sign. 3/5 strength is great! When I started my 'journey' I was a 0/5!

But I think you need to get back to the GP and get specialist assessment from a specialist gynae.

XX

cardamomginger Wed 30-Jan-13 19:32:25

Evening everyone.
Haven't posted for a while. It's all been a bit too much sad. Tomorrow morning I will be lucky enough to experience the joys of an MRI proctogram. Was wondering if anyone here has had one and if it is a hideously vile and it sounds and as I am imagining it to be. Would be really grateful to hear from anyone who's had one!

thrifty Wed 30-Jan-13 19:53:40

That's great news wouldrather, where in the country are you?

thrifty Wed 30-Jan-13 19:57:45

Hi cardomom, I'm sure someone described one up thread, said it wasn't pleasant but fascinating.

wouldratherbeskiing Wed 30-Jan-13 20:00:13

Bournemouth - Mr Balmforth

cardamom - sorry to hear you're still undergoing tests - great advice for mangled.

Cardamom - if you scroll back up to 14th Jan a poster called MiseryArse described the defecating proctogram procedure.

Wouldrather - that's brilliant news, very pleased for you.

Bladder - good luck with pre-op

cardamomginger Wed 30-Jan-13 20:13:51

Thanks! I shall go hunting.

mangledbits Wed 30-Jan-13 20:53:26

Thanks so much for the great responses.

Sorry to hear so many of you are going through so much. cardamomginger thanks so much for taking the time to reply, sorry you have more tests.

So I have had a good rummage. I appear to be weeing out of the correct place, which is brilliant. I had no idea things were all so close together {blush} my biology is clearly shocking. Had to google for a diagram to see what I was looking for. I think the problem there is that since childbirth everything is so loose! I never realised it would be so visibly noticable. Does everyone have this? My labia seem to be gaping open much more than usual and generally everything is a bit floppier and puffier? Does that make sense? Maybe that is why urinating feels different - a larger area for the wee to trickle around? ugh.

As for the fecal incontinence. I wouldn't really describe it as incontient - just sometimes I can't really seem to get properly clean. Not every time. And I have no problem holding on. Didn't have any scans or anything, and it was something that came on a few weeks after I saw the gynae so didn't mention it to him. Physio specifically asked me about that at my follow up appointment, as if it was something she's been expecting me to be experiencing. (yes, she was specialist womens health) She said that this was likely to be that when I have finished going, a healthy normal sphincter would suck up any last remaining bits of poo and they would stay inside until next time. With me, due to muscle laxity, this doesn't happen properly and so I find it hard to wipe. Does this sound plausible? TBH that is the aspect of this whole thing that doesn't bother me so much - the smelling of wee/feeling wet is way worse. I might have to start buying moist bum wipes though!!!

The gynae wasn't specialist urogynae but he does list prolapse as a speciality. He is actually an ob/gyn and works in St Thomas private wing. Maybe some of you have met him? TBH he was a bit disinterested and I think he did the app in his lunch break (they fit me in quick) he seemed preoccupied, but maybe that was my pnd creeping in as I was feeling very anxious at the time!

I will defo visit gp. Thing is, I am moving soon to new area and new gp, so will prob wait til then and hope for a more sympathetic doctor. Only downside is that I will be far from the gynae hospital.

THanks again for the advice.

fengirl1 Wed 30-Jan-13 21:35:28

Mangled - my inner labia blush seemed to be on a mission to reach my knees prior to my first op! As for the wee seeming to come from the wrong place, this might be because things have slumped so it comes out in a different direction iyswim? I'm quite good at weeing sideways over the back of my thigh and my buttock at times.....
Wouldrather - great news! I too felt much better after my second surgery than the first, just don't be over-confident! smile

cardamomginger Thu 31-Jan-13 12:04:23

Well, the proctogram was grim. But I survived. Although I doubt I'll ever be able to look at mashed potato the same way again (they squirted Smash up my bum) blush.

Dahlialover Thu 31-Jan-13 15:47:59

I missed out on a defaecating pictogram - it would have been interesting to know what was going on in there hmm. The 'Smash' has made me laugh so much!

Don't know whether my infection is going or not - back to doctors tomorrow [smiley resigned to fate]. Hope it hasn't done anything bad. Every thing was going so well. Hopefully this is a minor hiccup.

Hope you find a good GP, Mangled. I have always had problems if there is a bit of poo left - it always seemed to find it's way out and had to be 'removed'. I am not sure if that problem has gone or not - hopefully, there is less likely to be stuff left behind. I am still taking fibogel and using glycerine suppositories when necessary, although I have had a couple of successful goes without!

Tr0ubled Thu 31-Jan-13 19:06:46

Mangled, when pg with no.1 I always hit the cup perfectly for my wee test with the midwife but when pg with no.2 I rarely got any in the cup! My direction now can go anywhere and sometimes it just sprays out! (Gotta love this thread for tmi!). I also have problems wiping clean, this can either be because I still need to poo or because unfortunately I have quite bad haemorrhoids, skin tags and an anal fissure, all of which make it hard to clean properly and I often have to use my kids 'kandoo' wipes.

Cardamom, I have had 2 defecating proctograms, not sure why as the first one was conclusive. The first was actually rather comical as the spring on the X-ray had broken so the consultant had to kneel beside me to hold it in place, which meant I had none of the dignity of 'doing it' behind a screen, instead he was eye level with my waist!

Wouldrather, I'm so pleased you feel so good following your surgery and also great to know that the posterior repair is holding and healing well.

I went to see a colorectal consultant yesterday as my UroGynae suggested fixing the haemorrhoids, skin tag and fissure at the same time as my anterior, posterior and perennial repair! Guess I might as well get it all over with in one go but have to say I feel even more nervous about the level of post op pain I will be in. Think it would be ok if it could all be bandaged over and left to heal but the fact that all these wounds will be exposed to acidic urine and dirty poo fills me with dread. Anyway had another comical moment when the colorectal man suggested he would help the fissure by injecting it with Botox. Well if I was ever going to have Botox I never expected it to be in my bottom!!

cardamomginger Thu 31-Jan-13 20:11:33

Hi Troubled!
I had to do my poo lying down inside the MRI machine. I guess I had maximum privacy, but it was truly grim! But I think I would rather my experience than yours! Eek!!!
I had botox in my pelvic floor - I agree it is odd...!
X

hoppy35 Sat 02-Feb-13 12:25:25

Have been guided over to this thread and hopefully someone can help I suffer from stress incontinence I've had the tablets didn't help been for a scan which revealed" normal has this happened to anyone else this stress incontinence has completely put my life on hold any advice ?

Melady Sat 02-Feb-13 16:21:08

Welcome hoppy35, you've come to the right place, there's lots of advice here and someone is sure to be able to help you.

I have stress incontinence too and am booked in for the TVT op on Tuesday. Its possible I also have a prolapse which is being investigated at the same time but I'm hoping they won't find anything.

There's tests you can have done to decide the best course of action. Good luck!

surewoman Sat 02-Feb-13 17:00:42

Hi everyone - I haven't been on for quite a while as I am finally fixed!!!
Melady - if you have any questions about TVT I have one and have had no problems at all and absolutely zero leaking since the op in June.

Wouldrather - great to hear all is going well for you too XXX

Hope all you lovely ladies are healing well, hugs to all xxx

Melady Sat 02-Feb-13 17:19:04

Hi Sure, thanks for the offer. I actually feel like a bit of a fraud on this thread where everyone else seems to have much worse problems to deal with. I've done lots of reading through these threads which are really encouraging as well as others which seem to have the sole purpose of scaring people.

Out of interest, how long after the TVT did you need to take off work? I have my own business and can work from home a little but a week away will be a struggle and that worries me.

Also the thought that something else might be found during the op - Dr told me she thought I had a 'bulge at the back' which she'd investigate when I'm under anaesthetic is another worry. I'm hoping it's nothing that needs further treatment. Anyway, I know I can ask questions on here afterwards when I know what it is and if it's anything to be bothered about.

fengirl1 Sat 02-Feb-13 19:49:56

Ooooh hello Sure! smile aaaaaand?? Btw not that's it's anything to boast about, but I've broken your record. 123 days today. Really good to hear how well you're doing. grin

surewoman Sat 02-Feb-13 23:27:03

Hi Melady - I had other ops at the same time as the TVT (cystocele, rectocele and perineum rebuild) so needed a long time off work. I had the ops on 22nd June and went back to work after the summer holidays (3rd Sep) and needed all of that time. My consultant did say that for the tvt to work properly I had to basically do nothing at all for 2 weeks and then only light walking. No driving until 4 weeks. Absolutely no lifting (nothing heavier than a kettle) and no bending over/stretching. I followed his instructions to the letter as I really wanted it all to work. My consultant (a Uro/Gynae) told me he was very good at inserting tvt's as he had been doing it since they first came on the market and wasn't one to try out the newer models, preferring to stick to the tried and tested original gynecare tvt classic.

Just in case your consultant does find more things to fix, I would mentally be prepared to be at home afterwards for about a month if not more. It all feels a bit bruised afterwards (like my consultant said, what do you expect, you have just been skewered!!!) Good luck with it all - I will check in again in case you have any more questions xxx

Fen - how are you???? Any exciting gossip from you? Nothing to report here yet - I still have to pay a subscription on the dating website to get anywhere!!! Lol! Hope you are well xxxx

surewoman Sat 02-Feb-13 23:30:07

Fen - 123 days of what?????! Which record is that one???!!! confused!!!

mangledmess Sun 03-Feb-13 06:39:15

Can I ask the lady who has the peristeen irrigation equipment a question please. I am sorry I do not know the posters name as I am on my phone and can not find it again. Anyway the question is " did you have to do the whole anal irrigation infront of a nurse before you were allowed the peristeen kit to use at home?" I refused so they will not see me any more.

For the lady with cronic kidney... I have not heard of a rectocele being caused by the disease and I am a long term kidney patient.

Nice to read of people having their operations and hope you all have good recovery. Sad to read others are no further forward or even on the waiting list for surgery.

I was confused before reading replies for a mangled so I will get a new user name once I get to a computer and set one up.

fengirl1 Sun 03-Feb-13 07:11:57

Sure, I didn't mean to be mysterious, I was talking about the PDS stitches. I'm ok actually, back to normal hours at work and pretty much symptom and pain-free besides the stitches which still make me ache like I've been kicked sometimes. I even got in contact with a friend and went and mucked out six stables on Friday! I have no movement on the dating scene either, but I haven't really done anything about it. smile

Tr0ubled Sun 03-Feb-13 09:37:54

Mangled, I'm pretty sure I remember reading another lady saying they wouldn't offer the kit unless she had a lesson with the nurse. She didn't want to do this and so didn't receive the kit either.
Unless of course I'm getting confused with an earlier post you've written? I'll see if I can search for you.

Tr0ubled Sun 03-Feb-13 09:47:24

Mangled mess, I've just searched back but couldn't find anything within the last few months other than your messages at Christmas time. Sorry hon.

wouldratherbeskiing Sun 03-Feb-13 09:59:34

Sure - great to hear things have finally got sorted for you. Your experience of TVT’s will be so heartening to those diagnosed with similar problems.

Fen – I hear what you are saying and definitely taking it really easy and like Sure will be following everything to the letter to ensure I keep up this amazing recovery. Mucking out 6 stables!!!!! So pleased to read you are getting fitter.

I can’t believe how well I feel compared to last time. None of that post anesthetic ‘knocked out’ feeling and only a little discomfort – no pain relief necessary.

The last two years have at times pushed me to depths that quite frankly scared me. This forum has been such a comfort and I want to thank everybody who has supported me and those who don’t even know they supported me just by posting their candid experiences. So thank you everybody on here – I think I could be finally fixed and if something else goes I am in a better place mentally to deal with it and get that fixed too.

This thread is not accepting new messages.