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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.

Bladderama Sun 03-Feb-13 10:36:19

Thank you Surewoman and Troubled for posting these positive outcomes it is really good to hear especially before I go back into surgery tomorrow, the re-assurance and experience shared on this thread has been a lifeline and this level of real life information is just not available anywhere else.

The pre-op was just some blood tests so I didn't get to ask any of the questions that I had finally written down which was quite disappointing. I will need a new list to ask my consultant in the morning so that I don't forget again. I find that I get quite overwhelmed with information and don't ask the things that I need to.

There have been a few of you asking about bladder troubles. I can't really offer much advice even though a large part of my troubles have been bladder related. I do not have stress incontinence but will post my symptoms on the off chance that it might help some-one else in the future because it has not been an obvious problem. The main issue is that I leak when I stand up after emptying my bladder, the more this happens the more irritated my bladder becomes and I have to start going to the ladies far too often and during the night. I did have a bladder prolapse which was repaired last year but it did not help these symptoms, the urodynamics tests showed that I do not empty my bladder properly and retain up to over 200 mls in it after I have wee'd blush and also have a low flow rate.
They think that there is some-thing obstructing either the bladder outlet or the urethra which is one of the things that is being sorted tomorrow. The idea being that if they widen the urethra I will be able to empty all of my bladder and it will not get irritated so fingers crossed!
I am also having the back wall repaired again to sort out some post repair issues.

I am down as a daycase and have no clue what to pack, any advice or ideas?

Bladderama Sun 03-Feb-13 10:37:04

Oops that should have been wouldrather, can you tell I am distracted?

mangledmess Sun 03-Feb-13 10:41:06

Thank you for your time troubled and I have finally found the poster I mentioned, it was a lady called nannasylv. It was posted on the 4th thread and I didnt realize I wasnt on thread 7 (stupid phone).

Im am at present waiting for an appoinment for a 3rd opinion. My transplant consultant has referred me to a named consultant rather than just any old registrar that I would get with choose and book through the GP. He probably felt sorry for me as I told him I wished I wouldn't wake up at my last appointment. My referral was sent 7th january with all my previous gynae history and notes from the other hospital but not had a letter sent still. Everyday the postman walks passed my house with no mail for me I could just cry. Going to wait until the end of the week and chase it up. It's 4 weeks tomorrow since my referal and I think that is too long and nothing but cruel.

mangledmess Sun 03-Feb-13 10:44:03

Best of luck bladderama. I wish you well x

Bladderama Sun 03-Feb-13 11:15:01

Thank you mangled and that is terrible, can you ask your GP surgery to chase your referral for you? It really does seem to make a difference which area we live in as to how quickly these things happen.
I hope that you get an appointment as soon as possible xx

mangledmess Sun 03-Feb-13 12:17:16

Ahhh thank you bladdrama x I didnt want to chase my appointment up incase I appear to be a nuisance or annoy the new consultant in any way before I have already been seen as I am beyond desperate for him to help me.

mangledmess Sun 03-Feb-13 12:23:35

Ahhh thank you bladdrama x I didnt want to chase my appointment up incase I appear to be a nuisance or annoy the new consultant in any way before I have already been seen as I am beyond desperate for him to help me.

wouldratherbeskiing Sun 03-Feb-13 12:50:29

Good luck Bladder - Not sure what to take for a day case. I'm surprised they will not be keeping you in as even for a straightforward anterior repair I had a cathetar in until the next day and had to produce 3 'good' pees plus a clear bladder scan before being discharged. There was a lot of concern about checking I had emptied properly and I was told by the sister to have a pee then stand up and rock my hips and then go again. It is always good to get back to your own bed though but I would expect a longish day. Sounds like this is your 'home run' too.

Mangled - I felt a bit like you about making contact but eventually rang the Consultant's secretary. I said I wasn't pushing etc. but was finding the whole episode distressing and I wanted to have an idea of timescales. I found her really helpful and actually got an appointment sent the following day. Good luck.

Losh Sun 03-Feb-13 20:10:34

Hi everyone,

I am now 4 weeks post op for a rectocele and perineum repair. I started my period last week and whenever I passed wind or went for a poo, noticed quite a bit of discomfort. As I usually find pooing a bit more uncomfortable when I am on my period, I didn't think much of it.

However, my period has now stopped but I still have the pain. It is a aching / shooting pain in my bum, which gets worse if I have been standing for a while and especially noticable when I cough or sneeze. Dr Google mentions nerve damage in relation to buttock pain following this type of surgery. Does anyone have any experience of this?

I also have a slight chafing sensation in my vagina when I walk. I was wondering if this was to be expected with a perineum repair or if I should be concerned?

Any input gratefully received!

fengirl1 Sun 03-Feb-13 21:19:17

Good luck Bladder!
Losh, might some of your stitches be pulling at this stage? They probably won't be out yet (mine took six weeks)... The other possibility is that they might be poking you as you move. Could be worth getting your gp/nurse to have a look and see if any need trimming. I did get pain up the bum, can't remember at what stage, but if it goes on and on worth being seen anyway. smile

fengirl1 Sun 03-Feb-13 22:31:58

Oh and Losh, if your perineal repair was done with a continuous suture rather than separate stitches, don't be surprised if you start to feel like you're sitting on a cheesewire! It does eventually go. grin

Losh Sun 03-Feb-13 23:00:50

Thanks fen. Haven't a clue how I would know if the stitches were pulling?!

It's only on the left side and has been ok until tonight, when I had a big sneeze and the pain was incredibly intense for a second. It was my son's 2nd birthday party today, so I have been on my feet quite a bit.

I had sort of assumed that the worst of the pain would be over by 2 weeks, sigh!

The stitches in my perineum were separate I think, but they were taken out at my 2 week check, so unless there are more inside, hopefully I will dodge that bullet - sounds vile.

This stage is horrible - I can take the pain and all the weird feelings, but I just want to know that it's all ok. I hate worrying that something might be wrong with the repair, or that things might not work afterwards. It makes me anxious. I'm sure everyone feels the same way, but oy, it's wearing!

Dahlialover Mon 04-Feb-13 11:58:53

Hi Losh - I am 3 weeks post op with rectocele and perineal repair. I have been aware of a pain in the right buttock occasionally. It is not bad, but I do not have a 2 year old to run after! I am still 'reclining' with my pillows in the evening. It does not hurt, but I am wary and it feels funny, especially when I am tired.

I had what looked like over and over stitching on the outside of perineum, which seemed to be attached to a thread coming from the inside - felt like I had a pube caught in it all the time. This seems to have dissolved now. It was very irritating at the time. Consultant said that all the stitches would be internal except for one. I have no idea what is inside though. There is a hard lump in perineum and to the side (where the gap in my muscle was previously) which I assume must be stitches in the muscles.

On the encouraging side - doctor managed to, very carefully,take a swab last week (infection) and it was not too hurty, so there is hope.

cardamomginger Mon 04-Feb-13 12:22:08

Hi Losh,
Sorry it's so painful for you sad. I had a rectocele repair and perineum repair in June. I had more pain round about 4-6 weeks post surgery too. The stitches could be pulling - some of them could be starting to come loose and hurting you. I ended up with a thrush infection too - the stitches can act as a focal point for infection. So it is worth getting someone to check the stitches and take a swab. I got sharp shooting pains going up my bottom and vagina. If you had muscle stitched during the perineum repair, it could be some spasms as it heals more and starts to work as a muscle again. It could also be a bit of nerve damage. Try not to be too freaked by the thought of nerve damage - nerves can recover and they do heal and these pains should lessen as time goes on and as you heal. Have you been referred to a specialist physio for rehab? 4 weeks might still be a bit early to start and PFEs, especially as the stitches won't all be out, but I found that when I was able to start doing gentle PFEs again (probably about 7-8 weeks after surgery), it helped with the pain.
Good luck!

Dahlialover Mon 04-Feb-13 12:45:03

whoops - I have been flexing my pelvics gently over the last week or so - was told I would be back to ballet after 4 weeks! physio appt for 6 weeks though.

I have been going for short walks as my knees are aching from the inactivity!

Losh Mon 04-Feb-13 13:11:59

Thanks for the encouraging words dahlia and cardamom. I know it is only 4 weeks, so just have to be patient I suppose.

I was given a tablet for thrush at my 2 week check, so think I should be ok there.

*Dahlia - I couldn't see anything that looked like it was coming from inside. I did have a stitch that was pulling quite badly and had caused a small tear in the tissue next to it - that was extremely unpleasant as it was stinging constantly. My perineum is hard too but only a little tender to touch. At my 2 week check my consultant had a good rummage around inside me and there was no pain at all, so that must be a good sign? The stitches coming out were more uncomfortable than the internal.

Cardomom - you are quite far ahead in your recovery now. How do you feel? I am anxious about painful sex etc and wondering how long it will be before I can stand up and walk for any length of time!

This probably sounds ridiculous, but I had no idea how involved the recovery would be following this op. I was led to believe that the pain etc would be similar to that following childbirth (I was stitched inside and out then), and it wasn't until my pre-op a few days prior to surgery, that I really knew what I might be facing. Childbirth was a doddle compared to this!

cardamomginger Mon 04-Feb-13 15:19:02

Hi Losh,
I wouldn't rule out the possibility that there could still be a yeast infection. They can be little sods around stitches and if you've been on strong antibiotics as part of your post surgery care your system may be out of kilter.
I'm not the best person to talk to about long term recovery, I'm afraid! I had multiple serious birth injuries and my surgeon has unfortunately positioned me at the extreme end of the spectrum of the stuff he sees. The rectocele and perineum repair was the second lot of surgery I had (first was a uterine suspension and a colposuspension). I'm headed for my third operation Monday next week (not yet sure exactly what this will entail - I had to have some urgent surprise scans last week and am discussing things with him on Wednesday). So I am still in pain and discomfort, partly because I've had quite a lot of surgery and partly because I've still got stuff that needs fixing. But thinking about how things progressed after the rectocele operation, there was steady progression over a number of months. I'd suddenly feel quite a bit better, then things would plateau out a bit, then I might get a little bit worse, then I'd improve more. Even taking into account the steps backwards, it's been improvement all the way in terms of pain, muscle function, mobility, ability to go to the loo properly, energy levels, etc. I can't say anything about sex I'm afraid - that's still completely off the menu for me and DH both for physical reasons and psychological ones.
Listen to your body and respect what it tells you. And if anything feels wrong or just 'off', get it checked out.
XX

Bladderama Tue 05-Feb-13 08:27:39

Morning ladies. All went well yesterday and the staff have been fantastic. Still feeling a bit woozy and looking forward to going home later today x

wouldratherbeskiing Tue 05-Feb-13 09:04:24

Great news Bladder! Take it easy x

Dahlialover Tue 05-Feb-13 09:32:13

Good news and best wishes Bladder

Cardamomginger - thanks for the useful view from the other side and hope consultation goes well.

Losh - I too was told it would be like having a baby without the inconvenience of the baby but it is not quite the same at all! I had got really fit in the years before the op and feel my body was not ready to be cut up - after the birth of my first child (which caused the tears) I was not in the pain I was after the op. Also, whilst I had some nasty labial stitches which dissolved in the bath, I had only one big stitch through the muscle tear which I am sure did not actually hold anything together useful and therefore didn't hurt much. The lump to the right of my fanjo (where there used to be gap in the muscles is very hurty and whilst not exactly painful is awkward to sit on. I am sleeping a lot though, everytime I do a bit more. Didn't get that with the baby - he woke up every two hours.................

Dahlialover Tue 05-Feb-13 09:33:40

Meant to add that as well as saying it was like having a baby, consultant also said that my 'small' rectocele would not be any easier as 1 or 2 stitches is as bad as 20 sad

Losh Tue 05-Feb-13 13:41:00

Thanks again ladies.

I have put a call into my doctor this morning and I'm waiting for her to call me back. The ache is pretty constant now but I had a couple of back spasms this morning and the pain is going down my leg, which is like sciatica, so I am thinking maybe something to do with the nerves after all.

Dahlia I think I have been stitched up a lot more solidly with this op than post partum. I also suspect that a half-arsed pp repair along with terrible constipation a couple of weeks pp, is what caused this issue in the first place. I would rather have childbirth - my baby slept a lot in the first few weeks, but at 2 years old he is a little whirlwind so no rest for me during the day! Re pfe's I was given exercises to do the day after my op and told to do them every day at home until the follow up physio appt at 6 weeks! Is this not usual?

Cardamom you sound as though you have really been through the mill, I am sorry. You must be very fed up with it - I feel like a big baby for complaining now! I hope your new op goes well - fingers crossed it will put you on the road to recovery this time round.

mangledmess Tue 05-Feb-13 17:15:27

Bladder Pleased everything went well and hope you have a speedy recovery with minimal pain and no infections occur. Bet you will be pleased to get home and into your own comfy bed. Take good care of yourself and the wound xxx

Melady Wed 06-Feb-13 10:01:49

Hi ladies, well I had my TVT yesterday. The good news is the bulge is a only a slight bladder prolapse but no work needed. The bad news is the surgeon perforated my bladder so I have come home with a catheter fitted.

Have any of you ladies had this happen? Did it hinder your recovery?

Have to return for a day next week for checks and a special scan to see if it's healed enough to remove the catheter.

Must say I'm feeling a lot better that I thought I would today.

Thinking of you all x

Dahlialover Wed 06-Feb-13 13:26:34

Woops Melady! I hope everything mends well.

Losh - I missed my pelvic floor lessons with physio, as she was a bit fluffy brained and did not turn up in time before I was discharged. Nurse told me to do pelvic floor exercises, as I should know how to do them by now. I have a 6 week appointment too. Consultant wanted me up and about and the physio wanted me to rest, so I have done both confused

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