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Pt 7 (Feb13) Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc

(993 Posts)

This is thread 7 (again - see below) 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.

With apologies for confusion in thread numbers - the previous thread was called part 7 but it was actually the 6th thread.

Here are the previous threads:

Thread 1
Thread 2
Thread 3
Thread 4
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 27-Feb-13 18:39:34

Hi Multi. What sort of mesh is it that was used? I've had front, back and enterocele repairs using absorbable collagen mesh. Can't comment yet, as I am only 2 and a bit weeks post-surgery!
Agree that returning to work at 6 weeks is too soon.

remnant Wed 27-Feb-13 20:31:41

hello all, can I join you? I can offer a suspected cystocele as credentials. No pain but some incontinence (I think urine comes out of it sometimes). I think it's been there since I was about 39 weeks pregnant with ds1 almost three years ago but have only just noticed blush
Apologies for not having read the whole thread (or previous 7) but I'm wondering what I should do next? I am supposed to be having an erpc for mmc in the next week during which they'll fit a catheter afaict. Should I be telling them about the cystocele?

NeopreneMermaid Wed 27-Feb-13 20:52:39

Welcome Remnant! Yes, definitely tell them about your suspicions. Really sorry to hear what you're going through. I had an ERPC four years ago for a mc but that was before the cystocele. Also ask if you can be referred for treatment. You might have to go back to your GP for a referral. Be prepared to be persistent - three GPs fobbed me off before I sobbed at my health visitor and SHE referred me to a physio. If physio doesn't work after a year or so, you can be referred for surgery if you've finished your family. I had surgery last week.

So, day 8 post-op and I think I overdid it today sad

We got a new people carrier and I scrambled in through the boot into the rear seat - it was all a bit contortionist and athletic and now something feels not quite right. I'll see how it goes tomorrow...

remnant Wed 27-Feb-13 22:45:50

Thanks neoprene. I clearly have a lot to learn about all this. I only came across the word cystocele last night after much googling.

Why does surgery only happen if having children is over? Could you have a full term pregnancy without surgery? Would it mean a csection?

Sorry for all the questions.

Good luck with your recovery!

Hi Remnant - these surgeries have a significant risk of relapsing afterwards, with weight gain and childbirth being risk factors, so it makes sense to wait till after childbearing wherever possible, but some people do have surgery and subsequent pregnancies, sometimes even vaginal deliveries. Having to have the surgery repeated (and many people have to have more than one lot for multiple prolapses anyway) leads to a great risk of problems with scarring, tightness etc. That's my understanding anyway. It is really up to the consultant though.

multimum4 Wed 27-Feb-13 23:22:18

Thanks for the replies!
whoknowswherethetimegoes
Thinking I may try to go back a little later but work asked me 3 weeks ago when I thought I would be back and I had to sort of predict how I was going to feel- now it all seems a little optimistic especially after doing some pottering in the garden this afternoon in the sun and pulling up some weeds. The last week of term has got two three hour long parents evenings as well and I'm just dreading it because of all that sitting.

cardamomginger As for the mesh I don't know which one I have had. Are there good and bad ones? I was so shocked when he told me I didn't ask...

cardamomginger Wed 27-Feb-13 23:43:40

The mesh that is standardly used in the UK is the absorbable collagen mesh. It's more usually used for front wall and enterocele repair than back wall repair, but depending on the individual patient it may be used for back wall repairs too. It works by acting as a matrix for the body to lay down extra scar tissue, thus making the repairs stronger. It's very safe and has been around for ages. The worst case scenario is that the body rejects it, by liquifying it, and it harmlessly passes out of the body. This happens in around 10% of patients. Many surgeons use absorbable collagen mesh automatically as part of repair surgery, so I guess it wouldn't be mentioned as an additional thing, if you see what I mean. There are other meshes, including polypropylene mesh, that have been used in these sorts of repairs, but that are not usually used in the UK. Elsewhere, including in the USA, they use them more readily.
Never a bad idea to find out what's been used - do you have another follow-up appointment when you could ask?

multimum4 Wed 27-Feb-13 23:53:32

Wow that was a comprehensive reply thank you cardamomginger. That has put my mind more at rest (I probably read US scare stories on the web when I was initially trawling for information and hadn't found the mumsnet threads). I will ask my consultant though at my 6 weeks check.

cardamomginger Thu 28-Feb-13 07:54:05

That's what we are here for! In the UK, surgeons tend to just say 'mesh' as shorthand for 'absorbable collagen mesh'. And, yes, the US sites can be bloody scary indeed!!! Glad you have an appointment soon where you can ask. X

I'm sure I read somewhere (probably a link on here) that the synthetic meshes which have been the subject of so many lawsuits in America are no longer used here. My surgeon said they would only use mesh in the more severe cases, and didn't consider it necessary in most patients, I guess different consultants take different approaches to this.

There was a big win in one of the US lawsuits this week against a mesh manufacturer (I work in a related field and see the industry newsfeeds at work).

Bladderific Thu 28-Feb-13 11:18:31

Troubled good luck tomorrow will be thinking of you

Whodhave thinking of you too and hope that all the tests are not as bad as you think and give you some answers

whoknows it is such an ongoing worry about damaging our repairs. I have never been so aware of my own pelvic region. So pleased that you have a physio appointment ands ask all the questions that you need to.

MrsAnnie look after yourself, have also just had (another) first post op period and am very glad that it is over

Welcome multimum4 and agree with other do not rush back to work. With the first surgery I felt ok at home but went backwards when I returned to work and was exhausted for weeks

Remnant so very sorry to hear about your mmc. I would mention to them about the cystocele if you feel comfortable doing so becuase I do not think that they will mention it. Prolapse is something that health professionals do not seem to mention to us ladies even when they know that they are there and do seem reluctant to fix them before we have finished child bearing.

Neopreme slow down!!!!!! Please look after yourself and let everything heal properly (please learn from my mistakes)

Slinkychick hope that you are doing okay? Did you see you cons?

Nannaslyv any news on your new referral?

3 weeks down the line here and I am still utterly wiped out and meant to be going back to work next week sad

NurseryNetty Thu 28-Feb-13 12:40:13

Multi - I feel psychologically so much better knowing I am not back for a while yet. I popped in to nursery to visit on Tuesday and stayed in for 4 hours. I wasn't even doing my job and was exhausted when I came home.
Had a bit of a 'down' day yesterday, but the sun is shining today, I've been for a walk to the town and back and actually feel a bit more like myself.
If I had gone back to work next week, I don't think I would have allowed myself to properly heal and would have been paranoid about doing anything, which would have made me a pretty useless member of the team.
My sick line runs into my Easter hols, so I now have 5 more weeks off to make what I believe will be a good recovery.

Dahlialover Thu 28-Feb-13 13:04:58

Hi there,

I have just come back from my post-rectocele physio appt, expecting it to be about pelvic floor exercises, but it was someone who specialises in bowel problems, which was wonderful!!

Apparently you can get a bulge above or below a repair, which with the help of regular constipation, can lead to the formation of a new rectocele, or failure of the repair.

I now know a bit more about what I am doing right and have some new things to try. The fibogel was not really working any more.

It was really worth going.

MiseryArse Thu 28-Feb-13 15:21:49

I've found you again!

I'm on the list for posterior and anterior repair! The wait is about 4 months I think.

It will be done by gynae. He's not convinced it will resolve the problem but the colorectal surgeon is pretty convinced it will. I've got to give it a go I suppose

cardamomginger Thu 28-Feb-13 16:48:13

testing....

cardamomginger Thu 28-Feb-13 16:49:04

sorry for weird random last post - thread seemed to have disappeared from General Health, so I posted to see if that would get it back up.

consideringalloptions Thu 28-Feb-13 17:35:25

I'm new to this thread but not to MN. I've already posted about this on a separate thread but it was suggested to ask here as well so here goes.....

I'm wondering if anyone can let me know of their experience of a second pregnancy before having perennial repair surgery.

I had a very bad tear & extended episiotomy and spent over an hour in theatre being stitched back up after the birth of my first DC 16 months ago. I've been offered surgery to 'fix' the scar tissue and am waiting to see another gynae consultant for another opinion (have suspected prolapse which is getting worse) which will be in a few weeks.

My DH and I have decided that we want another baby, and sooner rather than later. We are thinking of ttc April/May onwards so hopefully I'll have had anything done that needs to be done by then, but want to consider all my options, i.e. is it worth waiting until I've had a second baby (which will be by elcs) and then fixing things, in case it gets worse during the pregnancy.

I'm wondering if anyone can tell me honestly what a second pregnancy is actually like when things down below are not good. Thanks.

multimum4 Thu 28-Feb-13 17:39:22

netty
I seem to be getting myself into a state about going back and doing myself a damage. Might pop into work myself tomorrow as I can walk there and have a chat with folks and maybe broach the subject that I might need a little more time off with my line manager. It will be easier than over the phone (hopefully!).The sunshine has cheered me up today and managed another very small spell of gardening even though it was freezing.

LovesBeingWokenEveryNight Thu 28-Feb-13 21:12:24

Evening all ladies. So I have my first hospital appt tomorrow. Am quite nervous and not really sure what to expect (other than having to get my pants off!)

I don't think I have that many symptoms but I'm only mid 30s. An I just getting used to them? Am I not putting things down to that?

Also feel like I'm about to start my period do keep your fingers crossed it waits till afterwards.

NeopreneMermaid Thu 28-Feb-13 21:16:36

Considering I had a cystocele (bladder prolapse) and needed stitches for s 2nd degree tear after dc1. I had a year of physio before I got pregnant again (vaguely ttc all that time) and the pregnancy took the prolapse right back to square 1 (due to all the relaxin released by pregnancy hormones).

You will probably find you won't be offered surgery until you've finished your family - even with an elcs - as just the pregnancy itself can make things worse or, I'm guessing here, even reverse the effects of surgery (can anyone back me up/shoot me down here?).

I had another natural birth with dc2 which didn't make the prolapse worse but certainly didn't make it better! I've now had surgery.

Bladderific keep telling me to slow down - I need to be told! Today I've developed a dose of the squits which is really not helping recovery.

MustTidyUpMustTidyUp Thu 28-Feb-13 23:16:57

considering I saw the gynae about repairing my ( very poorly repaired) episiotomy after DC1. I was advised to finish my family and come back to it. At that time i also had a mild cystocele. So I did and had 2 more DCs. Didn't affect pregnancies or births (small scratch with DC2 not worthy of the word tear) and nothing with DC3. Developed a rectocele sometime after DC3 and now, 2 years after last baby and family complete I'm having a posterior repair and perineorrhaphy in a few weeks.
If you can live with it I'd leave we'll alone until finished having DCs. However, you should try an get referred to pelvic physio to get your pelvic flor as strong as poss which may help prevent prolapses which are more likely if PF is weak from the scar tissue from your episiotomy - I have a much weaker LHS where my episiotomy scar tissue has affected my PF hence rectocele.

remnant Thu 28-Feb-13 23:27:57

I saw consultant today who confirmed cystocele and said i had a 1st degree womb prolapse too, and that it was all most likely caused by birth of DS almost three years ago. I'm slightly in shock that none of it has come to light sooner. I'm 43 so impact of menopause is probably more likely than that of another birth, but either way things are likely to get worse.

If I read back over the last 6 threads will I find pointers to good physiotherapist (ideally in london) or books/tips on exercises? The gynecologist said you could get balls to use in exercises confused?

Seems that most of you posting here are in the middle of or are recovering from surgery so that I guess that pelvic floor exercises haven't made a bid difference sad

cardamomginger Thu 28-Feb-13 23:33:53

Remnant - am PM-ing you contact details for my gynae physio in London. She is fab.

Remnant - a lot of people come and post on here when they start having problems and we advise them to go off and ask for a referral to physio, but they tend not to stick around on the thread. Those of who stick around tend to be the ones whose problems have gone beyond physio unfortunately. Also, many people don't seek help or manage to get a referral until things have gone beyond what physio can help with too. I knew I had a mild rectocele years ago, the GP referred me to gynae who just gave me an exercise sheet, which i stuck with for a year or so then gradually forgot about, mine got suddenly a lot worse last year and the GP and gynae agreed surgery was the best option by then.

If you want tips on exerecise, both specifically for the pelvic floor and for the rest of your body whilest avoiding straining your PF, google Michelle Kenway, she is a specialist Australian women's health physio and has lots of really good videos on Youtube and a book (which is £20 but good).

So, having had one op, I've got my first physio appt tomorrow. I have written a list of questions to ask. Will report back afterwards.

LovesBeingWokenEveryNight Fri 01-Mar-13 06:41:08

Hi all

Really starting to get nervous now. What if like most of you I'm sent away without any help? I don't want to make out its worse than it is and end up with surgery I don't need yet. I would be very happy to try the ring thing.

Does anyone else feel it gets worse during your period?

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