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AIBU?

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Original poster

Any medics on here- I’m having a panic!

65 replies

Bluffyslummers · 03/01/2025 19:28

I had a hysteroscopy yesterday and got diagnosed with grade 2 bladder prolapse.

this was very very surprising news as I have no symptoms. And I’ve had 3 internal exams over the past year (bleeding in between periods) and as many trans vaginal ultrasounds and nothing was mentioned.

is that possible? I’ve looked on the nhs website and it says that prolapses are diagnosed by internal exam- how could this have been missed.

im suspicious because im going private at the moment and this consultant keeps finding new avenues to investigate and now wants to do the mesh surgery for this prolapse and looking it up that is paused from the nhs.

surely 3 previous internal exams one done by the very same consultant it would’ve been mentioned?

OP posts:
Dotto · 04/01/2025 13:23

I had mid cycle bleeding that ceased after starting cyclical HRT, so I think mine was caused by progesterone insufficiency.

Puppupandaway · 04/01/2025 12:55

If you've had the ectropian treated, then you might find that your bleeding between periods has been resolved. Personally I would stop and take a break from scans etc and see where you are at in terms of bleeding and any discomfort. Sounds very strange that you are being told to have surgery on something that you had no symptoms of and doesn't need treating yet. Money grabbing consultant maybe. Stick to the nhs!

olympicsrock · 04/01/2025 12:40

Prolapse is easily missed during a speculum examination especially relatively mild and not the thing that you are looking for.
You don’t need surgery for something that is not causing you symptoms although some exercises with a good pelvic floor physio is important to stop things getting worse.

Dotto · 04/01/2025 12:28

I've read all your posts OP. Sorry, that consultant sounds like either a fucking idiot or a money-grabbing arsehole.

Original poster
Bluffyslummers · 04/01/2025 12:25

custardpyjamas · 04/01/2025 12:21

I thought the mesh surgery was banned rather than paused, women having horrendous surgeries to remove the mesh that starts to cause all sorts of pain and other problems. I had a prolapse repair a few years ago and it was just a stitched repair. I did have symptoms but absolutely fine since the repair.

Edit: I think they said it was a grade 4 prolapse, which I think is bad!

Edited

I looked it up and it’s paused, the other surgery, the one you had seems to be a major surgery which seems overkill given I have no symptoms

OP posts:
custardpyjamas · 04/01/2025 12:21

I thought the mesh surgery was banned rather than paused, women having horrendous surgeries to remove the mesh that starts to cause all sorts of pain and other problems. I had a prolapse repair a few years ago and it was just a stitched repair. I did have symptoms but absolutely fine since the repair.

Edit: I think they said it was a grade 4 prolapse, which I think is bad!

Original poster
Bluffyslummers · 04/01/2025 12:15

Franjipanl8r · 04/01/2025 00:41

No idea sorry. Stages weren’t even mentioned and neither was surgery so maybe mine wasn’t that bad.

Show quote history

It’s strange because I’m having none of the symptoms you mentioned yet I’m being told I ‘need’ surgery

OP posts:
Original poster
Bluffyslummers · 04/01/2025 10:36

GargoylesofBeelzebub · 04/01/2025 09:26

Why would you go for surgery for something not giving you any symptoms? Particularly such controversial surgery.

the consultant is saying I need it… but I don’t really want it. I’d heard before this the horrors of this surgery.

im just curious how it wasn’t found before, as it seems this consultant finds more and more things to bill me/ my insurer for.

first it was the hysteroscopy to look for polyps not seen on the scan. Then to remove the ectropian which he said was necessary.

now it’s this prolapse, biopsies because my uterine lining is too thick (10mm before period) and treatment to balance my hormones. I feel like every appointment there is more and more and more

OP posts:
GargoylesofBeelzebub · 04/01/2025 09:26

Why would you go for surgery for something not giving you any symptoms? Particularly such controversial surgery.

PinkDaffodil2 · 04/01/2025 09:23

Another GP here - approaching half of women who've given birth will have some degree of prolapse. It's very common and often causes no problems.

Unless you're actively looking for it you wouldn't expect to see / feel it when examining with your fingers or an ultrasound as the doctors fingers / the ultrasound probe would be pushing on the vaginal wall. Same with a speculum used the standard way - it puts pressure on the front and back walls of the vaginal when it opens so a mild prolapse wouldn't be apparent.
I don't go out of my way to look for them in women with different complaints. If I picked up that there was a mild prolapse while looking for something different I'd ask about discomfort and incontinence and encourage pelvic floor exercises but wouldn't be referring - certainly not considering surgery.
If mild symptoms I'd generally refer for physio.

Franjipanl8r · 04/01/2025 00:41

Bluffyslummers · 04/01/2025 00:15

I’ve also had a smear in this time and wasn’t remarked on then.

can I ask what stage yours was?

Show quote history

No idea sorry. Stages weren’t even mentioned and neither was surgery so maybe mine wasn’t that bad.

Original poster
Bluffyslummers · 04/01/2025 00:15

Franjipanl8r · 04/01/2025 00:12

I had a prolapse that was picked up by the nurse when I had a smear. I was having symptoms of not being able to empty my bladder and also wetting myself unexpectedly. I had pelvic physio and it’s now completely fine. There’s absolutely no way I’d want surgery for something that isn’t causing any problems.

I’ve also had a smear in this time and wasn’t remarked on then.

can I ask what stage yours was?

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Original poster
Bluffyslummers · 04/01/2025 00:14

Infracat · 04/01/2025 00:13

Do not do mesh surgery whatever you do! There are awful stories about that stuff. Its damaged so many women. I was on a pain management course at hospital in London and so many women affected by this. One woman never needed the op. It was the surgeon wanting to profit. He caused her so many problems life changing unnecassarily.

I think this is what is my concern is, 2 consultants at the same hospital, one didn’t recommend further tests, but these seem to keep coming

OP posts:
Original poster
Bluffyslummers · 04/01/2025 00:13

AppropriateAdult · 04/01/2025 00:01

GP here, OP; sorry you've been so stressed by this. To try to answer your questions - an internal exam usually refers to the doctor using their hand to examine the vagina/cervix, so nothing is actually 'seen' as such. If you're talking about a speculum exam to visualise the cervix, then as the speculum is opened it holds the walls of the vagina apart, which can actually mask a prolapse. So it's certainly not uncommon for it to be missed if it's not being actively looked for.

That said, I'd be extremely wary of having surgery for something which wasn't causing me any symptoms and may not get worse in the future - I think you're right to be really cautious here. Can I ask why you were having gynae investigations in the first place?

I had both, speculum exam and then also a physical exam.

i had the gynae investigations for some bleeding between my cycles. I had some investigation earlier in the year, consultant did both speculum and physical exam, said it was the ectropian can treat but it can come back, so I decided not to. Did an ultrasound to be sure, that was all clear. Was told come back if it gets worse.

went away for a few months and because id already paid my excess for the year, went back, and second consultant repeated all of the above. Didn’t mind excess paid. But he said he didn’t think the bleeding was from the ectropian as that will shed if touched, and I didn’t bleed in exam. Thought polyps despite it not showing on scan. Needed hysteroscopy, which was then this year, so new excess, no polyps, now prolapse and endometrial biopsies taken as suspected endometrial hyperplasia. But the hysteroscopy was the day before my period, so surely my uterine lining is meant to be thick.

OP posts:
Infracat · 04/01/2025 00:13

Do not do mesh surgery whatever you do! There are awful stories about that stuff. Its damaged so many women. I was on a pain management course at hospital in London and so many women affected by this. One woman never needed the op. It was the surgeon wanting to profit. He caused her so many problems life changing unnecassarily.

Franjipanl8r · 04/01/2025 00:12

I had a prolapse that was picked up by the nurse when I had a smear. I was having symptoms of not being able to empty my bladder and also wetting myself unexpectedly. I had pelvic physio and it’s now completely fine. There’s absolutely no way I’d want surgery for something that isn’t causing any problems.

Original poster
Bluffyslummers · 04/01/2025 00:04

ScaryM0nster · 03/01/2025 23:44

Even if you can’t get your insurnace to cover it, just call up and book and pay for a pelvic physio assessment.

Theyre usually less than a tank of fuel, and I’m going to make the assumption that if you’ve got private health insurance you’re not budgeting to the nearest tank of fuel.

(you keep saying didn’t they see it. If you literally mean see, then the speculum would be acting like a splint).

I have private cover through work and due to this surgery have to pay my sizeable excess- I’ll call around but I’ve seen nothing less than £150

yeab but didn’t see it, I’m not a medic, but from the nhs website they are diagnosed from an internal exam which I had 2 of, I don’t get how it was missed.

my youngest child is 3

OP posts:
AppropriateAdult · 04/01/2025 00:01

GP here, OP; sorry you've been so stressed by this. To try to answer your questions - an internal exam usually refers to the doctor using their hand to examine the vagina/cervix, so nothing is actually 'seen' as such. If you're talking about a speculum exam to visualise the cervix, then as the speculum is opened it holds the walls of the vagina apart, which can actually mask a prolapse. So it's certainly not uncommon for it to be missed if it's not being actively looked for.

That said, I'd be extremely wary of having surgery for something which wasn't causing me any symptoms and may not get worse in the future - I think you're right to be really cautious here. Can I ask why you were having gynae investigations in the first place?

staceyflack · 03/01/2025 23:57

Do you mean see it from the trans vaginal uss? The probe would probably push any prolapse out the way, as ScaryM0nster is alluding to.

staceyflack · 03/01/2025 23:51

I'm not a gynaecologist obviously... but in my experience anatomy after having babies can all shift a bit, at least. Sometimes a lot. It is only relevant though if it's affecting the person. I've never heard of an ectropian affecting fertility. Ectropians are often diagnosed in pregnancy when there's bleeding / spotting, and there is no follow up or treatment during or after. Are you anaemic?

ScaryM0nster · 03/01/2025 23:44

Even if you can’t get your insurnace to cover it, just call up and book and pay for a pelvic physio assessment.

Theyre usually less than a tank of fuel, and I’m going to make the assumption that if you’ve got private health insurance you’re not budgeting to the nearest tank of fuel.

(you keep saying didn’t they see it. If you literally mean see, then the speculum would be acting like a splint).

Original poster
Bluffyslummers · 03/01/2025 23:41

DinosaurMunch · 03/01/2025 23:33

Pelvic floor physio costs like £60 for a first appointment. Not cost prohibitive even if not insured

Can’t find anything under £150 where I live

OP posts:
DinosaurMunch · 03/01/2025 23:33

Pelvic floor physio costs like £60 for a first appointment. Not cost prohibitive even if not insured

Original poster
Bluffyslummers · 03/01/2025 23:30

Anon22224 · 03/01/2025 23:06

Do not get the mesh! It ruins lives, my cousins life was destroyed by it. It’s banned in many countries

Yes it’s very very strange to me that this was presented as the first option when it’s paused on the nhs and there are various options to try before hand.

i feel like the hysteroscopy was largely irrelevant, as was the removal of the ectropian as it can grow back and now this which was never mentioned before. Seems strange

OP posts:
Original poster
Bluffyslummers · 03/01/2025 23:23

BlueMum16 · 03/01/2025 23:10

Most insurance will allow a second opinion. Cheaper than unnecessary surgery.

I’ll call them tomorrow and see if they do.

I’ve asked for a referral for pelvic physio will see if they cover it

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