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

[Bluffyslummers]

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?

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 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.

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

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

can I ask what stage yours was?

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

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.

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

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

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!

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

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

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.

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!

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

I can’t get a drs appointment to get a referral for the nhs, they only see emergency apps and as this isn’t an emergency I can’t get seen to get a referral, hence why I went private in the first place.

I’ve never had pain, it was just the bleeding I wanted to check. But the second consultant told me the ectropian could prevent me from conceiving again and the bleeding was likely a polyp and now my endometrial lining is too thick and that needs to be treated, but it was the day before my period and it was 10/11mm which when I’ve looked up it’s perfectly normal. It’s an absolute mind fuck. As we’ve been ttc for about 6 months and no such luck

No, ectropion doesn't affect conception and that endometrial proliferation is normal, poss too thin if anything post ov, but I'm not a gynae.

What age are you?

I asked my friend who went through ivf and she said they looked for a min of 8mm for implantation so I think my 11mm sounds about right, and google tells me it’s pretty average post ovulation too.

im 35. I’ve a good amh level and my hormones are show im no where near peri. My testosterone was a bit low and my lH a bit higher than my fsh (on day 3) but not the extreme of pcos.

That's reassuring about the uterine lining level then. My bloods also didn't indicate peri, because it's so difficult to diagnose at my stage via bloods, but I've been on HRT since late 30s and it 100% resolves my symptoms, so don't rule out hormonal influences.

That’s one thing he did say for sure, bloods, hormones and ovarian reserve categorically rules out peri

NICE guidelines say peri can't be diagnosed via blood tests, as it's so inaccurate. I'm not saying that you are peri, just that hormonal testing is a dark art.

I’ve just looked that up, good call out. I think though I’d come under the ‘premature ovarian failure’ investigation section being under 40. Thankfully I don’t have the other signs, but it was something I was worried about.

Hello! I’m being menopausal with brain fog and can’t see all responses, this may have been said more concisely . You don’t say why you are under gynae and it doesn’t sound like you are having symptoms of prolapse, which may explain it not being diagnosed earlier.

Examination using a speculum can ‘support’ the prolapse hence it not being identified. The mesh hasn’t been used as first line for years however I’m not familiar with upto date gynae guidance for stages of prolapse. From a patient view I would email the Consultant with your questions for clarification. Second opinions are always a reasonable request, are you able to have an NHS referral? There may also be a specialist nurse available to see you .

Absolutely, diagnosis is now via symptoms. Many GP surgeries have a specialist nurse for this OP. Does the Consultant seem ‘old school?!!’

I wouldn't do anything without another opinion from a different company.

And I wouldn't have mesh surgery under any circumstances. I've seen the Newsnight reporting on it.