Anyone chosen hysterectomy over repair for prolapse?

[suwoo]

If you search my threads, there are many here about my 9 year old prolapse. Due to a change in my circumstances I thought now would be a good time for a repair. I was very shocked when the (very specialist) gynae suggested that a hysterectomy would be the best course of action. The prolapse is now a grade 3, and would be protruding significantly from the vagina if not fairly well managed by two ring pessaries. I said no to the hysterectomy and plan to try the repair first. I am a young uni student of 35 and although my family is complete after 3 children, I'd never say never to more.
I'm NBU to say no to the hysterectomy so vehemently am I?

No you are not, there is as far as I have found, no evidence to suggest that leaving your womb in place will have any negative effect on everything being held in the right position after the op. Apparantly older consultants tend to reccomend hysterectomy at the same time because it used to be believed that the weight of the womb could cause another prolapse. This is no longer believed to be the case. ( this is according to the great god google btw)

BUT be very, very careful after your op and don't do anything until you are healed or you WILL mess yourself up! My mil had the op done twice because she overdid things afterwards. The told her after the second op that they wouldn't be able to fix her again and she would end up with a catheter! She behaved second time round and put her feet up!

Good luck and I hope that made sense :)

Cheers love, it did. I think they are keen to do hysterectomy to 'get it all over with'. The lifting worries me as my kids are of the age to still be carried daily and I lift with work, hence me putting it off so long. The gynae suggested that the amount of mesh needed to support my prolapse is too much and can be rejected by the body.

I'm afraid I have no info to offer you on that. I haven't done too much searching into how much mesh iyswim? The problem that I think I have ( will find out on thursday hence my recent frantic googling!) has all the same post op issues of lifting but (hopefully) won't need too much mesh. One thing that it may be useful to know in avance is that they sent my MIL home 2nd time round with a catheter. They had made things so lifted and tight that she couldn't empty her bladder by herself at 1st. Once the swelling had gone down she was able to ditch the catheter , but she did say she wished she had at least known about the possibility of having it before the op. Not trying to worry you, in fact the opposite.

My youngest dc is 14 months so I'm dreading the prospect of "no lifting".

Where are you at kickarse? do you have a grade 3 prolpase too? My youngest DC is 15 months. I'd love a permanent catheter tbh, I have wee ishoos too

I'm in Norfolk, I don't have a grade 3. I think I have something else :( tbh I'm not sure which would be worse if I have what I think then the success rate is 65% - 92% for the 1st 5 years. I have an appt on Thursday to find out if /what is wrong.

MIL had wee issues and once everything was lifted back it got muuuch! better.

Not sure if this helps but ere fgoes.

I had a repair after DC2 when she was 2 yrs old, and older child was 4. I had a stage 1 prolapse. My DH worked from home for a month and my mum came to stay for 2 weeks. you must NOT lift- I was told anything over 1 stone ( 6kgs.) for 6 weeks at least. Lifting a child is a no-no, as are bags of shopping, heavy washing and hoovering etc.

I had a 2nd smaller repair a year later as i still felt "slack"- my problem was mainly the anterior wall.

After both ops I had a catheter for a week as I was unable to wee due to swelling. I was allowed home and went back daily to have it removed to see if I could wee.

I started jogging a few years back and felt a bit loose down there, so trotted off to see physio etc and was told no jogging. Was also told that another op was not possible as might end up with a catheter due to over-tightening etc.

I think you need another opinion possibly. Different surgeons ave different opinions. What you need to know is how much improvement you can get by a repair. Can they lift your uterus right back up?
Also, a hysterectomy can make vault prolapse more possible.

If i were you I would try to see a gynae who is an expert in re building pelvic floors and have a very frank discussion over pros and cons.

Oh and I'm 34 with 4 kids, so smilar situation I guess!

Being referred, :( good news that I haven't prolapsed. Bad news I have dodgy "Walls".

Hmm what does dodgy walls actually mean then?

It means the muscles front and back in my fanjo are not in place any more, the side walls are all that is holding it up. I have a rectocele at the back and my bladder is pushing in at the front (cystocele). Look on here and arrow down, you will find the right diagrams..

My gp thinks it may be partly related to the length of time I've been b/feeding because it causes the relaxin levels in your body to stay at a pregnancy level. I really don't like to think that b/feeding could contribute to this. Seems like nature stabbing me in the back if it has! So hopefully she is very wrong!

Just got to wait for the refferal to come through now and see what they suggest.

Thats like me then I think, rectocele and cystocele have been mentioned as well as a complete uterine prolapse which is outside the vagina .

No wonder they suggested a hysterectomy, they may as well put me down.

I had read that about bf too. I've lived with the full prolapse for 9 years so you wouldn't neccessarily need to do anything immediately. Maybe wait until the baby is older????

I don't think you need putting down, and as purplepeony says a hysterectomy could increase your chance of a vault collapse. I'm sorry your prolapse is so severe tho!

Well, whether its an increased risk factor or not, I won't be stopping feeding any time soon I shouldn't think! I only stopped feeding ds1 a few months ago, I've been tandem feeding since ds2 was born.

I feel ok atm, for some reason when I get my period it becomes much worse. Do you notice any difference?

Another one here with a cystocele and rectocele. I didn't notice any symptoms until well over a year after my youngest was born - and she was breastfed for almost 2 years. Bugger. :(

I don't want to scare anyone on here, but I am very scared of hysterectomy as I experience uterine orgasms and obviously, without a uterus, you can't have uterine contractions. I have heard of women on other boards who weren't warned about this, and were very upset at the effect on their sex life. :(

Yes kickarse, I notice a big difference when I am on my period, way lower and 'fuller' and just horrible. to you for tandem feeding.

I noticed the symptoms when I had my first bath at home after DD1 was born .

Welshleaks what is this of what you speak?

Uterine orgasms isn't about stimulating the uterus!

It's that when you have an orgasm (generating through normal means ) the uterus contracts. I feel it as my uterus tightening and pulling up into my abdomen, and it's a big part of the intensity of my orgasms. Anyway, the point is that I would be very sad to lose my uterus and have orgasms that were low intensity and generally a bit meh. And it's worth knowing about as a possible side effect if you're considering a hysterectomy, but don't absolutely need one. Part of the balance of benefits and side effects.

By the way, I just looked up hysterectomy on Wiki and it stated that the risk of vaginal prolapse is 80% for women 10 to 20 years post-hysterectomy!!! That isn't so bad if you have one in your 70s I suppose, but a real shock for those of us in our 30s and 40s. I certainly wouldn't want to give up on my sex life with DH until we are very old and creaky.

Anyone know if that statistic is right?

Welshleaks! That is a terrible percentage! BUT is that the risk of vault prolapse if a hysterectomy is carried out instead of a womb prolapse repair?

I've seen several sources state that a hysterectomy at the time of a prolapse repair can increase the chances of vault prolapse.....

Suwoo, Thats exactly how it feels to me too! My cervix seems much lower then too but the GP swears that my womb and cervix are not dropping at all and says my pelvic floor is very good. I never set out to tandem feed it just worked out that way and I have to say it was fabulous avoiding all the engorgement at the beginning of b/feeding, but on the other hand I've been producing twice as much milk as most women produce for over a year and my total b/feeding now totals 67 months. That may not have helped my current problem!

I think I might have a prolapse but am too ashamed to get it checked out. Sorry if TMI but I seem to have a fleshy lump inside my vagina towards the front. Nothing pokes out but i do find inserting tampons a bit tricky. Not sure if this is related but whilst I have no problems with actually having sex, I find I'm quite sore afterwards. Does this sound like a prolapse to you? I too breastfed my DC for longer than average and am now worried this may have contributed to my problems [hsad]

Tinkerbell33, theres nothing to be ashamed about! You do need to get whatever it is checked out. There are other things it could be and its unlikely to resolve itself by itself.

I really don't like the thought that b/feeding could be a contributing factor. Until my gp mention relaxin levels I had never heard of any real negatives to b/feeding. I suspect that its just a hypothesis. ( i hope!)

Go see your gp, you are going to keep worrying until you do. Hope you are ok :)

Tinkerbelle, don't be ashamed, that is just silly! I had similar symptoms to what you describe straight after DD1's birth and was referred firstly to a specialist physiotherapist for 'fanny physio' as I liked to call it. That proved unsuccessful as I was unable to even do one pelvic floor contraction (or whatever they're called).
I then saw a specialist gynaecologist (female) at a uro-gynae dept and I have been under them ever since.
If it is only a mild prolapse it can be well managed with a ring pessary.

I definitely had read about the relaxin levels when I bf DC3.

Hi,

I had a radical hysterectomy 5 years ago (this week!) for cervical cancer and had to have a vault prolapse repair 1 year ago!

I still have problems, definitely have a rectocele they want to operate on and seem to be developing bladder problems aswell but I'm resisting another op at the moment because the last repair was horrid, recovery took ages.

I would think carefully of having the op and then really, really take it easy after. When I had my hysterectomy ds1 was 3, ds2 was 15 months so I don't think I really took as long as I should to recover. When I felt better I got back to normal, partly out of necessity but that must have contributed to the vault prolapse I'm sure.

Thanks dytts, Advice much appreciated. :)

What is the score with coils? does anyone know? 'only I have one and thinking about it, my symptoms have really become more noticable since I had it fitted. Prior I hadn't notice any problem at all.........

Should I get it removed???

I had a coil for the 6/7 years or whatever it was until I accidentally pulled it out and conceived no 3 .

Can't say I noticed any difference.

Sorry to hear about your cancer doyouthinktheysaurus , hope all is well now x

Hiya, I just found this

Its quite a big list of exercises, do you think it might help?....

I am planning to go to my GP and ask for physio.

When the rectocele was diagnosed she said that she didn't want me to go to a gynae as a gynae would go straight to surgery, and she assumed that I didn't want surgery. At the time, I was a bit "well, how do I know that I don't want surgery when I haven't even discussed it?", but actually, having done a bit of research, I think that it would be a bad idea now. I have two small children and the youngest, particularly, would not cope well with 6 weeks of not being carried around or picked up at all. So physio it is for now, except that she has only sent me for continence physio (other problem, see name), not rectocele physio.

Anyway, the point is that I need to go back and follow up on this and I'll report back if I do get specific physio. I reckon that strengthening the area and increasing blood flow can only help, even if it's not a magic cure.

Thanks Welshleaks, I'm waiting for my referral to come through so I'm comprising a large list of questions! They may wonder whats hit them! ( I did wonder about the name!!:))