Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc part 4

[Ben10NeverAgain]

This is thread 3 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

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.

Thanks surewoman. My GP was fab actually and she was the one who said I had an anterior prolapse. The gynae said I didn't, though she didn't get me to stand and bare down or anything. She just poked around and said I did have a slight posterior prolapse. She seemed very preoccupied with the scarring and kept saying 'this is why you're in pain'. I kept saying that the pain was internal, not external and that I didn't suffer from the back prolapse.

How do I get a second opinion? Do I go back through my GP?

Feeling a bit rubbish today despite the glorious weather! Despite writing just lastweek about how the bulges I had looked notas bad as the lady in embarrassing bodies, I think things have taken a sharp downtown in the last couple of days. I can now clearly see what I think is a cystocele and rectocele in the mirror. The pressure has really increased too and I've had some trouble passing a bm. I've just finished my period-not sure if its related to that? Had high hopes for the estim working, but not sure if its just too late for that now :(

Sorry about the me me me post, just gutted :(

Roseanna - please don't feel too gutted.. things in that department are always a lot worse immediately before and after a period due to hormones (lack of estrogen?? or something). If you have been standing up a lot ie all day, especially standing still, then that can make things worse too. Try lying down on your bed with your legs in the air and your pelvis raised (not a very good description, sorry!) because prolapses can disappear back inside and up for a bit... big hugs (((((hug)))) to you xxxx

Alloverit - if you can find the name of a uro/gynaecologist you can demand to be seen by them. Your GP should be able to fix the appointment for you, or contact their secretary directly. Urologist/Gynaecologist is the best person to see as prolapse is one of their specialities and they know what they are talking about. Let us know how you get on. xxx

Thanks for the advice guys. I eventually dared to get a mirror to have a look. There is no obvious buldge but things look a bit full if that makes sense. My pelvic floor looks really good (I have always done my pelvic floor diligently) but it looks as though thing might have slipped down below my pelvis floor line, I guess the vaginal wall, is this a type of prolaspes too? Sorry for all my questions, it's just that I am seeing a different GP on Thurs and I want to go with all the info I can.

Alloverit - My friend said that you can refer yourself to the well womans clinic who will help with prolaspe and pelvic floor problems, but you need to go through your GP - no sure if it would be the help you needed but might be worth checking out.

Rosenna - Big hugs x

Hi to all! Good news (I think!!) - my mum came home today. Yet to see how they cope of course.... Bad news - I went back to doctors today and sure enough I still have an infection and was told 'it's quite offensive' and that it was a pretty nasty infection. Tmi I know but it STANK . The nurse went to ask the doctor what to do next (already had metronidazole) and left the door open. I cried all the way home. No wonder I've been feeling so rotten and still have so much pain. Suffice it to say I'm a bit fed up.

Glad your mum's home Fengirl, but that's rotten about the infection, have they given you a new antibiotic?

Thanks surewoman, just panicking a bit but feel a bit better today. This journey feels a bit like a rollercoaster at the moment! Need to get my head round it I suppose :(

Fengirl - bless you, you seem to be dealing with so much right now. Sending soothing, healing vibes your way!

Thanks whoknows and rosanna. I'm on augmentin now and I really hope it works. It's early days yet but I think I will go back to get checked when I've finished them as I had no idea there was so much gunk and rubbish up 'there' and don't think I'll be happy until I know for sure it's gone - just hope next time it's not so painful. Oh well, one plus is that I can at last raise a glass to my mum's recovery - not that I feel like it at the moment - typical!

Fen - so sorry you are having such a hard time. Fingers crossed for you that this will knock the infection on the head once and for all. What about taking some strong vitamin C tablets too as they help healing??

Good news about your Mum coming home, that's great.
Hope you feel better v. soon xxx

Sure - thank you. I already go off to bed with a steaming cauldron of vitamins but will add in vit C when I next go shopping. DM and DF both seem to have calmed down a bit now so hopefully all will be well.

Hi to new posters. Big hug to everyone still grappling with these hideous conditions and to those returning to post positive news.

Well, the upside is I?ve been away for a lovely holiday with dear friends. Had a very relaxing, fun time and didn?t overdo things but knew things were happening down below. I am 11 weeks post-op for rectocele and that I think has held well. I was just starting to feel ?normal? and at the end of the tunnel when I think my front wall has slipped. I was told they had found a slight bulge on the front wall during the back wall repair but now it feels like it has completely gone or my uterus as dropped. So?. my first day back to work tomorrow and the only time my GP could see me is tomorrow afternoon. Have had to email my boss. Ahhhhhhhhh!

The good news is that (as it is at the moment) the discomfort is nowhere near as bad as a rectocele and I?ve been assured the front wall repair is also more comfortable. Also, don?t think my bladder has dropped because I am continent (thankful for small mercies).

GP was very supportive and when I told him the consultant I saw for my 6 week check (different to the one who did the op) told me I can never again lift skis or a saddle - he said that was ridiculous.

I have decided this is my annus horribilis!!!!!!

Hi everyone,
welcome to all the new posters. I have been lurking again since my maiden mad posting day on 15th May when the welcome and advice from everyone was really appreciated. Some of you have had so much to cope with recently and still are there for others I feel really bad that I feel so negative and sorry for myself at the mo.
Just to let you know I have my pre op assessment at the end of the week.
Surgery a week after that. OMG the panic is setting in!!!!
Looking at what has been happening to some, although my surgery is supposed to be Anterior and Posterior repair I also have some descent of the uterus, surgeon says he will decide if hysterectomy neccessary at the time IYSWIM. Thinking of saying B4 I definitely want the hyster at the same time.
Just don't think I,LL cope if I need surgery for that shortly after.
Anyway just an update really.
Hope you are getting over infection Fengirl
Welcome Hawkesmead,
If you think things are different down there definitely get a second opinion.
I was ignored by 2 Gp's when I had what i now know
were symptoms of worsening prolapse over a year ago.
Got refered to pain management!! who in turn months later refered me to orthapaedic surgeon, had all sorts of tests xrays and MRI s then
On my hip and back!!!!!!!! Still having them when everything fell down totally in March. Finally 3rd GP realised the problem and got to see gynae.
He just said 3rd degree prolapse front and back and uterus could be following. Hence surgery soon.

Update & request for info/advice.

I saw the consultant last week. He is a colo-rectal surgeon and he can sort out my rectocele. His plan of attack is to go in through the anus, make a semi circle cut around the inside of the rectum just above the anus. He then separates the wall of the vagina & the wall of the rectum and pulls the muscle wall together from bottom to top (if that makes sense). Gynaecologists, tend to go through the vagina & pull the muscle wall together from side to side.

Has anyone had that kind of repair?

Hi Footle, I saw a gynae a few years back & was so unconvinced I've been struggling along since then. The advantages of peri-anal repair seem to be a better recovery time and no scaring within the vagina itself. After two very damaging births, my vagina is a mess of scar tissue, so I was a little concerned to generate even more.
The downside of the anal approach is a possibility of impaired wind control & in very rare cases anal leakage - but the surgeon said that has not happened to any of his patients yet.
I liked the surgeon. He was very steady & calm. Was at great pains to explain the risks & say that managing by sticking your fingers up your vag was considered a treatement option!!!!!
Still, it would be good to hear from someone who has actually had this kind of repair.

Hi all. I spoke to the nurse practitioner at the hosp gynae clinic today and they want to see me - unfortunately as I can't go this Thursday (dd2 has a transition and planning meeting at her new school) it will have to wait til next Thursday but I am feeling reassured that they will check me over. The nurse was disgusted that the emergency doctor didn't take a swab. Anyway, if these ab's don't work hopefully they will sort me out.

Sure - have you turned into a night owl?

Nannasylv - are you still out there? Still thinking of you.

Night owl on line now!!! Twhit twhoo!!!

PostBellum - I looked into the anal aspect of repair and decided that the vaginal tissue was meant to be stretched (and torn (occasionally!?)) but not the anal tissue by nature, which seems to correspond with the successful outcomes for vaginal repair. There are some You-tube postings showing repairs both vaginally and rectally. Personally, I would rather have problems via my vagina than incontinence issues via the rectum post op - too smelly by half!!! lol! I hate these types of decisions that we have to make - it would be far easier if there was a 'one op fits all' scenario. Good luck x

(feeling smug as have just got my very first pair of reading glasses and can now see what I am typing/reading!!! Lol! Old age kicking in - but got them so I can read my book in hospital at the end of June; that's if I can get past the pain killer drug induced hallucinations - last time I had grizzly bears walking into my bedroom and picking flowers !!!) Stay off the tramadol/co-codamol wherever poss!!! X

Hello all

Well after my last post I decided to go for the op. I have had my pre op assessment and just counting the days till Saturday, which is my operation date.

I am feeling a bit anxious now and wondered if you had any last minute advice. The pre op nurse seemed to think I should be back on my feet after two weeks.

Best wishes to you all

Pip

Also anyone with a cystocele I was told I have a small one but the consultant did not meantioned operating on it only the Rectocele. I ask because I now have this problem with emptying my bladder. I have no incontinence issue just getting it fully empty so I can go but will then have to jiggle around lean forward and back to get the last bit out.

Is this a symptom of the cystocele?

Thanks

HI everyone. Sorry, not very good at posting at the moment. Back at work full hours and still struggling along with swelling!
I had the results of the MRI last week and I do have a Seroma, (collection of plasma in a space) but it burst internally the night before the scan which just seemed to be sod's law really. I don't have the strong cyst wall, or bursa, which is good news as it should eventually go away on it's own, sort of. They are notoriously difficult to treat if info on the internet is anything to go by. I have developed my own technique: a rolled up sock for compression, two pairs of tight knickers to hold it in place, and at night I have a make up pad soaked in helichrysum, clove and grapefruit essential oils in almond oil, stuffed in place with the double knickers again. It seems to be doing the trick so far!

Sure, you asked ages back about the TVT. I knew immediately that something was wrong. I couldn't wee a drop for six days, they loosened it day three as I was getting ill and still couldn't go. I catheterised for a while after and was able to go about day seven. Once I started coming off the strong painkillers for the rectocele and perineal body repair I was in a lot of pain from the tape. It started to move and cut me internally, and would sort of store up movement and suddenly go, which was agony. It also started contracting along it's length as well so I was being cut sideways and lengthways. It pulled on my labia and restricted my movement so that i had trouble going up stairs or moving forward. There are several sites which also document that it degrades, peels, breaks, migrates and causes inflammatory reactions and neuropathy. I have had that and a friend who also had hers removed by the same surgeon has had it too. I am in contact with four people with varying problems but we have all thankfully had it removed. My only advice would be to please, please not have it put in. I know I wished you luck once you had made your decision, but it worried me all the same. I would hate for someone to have to go through what I did.

Post, I have had surgery up the back end and it caused 3 anal fissures ( I posted ages ago, they are not good). The anus is not meant to be stretched like that. The vagina is far more obliging in that way and I have to say that surgery up that end was so much easier to cope with. Again I don't want to put you off either, but personally I won't let anyone near my anus ever again!!
Lots of love to all you lovely ladies,
Xxx

Hi Everyone,

Not posted for ages but been lurking about. Sending hugs to all that have had operations - but to be honest when I read the posts I have been getting down, it all sounds so awful. Is everyone that has had the op, glad that they had it done?

Pip, you have the same symptoms as me, I went to gynae and he said I had a grade one prolapsed bladder and uterus and a grade 2 rectocele, but only going to operate on the rectocele. I have been busy, but next week I am going to try and get a second opinion, as I can see the cystocele, and like you do not quite finish when having a wee. I do not want to have the op for the rectocele and then only to be told I need another. Also when I was examined, the gynae man only asked me to cough so compared to what some of the other ladies had to do, I think he was useless. Anyway been having major problems with bm's which has been getting me down, everything just seems to be getting worse :(. Well thats my moan for the day, take care everyone xx

Hi Pip I was also told only getting rectocele repair but when he went in :) so to speak. Told I only had mild cystocele then he discovered cystocele worse and so he just did this while he was there. My symptoms were not being able to empty bladder fully unless I tilted pelvis, going half an hour after having just been. Needing to govery frequently and sometimes feeling as though I needed during sex and also up 3-4 times per night . I also had stress incont whilst coughing, jumping,running sneezing ect ect hence why I got TVTO. Funnily enough I also had this other sensation of constantly needing to wee if I was in bath or pool very very strange but I do not have this now..

Jackie so glad you are feeling a little better, I agree that it is not a decision to be made lightly about TVTO and after I have had mine stretched I am waiting to see if all will be better, I was no where near as bad as you ((((hugs)))) But my consultant did say if not he will take it out. Apparently he is a bit of a perfectionist and doesnt like to leave it in if you are suffering any symptoms which is fine but I would like to give it a year to see if things settle more. To see if I could lose some wieght and relieve pressure on the pelvic area when I bend or squat. Still get a little toothache like discomfort on right side but not sure if this is more hip, as no pain whatsoever during sex now but some discomfort next day . Wondered if this was just due to pressure on the pelvic area??.

Tinkxx65 Yes I am glad had op done, to be honest during first few months recovery , following infections, dissolving stitches, pain ouch!! and the general curtailment of activities such as lifting driving ect, I did wonder what on earth I had put myself through. I thought things were never gonna be normal again. But now I feel so glad I had it done. I splinted everytime I went to loo and it was getting even that did not help, planning a day out via tiolet stops was a nightmare and also no matter how hygenic I was, I still imagined I could smell urine (although DH asssured me not). So I guess it depends on how it all impacts on your life , also you have to bear in mind that the full recovery takes time at times you may think you are losing your mind, god knows I did but hang on in there it gets better.

PostB not so sure I would have the anal approach. For all the reasons the others said, particularly the stretching element. I know it is done here by urogynae unless you have a rectal intussusception(prolapse of the rectum out the anus), then it is a colorectal surgeon, I know your choice is due to previous scarring but have you spoke to a urogynae to see how this would affect the scarring, matbe they could sort that out whilst they are there??.

Love to all hope pre-ops dont stress too much and Post ops are recovering without too many issues or at least are getting them sorted xxxxx

I have not been around for a while and soooo sorry to hear that so many people having a hard time of it both health wise and with family bereavments and injuries/ illnesses / pressures.

(((hugs)))) to one and all.

To those asking about the tvt and being told about the possible problems ..... if you want to consider summat else or ask concultants..... maybe a bladder buttress might be a possibility.

I was offered this instead of a tvt and soooooooo glad I had it done.
I have NO stress incontinence and the only issue I have post op ( 8 weeks) is a worsening of urge incontinence from about 3 weeks post op .... and that might be sorted with a change in meds.

I am certainly most glad I had the op done (anterior and posterior repair).

I hope all goes well with those ladies having ops soon

I think I should add to what Tazzle said despite my setbacks I can wee all in one go!