Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc part 5

[Piplysmelie]

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
Thread 3
Thread 5

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.

It's lovely that you are Footle, but I feel you're a 'guiding hand' to those of us with far less experience, so actually I'm grateful to you.

Hi all - just another quick note .. been in touch with Kitty11 in New Zealand quite a lot as she and I were contemplating tvt or not. She opted for not and in the end I went ahead. Well, she is now leaking again and so far, I am not (but I am only at 6 weeks). Early days yet as I have heard that problems can re-occur a few months down the line so I shall wait and see. The big bonus is that I can pee, get in the car, drive to the supermarket, shop, drive home, unload shopping (with help of DS's !), get supper and still not have needed to rush to the loo for another pee!! Whether that is the cystocele repair or the tvt I have no idea, but the end result is definitely better so far (even contemplating going camping again, where peeing in the night is SOOO embarassing as all can hear!!) Mind you, what I shall be reporting further down the line in a few months may well be a different story...

One day they will invent something to help us that is not invasive but natural that works (maybe even resort to adequate birth plans!!! Lol!) xxx

Footle - x 2 for your comment. Even if I haven't always posted in response I've been very grateful for your comments on this post and everybody elses. I hope anyone following this thread, even if they don't feel like contributing, will be in a better position to pose questions to the practitioners treating them and will not feel so alone.

Sure - great to hear some positive news

Just to add my own gratitude. I've followed these threads for a long time before posting & found them very informative and helpful. I've trawled the internet for resources and whilst there is a lot of good medical science out there, there are very few places where real women talk about their real experiences. As ever, Mumsnet is a fantastic resource of collective experience, support and wisdom too.
I am continuing to make good progress. IBS has settled a bit, actual wound not giving me any trouble (touch wood, thank God, lucky stars etc). BP still a bit pants, but as long as I give myself time, I don't end up seeing stars and wondering what planet I'm on!

Morning all.

It's good to read your post-op updates, lots of healing thoughts being sent your way you ladies of the fallen fanjo. Any news from those who were waiting for appointments?

Two weeks post-op for cystocele and rectocele repair here. I saw my GP yesterday for another sick note and he had a quick look and said all was fine. Pooing is no problem as long as I take the lactulose. The copious passing of wind is still an embarrassment and a side effect of the lactulose is that it is so pungent I have even seen my partner wrinkle up his nose and he is famous for not being able to smell anything!

I've been asked if the repairs have fixed the problem so here's what I think 2 weeks in:

Cystocele: The bulge has gone! There is no more gaping, woohoo. Pre-op I took ages to wee and couldn't empty my bladder or increase the flow at all. Immediately after the op it was much better but now things are settling down I seem to be going back to how weeing was before. If you were in the next cubicle to me you would hear a lot of widdlewiddle tiddle widdle twiddle twiddle widdlewiddle twiddle widdle twiddle widdle widdle etc followed by various muttered curses and "Bugger this, I'm not sitting here any longer." Maybe this will change as things settle and find their new position in life and in my fanjo.

Rectocele: This repair has made things feel much better. When full, the rectocele used to put pressure on the cystocele and that was when I could leak urine without warning. This has not been happening! I feel that the poo heads straight for the exit instead of trying to head-butt its way out through my fanjo. Before the op, lactulose would not have had any effect at all. I am thankful my consultant did this repair even though he couldn't see the rectocele at my initial examination.

I find I can't sit up for long periods yet, I had a visitor yesterday and sat downstairs talking to her for an hour and a bit then had to get the weight off my rear end which felt like it had filled up with barbed wire. I wonder if my age might be a factor here as the tissues are thinner than they used to be before the menopause. I think that younger fallen fanjos will heal faster.

That's my update. How are you?

Livelong - you made me chuckle with your description of going for a wee! Sounds (!) just like me and I've noticed the last two days how often I go compared to my dds. (We spent yesterday and today up at the coast which was lovely but Crikey that sea air works. ) You may find sitting upright a bit of a challenge for a while. I've had to change my driving position to a less upright one as after 45 mins or so it still makes me ache. I spent a lot of time laying on the sofa in the early days. Glad to hear it's all going well so far.

Hello ladies, just back from seeing the consultant and am still slightly reeling from it all. He diagnosed a large cystocele, a rectocele, a uterine prolapse and a problem with the perineum...broken my fanjo then!
I have decided to initially get the cystocele, recotcele and perinieum fixed and see how it goes with the uterine prolapse. I nearly vomited when he said about having a hysterectomy and have asked to avoid that for a while (am only 37).
Op will be in 2 weeks .
Some-one asked about the leaking after urinating when you stand which is something that I have and he said it was due to the large cystocele and the volume of urine that sits in the part of the bladder which is in the vagina that gets to leave when you stand up.

No idea if I am making any sense.

Hope that you are all recovering well

Bladder - Poor you . I think it is a good decision to not have a hysterectomy. I have heard that by strengthening the vaginal walls, it can hold the uterus up better, without everything pulling it down (plus if you did have a hyst then you may well add enterocele to your list of troubles).

I think perhaps a name change for you is in order - Fanjodrama or Allfalldown..?? . I know it isn't a laughing matter at all, but at least you are getting sorted and quickly too. Try and stay calm, get lots of early nights, lots of exercise as you will heal better afterwards, and eat really healthily to build up your vits and you will sail through all of this! Big hugs your way xxxx

Lol at fanjodrama

Surewoman thank you so much for all of your support, kind words and advice. You have been a tower of strength to me this past couple of weeks and it is difficult to put into words how much I appreciate it.

You are one of the amazing ladies on this thread who have made this all bearable and given me the strength to cope.

x

I just wanted to make an announcement, 21 months after my rectocele repair, in case anyone is in need of a bit of encouragement.

I managed to do a bit of trampolining on holiday with the kids, without any leakage at all! AND I also did a bit of skipping!

It can be done!!

That is really good to hear BoffinMum - I have had to give up running pending rectocele repair and am worried about my long term exercise prospects. I actually think the DCs trampoline might have been what finally did for my nether regions......

If I didn't have a bad hip I am sure I could run and jump and do everything I did before children, subject to having been to the loo first.

Bladderama - that's a lot to take in but in some way it must be a relief to know what is wrong. You've had a lot going on there and have done well to come this far. I think it's good you only have to wait 2 weeks - the sooner it's done the sooner you can recover and get rid of all the horrible symptoms you've had to put up with.

My rectocele repair feels really good now - I just wish they'd repaired the small bulge (cystocele) they reported at the same time. I have a referral but I am waiting for a particular consultant so can't do the choose and book system. My referral has gone to the consultant (I've checked it's there with his secretary!) and he will say when he can see me - appointments will then send me an appointment. He's away this week so won't hear too soon and I don't expect the appointment for quite a few weeks. This suits me as I want the rectocele repair to be fully healed and I'm still weighing up the cystocele situation which is hard to believe is just a 'small bulge' - it doesn't feel it to me

Boffinmum - thanks for posting such encouraging news. It's what we all want to hear.

Wow, Bladder that was quite some consultation. However, as everyone says best to know what is going on and get a plan of attack. I agree that you should try to keep your uterus.

From what I understand, most hysterectomies result in early menopause (even when it is just the removal of the uterus) because the blood supply to the ovaries is so compromised by its removal. I know there can be really good reasons for a hysterectomy but think if you can keep your uterus, you should.

8 days on from posterior repair & I seem to be making good progress. I can't believe how little it takes to exhaust me. DCs came home on Sunday and they are being really helpful - feel very proud of them both.

Aw your boys sound lovely post and am glad that you are making good progress on your recovery.
Thank you for all of the reassuring words about avoiding the hysterectomy. The consultant did say that if it falls more when he repairs the others he would use a keyhole approach and put a mesh on the back of the uterus and then attach that to a spinal something but I am also keen to avoid that.
I am really grateful that this will be over quickly and was impressed with the consultant who was incredibly understanding and professional, feel quit about my meltdown last week.
Hope that your appointments arrive soon wouldrather,sure and who knows.
For those of you who are post repair did you have a general or spinal?'and what would you recommend?

Can you tell that I am a nervous wreck?

Bladder - I had general, but there is someone on here that had a spinal and sedation and said it was fine and she had very little pain post op as the effect was still there. Personally, I prefer to be totally out of it otherwise I am just too embarassed by the whole thing and would rather not know how many people are in the operating room staring at my freaky fanjo!! You will be having the same as me - rectocele, cystocele and perineum fix (I also had a tvt inserted whilst there!) so any question, please ask. My one advice would be to make sure this week that your bowels are working really well, and regularly as it will make things easier after the op. Maybe even get some lactulose in and take a bit in the morning, drink lots during the day, and get your BM's nice and soft pre-op. xxx

Hello again :)

Just back from my gynae appointment and I have a moderate rectocele and a mild enterocele and need a bit of advice, if anyone can help.

I'm being referred for physio, told to lose weight and to stop drinking tea/coffee/pepsi max :(

I asked about surgery in respect of things only going to get worse and was told that there are several pathways that need to be followed before coming to surgery and the above are the preferred first course of action. Having had physio before to only moderate effect, I had hoped that the gynae referral would have meant I bypassed that stage this time round. So, I am waiting for a physio appointment, they are going to perform an ultrasound on my bowel and I will be seen back at the clinic in 4-6 months.

I have private health care through DH's work, would I be able to seek a second opinion through that route, or am I now stuck on the NHS treadmill and need to follow it through? knowing it can take up to two years? :(

I am so disappointed, I was hoping for something constructive being done, not more lose weight (I have already lost two stone to no discernable effect) and stop with the cola. Surely that is an urge inco issue, not stress inco? And am I right in assuming that no amount of physio will correct a gaping hole in the muscle wall?

Feeling really despondent :(

Oh and they had me empty my bladder immediately before the examination, so not sure how they could measure the extent of the enterocele?

Daisy, you can get another opinion any time you like. Sounds to me that you are following all the advice and it's not working, so worth seeing a gynae IMO.

Daisy, did anyone actually assess the strength of your pelvic floor muscles? If not, how can they say you need more physio? I went through this farce a few weeks back - until I wrote a letter to the top bod on the gynae team, spelling out exactly how my symptoms affect my life, my self image and self esteem. The upshot was an urgent appt to see her, at which I pointed out that no-one had assessed my pelvic floor and that I do pfe's anyway. I'm now waiting for an op (end sept roughly). I should say I've already had one op during which the surgeon chose not to repair my rectocele so they haven't a leg to stand on really.

Wow Bladderama! Your consultant has been thorough, seems to have found everything and has discussed how to deal with it in detail with you. He sounds great. I know it's scary but as it has to be fixed, it is better to have it fixed as soon as possible so you have less time to worry about it. I had a general, and a second one 24 hours later to put some extra stitches in. No problems with either of them. Same as Surewoman, I'd rather not know what's going on while it's happening!

I also second Surewoman's recommendation about taking the lactulose pre-op to soften everything up. The most pain I have experienced since the surgery was when I couldn't poo for a couple of days - only eclipsed by when I actually finally did! Fen had the same experience too.

Until I read your post about more wee coming out after you stand up, I had forgotten this used to happen to me. I had no idea why it was happening so your consultant's explanation is very enlightening. Since the op, it doesn't happen any more.

Footle I am liking the idea of reclining on a chaise longue! Fen also said that it takes much longer than two weeks to be able to sit for any length of time without discomfort so I shall be more realistic with what I expect to be able to do, and not feel embarrassed to ask visitors to come up and chat with me in my bedroom.
PBB and Wouldrather Glad to hear your rectocele repairs are good and healing well. Mine has really improved my quality of life already. Hope you get your appointment soon for the cystocele Wouldrather.

Boffin This is good news and gives a great deal of hope, thank you!