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.

Hi all, just a quick update from me. Saw the consultant last night after the urodynamics test, and now booked in for a tvt-o procedure on wed. All your lovely messages of support have helped convince me its the right thing to try, so thank you for sharing your experiences. I didn't have an examination this time, but he did say based on the last exam that I have a cystocele and urethrocele. He said he won't look to fix those as the tvt should fix the urinary incontinence symptoms, and further pf repair could jeopardize the effectiveness of the tape. I've been experiencing leakage during sex on the two times we've tried it since the rectocele repair 10+ weeks ago, and he said the tape might help but no guarantees. He mentioned I was very young at 39 to have so many problems, but the bulging and sex issues may just have to be lived with, which I was a little disappointed with! I'm curious to know from some of you ladies if any of you have had similar experiences?

roseanna - do you think it might be worth getting a second opinion?

nanky, I'm all for pelvic floor exercises - I think they are really important. BUT, one of my big frustrations with the current system is the idea that a hernia or tear in muscle tissue (which is what many of the "cele" type prolapses are caused by) will somehow get better with pelvic floor exercises.

I have really strong pelvic floor - not just in my own imagination but commented on by every health professional I have seen with regard to my issues and yet they didn't stop the tear in my muscle wall getting progressively larger in the 8 years since I first noticed it. Yet, when I first saw a consultant back in 2005 the recommendation was keep going with the pelvic floor exercises, a referral to a physio (to show me the same PFEs I was already doing) and to see how I went!!!!! This seems to be fairly common practice, as though trying to winnow out all but the most determined. If you go through these threads you'll see the frustrations of so many of us who are referred to physios, like some kind of delaying tactic.

At the end of the day, no amount of PFE can repair a torn muscle wall or an overstretched ligament.

Hi Post, Whoknows et al!
Bladder - glad to hear the BM's are behaving at last! Take care of your back.... trying to find other positions can take their toll.
Daisy, all I'm going to say is tut tut!
Ah Footle, you're only as old as the man you feel. It's interesting that your cystocele is going to be left - my new one won't touch my urethrocele . I'll pass on the cones thanks all the same .
I'm glad to hear you're doing well Sure. I think your mum and mine are secret twins - mine has had a painful and swollen broken toe for three weeks and won't do anything about it!
Roseanna - see what I wrote above to Footle!
As for me.... I actually thought things had more or less settled down the last few weeks - until I went shopping with my mum yesterday... Ho hum!

:o

I really cba explaining to him/her fengirl. Bit gutted that I didn't get deleted for a personal attack though

Will catch up soon. Love to all :)

Feeling very sorry for myself today.

Up half the night with stomach cramps/feeling sick, and have hideous squitty bottom. Woke up from a nap earlier to find I'd lost control of my bowels :( :( :(

So fed up with this.

daisy and a big hug that is awful for you x

Surewoman yes I do grin like a mad woman when I have another pee free night!

footle what the heck are cones?

Fengirl are you psychic? I still can't sit down and am getting very achey and grumpy. Did anyone else have a perineal repair done at the same time? How long does it take to be able to sit again?

Roseanna what a journey you are having, really hope that your tvt sorts out your bladder troubles x

Am dreading going back to the consultant this week incase he examines me I am too sore

Big hug to you Daisy.

Twas not me Footle, but am fascinated nonetheless!!!!

Bladder, I had perineal "strengthening" with my rectocele/enterocele repair, but it doesn't sound like it was as significant as yours. With my first baby, when my perineum was shredded, it was about 4 weeks before I could sit remotely comfortably. Bizarrely, I found it more comfortable to sit on a firm surface, rather than a sofa and I found the rubber ring torturous. Hopefully, your consultant can check to make sure nothing is pulled too tight when you see him (and he won't hurt you).

I am sorry footle I have asked for my last post to be deleted.

Evening all,

Got my surgery date through today, last week in September, so I can start planning for childcare etc, really is a bit of a nightmare (I'm not a great delegator and because my work hours are short and entirely in school time I normally do at least 90% of housework and childcare).

I was wondering, on the day of your surgery, did you all have someone at the hospital with you, or was there no need / no point?

Daisy - hope you are feeling a bit better tonight.

Roseanna - good luck with the TVT, hope it sorts your symptoms out, sorry you are having to have more work so soon though

WhoKnows - glad you have got your date through. I didn't have anyone with me on the day of surgery, but most of the others that were there did. I think for at least two of them it seemed to make them more anxious, whereas when they were on their own they could read a book or chat. Actually, it was quite nice to be able to chat to women in a similar situation and the poor other halves felt a bit spare-partish!!! (not to mention ! Lol!).

Roseanna - when I was due to have my tvt inserted I mentioned to the consultant that the cystocele had got worse and he said he was glad I showed him (standing up and coughing!) as it changed the plan for the op - he said that it wasn't so easy to fix a cystocele once the tvt was inserted and he would rather do both at the same time. Maybe you should get a second opinion?? Also, find out which tape your consultant is intending to use as 4 have recently been recalled (last month). I have not had any trouble with mine so far, but it is the traditional tvt not the tvt-o. Any questions, please ask.

Bladder - I had perineal repair done at the same time and to be honest I am only able to sit comfortably quite recently, 10+ weeks post op. If I have been doing a lot during the day, then I'm quite achey by the evening and am better lying down.

Nanky - my mother refuses to go and see anyone. I put it down to plain old embarassment as it must be years since any doc has been near her lady bits as she had a hysterectomy 30+ years ago, so no smear tests or anything needed. (plus she is of the generation that don't like to bother the GPs and self-medicate at home!). I agree that we are looking at a future of older women and think that my age group (40+) must be encouraged to get fixed now to cut out problems further down the line - I am convinced the NHS and GPs all have shares in tena ladies, hence the reluctance in mending prolapses!!! Maybe they secretly own the company along with i-touch pelvic floor machines, cones, dilators, etc. etc. Big Business!!!

Footle - wasn't me, but keep feeling!!! x

Advice please - I have got my final check up with the consultant on Monday but have just started my period today and will be full flow by then. Do you think I shall have to cancel? Big bummer as back to work on Tuesday and wanted the all clear beforehand.

Sure - I was kind of thinking that I would get DH to just drop me off, he's going to have to take enough time off work because of this as it is. I am a fairly independent sort of person who enjoys chatting, so I should be OK I think. If I was you I would still go for your check, they will be used to periods and would probably prefer that to having you cancel at short notice.

I am going to ask to be examined standing up at the pre-op, I am still concerned about the cystocele which the Dr I saw previously said they were going to leave.

Hi all, thanks for all your replies x Thought about a second opinion, but (and am v. ashamed to admit this) but it took me so long to pluck up the courage to go in the first place that I just can't face starting the whole story again with someone from scratch. I do respect and trust my consultant too, I think its more that I'm a details person, and he just tells me the need to know stuff which leaves me not always entirely sure why he's made certain choices rather than others and I get the impression he thinks I'm being neurotic when I ask lots of questions...he might be right about that though lol

Interestingly Fen, that yours won't touch it either...perhaps a new approach to this is coming through as I haven't seen many others not having both at the same time? It kinda makes sense if you just consider the urinary symptoms in isolation, but won't address some of the quality of life and discomfort issues. When I mentioned the sex side of things, he looked a bit taken aback and said that his patients were generally 20 years older (late 50s) as if the sex wouldn't be such an issue at that age!

Sure - interesting too that you've been told it would be more difficult to do further repairs later. I'd kind of concluded that I would just do the tvt-o and then take it from there once I knew what symptoms were left so to speak, but that's given me food for thought. I wont see the consultant again before the surgery on Wed so would need to cancel, so not sure what to do. He won't convert during surgery even if he sees something else during surgery I don't think because the preauthorisation from the insurance only covers the tvt-o. Hmmm...more thinking required in a hurry methinks! Can I ask how much pain there was after the surgery that you feel was attributable to the tape? I've got a few days annual leave, then working from home the week after...do you think that will be enough?

Whoknows - dh wanted to be with me until I came out of surgery, so he came with me and stayed for about an hour after. I sent him home at that point as he was getting bored in the private room and I wanted some peace! The privacy was good, but I did think maybe it would have been nice to have a bit of camaraderie with some other women going through the same thing! Going to try and convince dh to just drop me off and pick me up on Wednesday...guess its kinda a personal preference type of thing, but I think there's a bit of feeling you need to entertain visitors/ dh etc when really I just want to get on with what I need to do to get.home lol

Whowknows my DH dropped me off and came back later before I went into surgery and I am glad that he was there because the consultant came out of surgery and spoke to him whilst I was in recovery.

Roseanna I was also on the pre authorise code thing and my surgery plan changed when I got into theatre. I woke up to find a different and more appropriate procedure had been done and it was no problem from an insurance point of view so try not to worry x

Post and sure thank you for the perineum comments I really think that I need to ask some questions this week.

Roseanna - If I had only had the tvt, I think the pain would have felt like a stinging cut when I peed (the incision on the urethra is small) and a bruised feeling around the pubic bone. When I lay down, depending on how I moved, I sometimes felt a kind of pulling feeling inside (where the tape is), not painful but wierd. That has stopped now as I presume I have scar tissue that has grown around it so it doesn't move anymore. I don't know about the tvt-o post op as the tape comes out in your groin and can hurt for longer as it is where you sit. Someone called Happy2bme had a tvt-o a few months ago and her posts are on thread 3/4 I think which might be helpful.

I have always wondered if fixing the cystocele would cure the leaking problems. My consultant said the leaking was due to a kink in the urethra and fixing only the cystocele would/might make leaking worse. I felt that the urethra was kinking because the bladder had dropped. I'm still not convinced but will never know now! But... who cares, as no more leaking!!! Lol!

Roseanna - another thought; how about phoning a different consultant and asking for an opinion over the phone? That is how I approached my second consultant - a phone session for about 30 mins so when I went to see him he already had an idea of my problems. xxx

Hello

i am about to have an operation with a lovely urogyneaecologist recommended on here by a lady who has been superbly helpful to me.

He said I had two options to either have an anterior repair with collagen (dissolvable mesh) and posterior repair, with tvt repair for incontinence.

Or a colposuspension and then the posterior repair a few months after. He suggested I went for the tvt option due to having thickened bladder walls.

I am rather nervous about the tvt tape and would really appreciate any comments about how people have recovered with the tvt tape and also why anyone chose a colposuspension over this?

This is my third op and like everybody else I am desperately hoping it will be my last!

Many thanks x

Hi other daisy :o

I'm not at the op stage yet, so no advice, but wanted to say hi :)

Hi daisyji - Sorry to hear this is your third op. Fingers crossed for you it's your last. I have had the tvt and so far (11 weeks) no problems at all and am very happy with it. I believe the outcome is very dependent on the skill and expertise of the consultant, so if yours is very experienced in this then I would probably trust him. Is it the colposuspension that can change the shape/angle of your vagina or am I thinking of something else? And is that done through the abdomen?? I think there is something that can be done laproscopically with a good success rate. If you have any questions re. the tvt, please ask and I will answer if I can xxx

That's good to know surewoman. I guess I'm concerned about feeling the tvt tape as it's in such a sensitive place and worries of it eroding etc.

How were you pain wise after the op? I know surgeons tend to say there won't be much pain but the reality is often different!

Yes, the colposuspension aims to correct the cystocele (collapsed vaginal wall) as well as sorting out the incontinence. Have to say I like the idea of no mesh, but want obviously want to do what my surgeon suggested.

It makes sense about the result being dependent on the skill of the surgeon.

So pleased it has worked well for you x

Thanks for all the advice Sure x

I thought it was a good idea about the phone consultation, but after a lot of getting passed from pillar to post it seems noone is willing to talk to me and can't get an appt with anyone else until well after Wed when I have the op.

Think I'm going to have to put my faith in the doc and go with what he suggests and work out anything else later, praying it won't make things more difficult later.

Am also working my way through the thread you sent me. It's been really usefulso far (am about halfway through) but what struck me most was your own story Sure. You have come so far, and have dealt with all your challenges so bravely I was actually quite emotional reading it through...you probably don't realise it but you're quite an inspiration!

PS. Thanks for the info Bladderama...didn't know that so fingers crossed I can get a quick word with the doc before the op x

Hi everyone, was wondering if I could join in this thread? I confess I haven't read all of it because it goes back such a long way. I go through bouts of trying to pretend problems aren't there but at the moment feel bit depressed about them. Before DC I was so fit and now can hardly follow shop assistant when they say "it's just over here if you'd like to follow me". Feel old and decrepit. And uncomfortable. All the time.

Hi everyone, Im looking for advice. I have posted before, about 6 months ago. I had a hysterectomy last wednesday, it was keyhole/vaginal assisted and I lost my womb, tubes and ovaries.

The thing is I have a really funny feeling, its like a bubble in my vagina, if I move position it gushes out I can't tell if it's wee or discharge. I couldn't empty my bladder after the catheder came out and had to be manually done. The nurse carried on like she was digging for coal apparently my previous TVT was making it difficult.

Does this sound normal? I'm aware that it hasn't been a week yet, so don't want to jump the gun. Thanks