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.

Bagpuss, ask the consultant about a pessary. It fills you with hope that your gp had bothered to read your notes doesn't it? They spoke utter rubbish! It's good that you're being seen so soon though.

Thanks Fengirl, it's just bloody soul destroying!! I know I'm right!! When I was diagnosed last year the gynae said something about 'do pelvic floor exercises to defer surgery' so clearly surgery always on the cards!! My symptoms are a mirror image of what you described in your post from a few days ago, my sympathies :(

Bagpuss, there is definitely a two tier system (IMO anyway). If you have private health insurance you can call the shots much more than if you don't.

When I first was diagnosed with the rectocele, I didn't have health insurance and I got stuck on a long waiting list, saw a consultantant and ended up with a physio referal to learn how to do pelvic floor exercises I was already doing with a religious fervour. 7 years later on, with health insurance, it was as though I'd walked into a different world. I specified the consultants I wanted to see, I requested second opinions and went from first seeing my GP to choosing the date of my op & having it, in less than 4 months.

In my consultant's opinion, pelvic floor exercises will not repair or even significantly improve a rectocele or anything that involves torn tissue or over stretched ligaments. That is not to say they are a waste of time and will help support the pelvic area generally, but he doesn't believe there is any evidence to suggest they can bring about an improvement.

Thanks postbellumbugsy, so true about private health care, it's a different world. I'm very lucky to be covered by DHs health cover through his work. Frustrating thing was when I saw my gp I knew he was talking crap but he wouldn't listen - until I mentioned going private, funny isn't it?!! Really hope I can get myself sorted as quickly as you were able to, just some sort of plan would make me feel a bit better.

I noticed the two tier thing with a previous complaint I had (alopecia). I used to have private cover through my job, my GP wouldn't refer me to dermatology on the NHS, but she did via the private. However PPP told me that they would only cover one consultation as it "wasn't a proper illness". Anyway I went along for my one consultation and spent a lovely half an hour with a very nice consultant in a very swish office, went all through my options, he gave me all sorts of helpful info and talked about my work and his (I worked in a medical field). He agreed to transfer me to his NHS list when he heard I didn't have any further private cover. Next visit was with the same consultant, but 5 mins tops in a grotty basement room, no chat, in and out, job done.

Anyway, I've been for my pre-op today, so all systems are go for next week. Since the DCs went back to school I have been on a mad frenzy of decluttering and housework to try and get ahead (I'm a long term resident on one of the Flylady threads) and I am getting tired and achey very easily now. I didn't help myself by doing three hours shopping after the pre-op today. So I am going to have an early night.

Whoknows - sleep well and get rested !!! x

NHS for you.... Went for my check up today at 4.00 - was told there was a delay of 50 mins. Waited until 5.15 and was then told that the consultant had to go off on an emergency call, so I had two options - see someone completely different or re-book and go home!! So,I went home!!! I do feel sorry for the consultants though, as it is not their fault that their NHS appointments are so fully booked that there is no time between patients and a limit of 10 mins per patient. I do know that my consultant likes to have a proper consultation, so is more likely to over run therefore I am not complaining, but.... Oh well, another 2 weeks I suppose until I can get the all clear and ask my final questions!!! xxx

Could be worse Sure, dd1 had to see a top specialist eye bloke a few months back.... Arrived 10.20am and we went in to see him at 7.20 pm ( I kid you not). It was an urgent appointment so we had no choice but to wait. I think they should sack a few management bods and get more doctor's in don't you? And get rid of some of those 'nurse specialists' who see patients instead of doctors but that's a whole other story....

And Whoknows, slow down!

Fen - how are you? xxxx

Hi to everyone,

I have not posted for a while, had a virus on computer "security shield" which was a bugger to remove and have also been feeling very upset with everthing. Just a quick update really and am hoping to get some advice from you knowledgable ladies. I have a large rectocele and what I believe to be a large cystocele, when I have a look I have three alarming lumps, not sure what the one at the top is.....a urethrocele maybe. Anyway I was told at my first appointment about the rectocele but was told everything else was where it should be for a woman of my age etc. I then requested a further appointment, as the bulges are getting worse and I constantly feel like I need a wee even after I have been and I have also on two occasions had some wetness. Anyway I tell the consultant this and she fixates on the two time I had noticed my knickers were a bit wet and sent me for urodynamics even though I tried to say that I didnt think I had stress or urge incontinence... I think I wet myself after I have been, as sometimes a bit more comes out when I stand up but at the meeting I had not worked that out. Well the test come back normal as I knew it would and I got a snotty letter telling me that everything was fine and implying that I had made things up (well that is how it made me feel). On top of that she said she was not going to see me again??? I rang and was told that she had probley written the letter without looking at my notes (gives you a lot of faith in them doesnt it) subsequently I have been booked in for a posterior repair in December, 10 months after going to the doctors. I am pissed off that she is not going to see me again, oh and I forget to mention when I saw her she said my front wall was saggy? very technical. Anyway the doctor has received a letter and it says I have a mild to moderate cycstocle. Shall I get to the point :-). The cystocele is uncomfortable and is getting worse, but it would seem that my consultant is not interested in sorting it out. My thoughts are that it should be done, as surely it is only going to get worse (if it gets much worse I will be picking it up) and I just wondered what you ladies would do, how much of a fuss would you make. I hate arguing and am not very good at it, I dont want to upset anyone but am feeling like no one is listening. Sorry for the ramble.

Tink - Hi there, and I can completely understand why you are so fed up. The constantly needing a wee is because of the cystocele - I've just had mine 'mended' and that feeling has gone away. I would really press for having everything fixed at the same time, but I know that most consultants are reluctant to do this due to risks of a too tight vagina afterwards, adhesions, and problems with the bladder. What you would need is to get referred to a good urogynaecologist. Just fixing the rectocele (possible enterocele too??) may well make the cystocele worse afterwards if it is not corrected, as one can prevent the other from dropping further. I had only the rectocele/enterocele done first and have since had to go back in to surgery to have the cystocele/rectocele done. The pain after both is similar to that after just the rectocele/enterocele but you would need a catheter for a couple of days afterwards. Don't be fobbed off - it's your life and only you know how much it is affecting you, and to go through two ops is unnecessary when it could all get done at once. Hope this helps xxxx

Thanks Sure,

It is ruining my life - a bit dramatic maybe, but that is how I feel. I just dont know what to do. I have been trying to write a letter to send to my consultant but feel that I am going to annoy her as how
cross I am comes over loud and clear. I just dont understand why she didnt see me again to talk things over. I was told on the phone by the waiting list lady exactly what operation I was having, the consultant did tell me I needed the rectocele fixing but has never told me how they do it or anything. I am not working and need to be, but have been waiting for this operation before getting a job, little knowing that I would be waiting 10 months for it. I feel if I dont get the cystocele done at the same time, I will be facing another operation whenever and I am adament that that is not an option. I feel like I am a number on a conveyor belt and that they dont give a damn.

Anyway enough of my moaning, I hope all you ladies are doing well. Take Care x

I haven't caught up with the thread yet (not having a great week) but have just seen Tinx'x posts.

Tinx I am so for you what an awful way to be treated. I wanted to share a discussion that I had with my consultant prior to my anterior, posterior and perineal repair 4 weeks ago. My main symptoms were bladder related the worst of which was leaking after standing up after having a wee. He said that this was because of the large cystocele that meant that part of my bladder was sitting in my vagina and could not empty properly and it was this volume that was stuck which leaked out when I stood up. He also said that he preferred to repair one at a time but agreed to do both at the same time for me once I understood the risks and I am really glad that he did. I think that there are a few ladies on the thread that have been booked for one and woken up with both fixed. Keep pushing until you get the result that you want it is your body. The change in my quality of life since repair has been incredible and I have no regrets whatsoever x

The two tier system is just awful and the medical approach to this condition is so varied and usually not the most helpful it makes me realise just how lucky I have been with my treatment and such an understanding consultant.

Thank goodness for you ladies on this thread x

Tinx - just want to scream .............................. it seems time and time again there is such a lack of information and care.

Because you are an 'open' case and haven't been discharged I think you may be able to ring the consultant's secretary (if private and NHS then they have separate secretaries for each) and ask her if you can arrange an appointment due to changes in your condition prior to the op. I have found the NHS secretary to my consultant very helpful and she helped me navigate through for a further referral.

The consultants are there to work for their patients and you should not be worried about making a fuss - wanting to talk about how, what, etc. about major surgery should be a priority.

I am seeing my consultant in two weeks time I'm really hoping I don't have to go to battle as I cannot imagine being left like this. I can empathise with you saying it is ruining your life. It's a horribly emotional condition that strips us of our femininity and stops us living life to the full.

Bladderama - so pleased to hear things are continuing so well for you - it gives me hope.

Fen - the waiting is terrible. So sorry to hear your appointment is delayed.

Wouldrather I am intrigued to know what you do for a living! I am also in a medical related field...

Do you mean me Bladder? At that time I worked for a company supplying drugs for clinical trials. I've moved on to diagnostic products now. What about you?

I am still only supposed to be having the rectocele repair next week, they have told me they won't do the cystocele this time (I asked again at the pre-op yesterday). So it will be a waiting game afterwards. The cystocele doesn't give any problems at the moment, so I can see why they are taking this approach, but it is a bit worrying. I was wondering if maybe I should think about a pessary to support it afterwards to prevent it getting any worse.

Oops yes it was you whoknows! And yes we are in similar fields will PM you so that I don't out myself.

An interesting piece of advice that I was given about ring pessaries is that they are only suitable if you do not have a rectocele otherwise they cannot sit in the correct position and fall out.

Gaaaah! Just lost a big post. So this time in brief:-
Sure, glad you're doing so well. Have had a drama with dd2 - MRI next week... I'm in more pain now I'm back at work! Worried about dd2 and the op of course.
Wouldrather and Tink, sorry you're having a hard time. Hang in there (and come on here to have a moan if you need to!)

Oh Fen - thank you for your good wishes. I'm so sorry you are having to deal with your DD2's health worries as well as your own.

Fen - big hugs from me to you xxxx

Fen, sorry to hear you have a double load of worries at the moment.

For all those of you heading for rectocele repairs, 7 weeks on & I am feeling nearly 100% normal again. I am still incredulous everytime I poo, that it comes out all by itself & when I've done the poo, it feels like it is all gone! There is nowhere else in the world I would admit these things - but I'm hoping that all of you heading off for the op, want to hear that it can be fixed and you too, will be able to poo without splinting going forward. Also the horrible bulge coming out of my vagina has completely disappeared, along with the associated looseness at the entrance to my vagina too. Anyhow, sorry if that is overshare!

That is great to hear Bugsy, thank you.

Fen thinking of you, you have so much on your plate at the moment.

Good to hear that you are doing so well Post and I totally understand your comments! I am still gobsmacked at how much better things feel and work.

Am still very uncomfortable from the perineal repair and have no idea how I am going to manage to go back to work anytime soon, I can barely sit for an hour never mind 8 per day plus the commute.

How long do the internal stitches usually take to heal and fall out?

Bladder don't rush your return to work. If you are sore, trying to sit for long periods won't make it any better.

I went back for 4 hours a day after 5 weeks & it was very tiring & I felt really uncomfortable after 4 hours glued to my chair. I probably should have left it another week. The second week I did 4 hours again and it was better, although still very tiring - but alot less uncomfortable. I'm 7 weeks now & back full-time & it is fine.

However, I had much less work done than you - so don't use me as a guide. You need to go by how you feel. I was starting to get really bored & restless, which meant I felt ready to go back. If you are not ready, your GP will sign you as unfit to work. I would strongly recommend phased return, particularly if you have a commute to factor in as well. Your GP can give you a note for that too.

HI all

Wondering if I can join you all and ask a question? I?ve posted in childbirth with no response yet. I thought that this thread might be helpful!

I am due DC2 in 6wks. DC1 was massive at nearly 11lbs. She caused some damage to whole area during birth.

As this pregnancy has progressed, the issues from last time are exacerbated and I had a review yesterday whereby it was apparent I?ve got cystocele and absolutely no pelvic floor tone.
I am planning natural home birth again but now panicking that I?m going to end up totally broken after birth with major bladder/bowel issues. This isn?t about vanity!

What are your experiences of a 2nd birth after damage? did it make it worse?

More info
DC1 was born via normal vaginal delivery with no birthing issues.
Whole area was a car crash for ages and then I had unpleasant bladder symptoms for months (constant urge, discomfort feeling that bladder was hanging out).
The damage was mainly to my bladder and that department but also all my muscles around back passage were also massively stretched and now don?t work properly (turn inside out easily and remain like this all the time at the moment due to pressure of current baby).
I got fobbed off by a doc who said nothing was wrong.
Saw women?s health physio for a bit which helped with bladder issues.
I only now learn that there is a cystocele prolapse which is frustrating.
Following DC1, it all got better with time and stopping breastfeeding around 9months. It was never perfect though.