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.

morning ladies just wanted to say thankyou for you kind words and to let you know albeit a tiny wee i have managed to go on my own twice now bladder still not emptying but hopefully this is the start it has been helpful reading what people have to say on here i dont feel alone any more thankyou again xxx

whoknows - glad you are doing well.
Sure - good news for you too.
Roseanna - hope your phased return to work continues to go well

Fen - thinking of you today.

Bladder - wincing on your behalf.

I'm 9 weeks post op & I did the long (I haven't got car-parking near the office) walk this morning for the first time. All fine, no aching - so think I really am properly better.

This thread has been invaluable & I am beyond thankful that it exists.

Loving the positive vibes today :)

Nana - Glad things are improving for you. I luckily only had retention for 24hrs after the tvto op, so not the same as you I know, but the nurses did say to me that once you can go a little bit, it just gets better and better after that, so hopefully you're now on the
road to recovery.

Post - great news, so glad to hear you're all better so quickly. And totally agree with you - I honestly don't know what I would have done if it hadn't been for this forum :)

Ladies - on a serious note, would it be at all possible for a get together near Christmas? I know this is an incognito site, but I feel we have all shared so much that it would be lovely to be able to put faces to people. What do you all think? Is it an insane idea??? Too ?? A meeting in a pub in London???

Fen - wondering how you are doing xxx

I'd love that Sure, I'm not too far from London. Need to make sure we find somewhere with very comfy chairs!

Nana - glad you're starting to get a bit of relief.

Fen - thinking of you today.

Hi. I've been following this thread for a few months, your all so supportive&well informed so i was wondering if i could ask your opinion on a few matters.

I realised due to reading this thread&clicking on a link,that i had some sort of prolapse. A red lumpy 'lump' appeared in my vagina after i gave birth to my little boy 4years ago. No pain or problems so didn't think it was anything to worry about-wear&tear after 5 normal births!

A few weeks ago i noticed there are2lumps,like 1 at the back&1 at the front...

I avoid doctors,nurses anything medical like the plague&would ignore this probably until my bits dropped out BUT we r ttc.

What happens if you have a prolapse before/during pregnancy?

Im presuming it will get worse.

Any advice would be greatly appreciated!

Whoooooowoooooooo Sure - I feel really emotional - I am just so thrilled you are officially fixed. I'm a couple of hours from London so could meet up.

Here's hoping all this positivity continues for those recovering and for Fen and others who are currently undergoing darning.

Shellywelly1973 - I accept you are reluctant but would recommend you see your GP for advice and possible referral to a uro-gynae. I'm sorry I can't offer any experience as only developed prolapse problems since joining the menopausal club. I wonder whether midwives could offer any advice. Hopefully somebody else will be along with experience. Good luck.

Skinikki - are things still going well for you? Keen to hear about people's return to full fitness.

Shelly - I would go to the GP and ask for a referral to uro-gynae dept, they are the experts and can advise you on all the things you can do / not do in order to minimise any further damage.

Have just logged on for the first time in ages and tried to catch up with everyone's going ons!!
Fen: really hope today went well for you. Post when you can.
Sure: great news you are all fixed and well.
Roseanne: listen to your body and don't do too much too soon.
Any I have missed good luck with all your fallen fanjos. Hope your appointments/ outcomes are successful!
Update on my recovery: I am now 12 weeks post op for anterior repair and tvt. I am have been back at work for 4 weeks and am back exercising. Managing to get back out on my bike at least 3 times a week and am up to 22 miles now no problem. Am trying to get as fit as I can before Nov 9th as have been booked in for a posterior repair. Prolapse of the bowel was evident 6 wks post op and I know straight away things weren't right. Am still quite positive as things have been pretty straightforward and am thinking there is no reason why they shouldn't be again. Just wish it could have been done all at once!
Am thinking if I get myself fighting fit beforehand recovery will be straightforward again! Am looking forward to a week mountainbiking in Scotland the week before the next op...... Think I will need attest after that!! Am then hoping to be fully recovered for skiing in February :-)
Keeping my fingers crossed for all you lovely ladies out there :-)

Skini - great to hear how you are getting on. Have you not had any trouble with the tvt either? All the horror stories, it's nice to hear of someone else that is happy with it too! Good luck with the next op, I'm sure being fit does aid recovery enormously so hopefully that will be just as plain sailing for you xxx

Hope that all went well Fengirl and that you are recovering well, have been thinking about you x

Surewoman that is fantastic news so pleased to hear it after your long journey you have been such an inspiration.

Whoknows I am not booked for a 6 week check, I had one at 2 weeks and my next one is at 4 months!

Roseanna that is great to hear that your first day back at work went well and hopefully you will get some more normal weeks for a while.

Bugsy and skinikki so pleased that you are all recovered too - it gives me hope.

Nanaof2 hope that things are improving for you too that sounds so stressful x

Wouldratherbeskiing good luck on friday at your appointment the waiting is just awful.

Shelleywelley I would second the seeking advice, my trouble started with the first delivery and only got worse from there but I had no idea at the time so did not seek the help and advice that I needed.

Feeling much brighter here and things have settled back down. I contacted my cons who was not worried so have decided that I do not need to worry.

Surewoman it would be lovely to meet up and not at all. I am a good few hours north of London so would need quite a lot of notice to organise a trip down.

Hello all. Hope all is going well for everyone, or as well as can be expected.

I've not been here for a while because I'm in denial I've not had much to say but it's now time to update.

I've seen the uro gynae consultant who has confirmed a mild cystocele and a mild to moderate rectocele. He confirmed 4+/5 on pelvic floor strength and no uterine descent. Surgery would be uncomplicated and likely to be a day case. All good so far.

The bad news was that he doesn't think the rectocele repair would help in any way and has referred me on to a colorectal consultant. It's looking increasingly like rectal prolapse/intussusception. Things have deteriorated considerably. I had some success with the medical regime but initial hopes are fading. There's definitely a physical issue that needs to be resolved but there's another delay now as I wait for the colorectal appointment.

Bit miserable to be honest but trying to keep positive

Hello all! Thank you all for thinking of me ? it was nice to come home and see the messages. Luckily this time I was able to wee reasonably well so catheters only played the usual part in my stay, and the pack came out reasonably well too. I have been rather surprised by the amount of bleeding this time round, even while the pack was in place as I did not have this last time. Ditto the bruises! I?m so glad I have a ring cushion as atm it?s literally like sitting on barbed wire?. However, I?m feeling much more human than last time although very tired. I?ll come on another time to tell you all the trolley debacle?.

MiseryArse - Could you have an enterocele?? Please do NOT have surgery as a day case (I have still not psychologically recovered from my first op, day case, and asked my other consultant on Monday if he would ever do rectocele/enterocele as a day case- he said 'no' he wouldn't, it's only a money saving venture!). If you are day case and they find things worse once they 'go in' then you have two options (1) not everything fixed as they don't have enough time and (2) being discharged 4 hours after the op whilst you are projectile vomiting, fainting, unable to poo, terrified, bleeding, etc. etc. Please don't go as a day case - you are worth more than subjecting yourself to being a piece of meat on a conveyor belt as it is a question of 'next please' and no privacy at all!!! Rant over!! xxxx

Fen - You made it, hooray!!! Oooh, that barbed wire fence!! Remember it well!! Lol! Don't worry about the bleeding, there is quite a bit for about a week or so (period type) but then it goes pinkish and then stops. If it gets worse or very smelly, a&e and anti-b's!!! (but I'm sure you know that after last time!) xxxx Looking forward to a full up date x

Bladder - glad all good with you xx

I probably need to re introduce myself as only posted a couple of times in July but needless to say I am in a similar position to all of you and now finally have a date confirmed for surgery, rectocele and perenium repair, but not until the 20th December. I was offered sooner but as I have small children I needed time to organise temporary childcare for them as my family are too far away to help and my partner is self employed and must work as we are quite broke.
I have been trying to catch up and really want to send healing vibes to all those in recovery.

Sure you mention above about not being seen as a day case, I am nervous that I have been told I will only be in for one night, do you think this is sufficient?

I'm being operated on at St George's in Tooting fortunately by the urogynae team as opposed to colo rectal. I may also have bladder muscle issues, not a cystocele though but I'm having a urodynamics (eugh!) test next Tuesday to determine if it will need surgery at the same time.
I guess I have been fortunate in that I have had every diagnostic test available; colonoscopy, defecating proctograms, biodynamics (lots of probes up my bottom!), a pelvic scan, and now the dreaded urodynamics , but I suppose this means they won't miss anything.

My initial diagnosis was in June 2012 but it is only now I have a confirmed date for surgery that the reality is really sinking in. I can't wait to not have to splint and to have a fanjo that isn't falling apart but I'm so nervous of the journey to get there.

Troubled - as long as they have a bed reserved for you, you have the option to stay longer if needed. However, if they only have you in for day surgery, then find your problems are worse when they open you up, they won't have made any provisions for you to stay and when the day surgery closes they kick you out without any doctors to discharge you, etc. whatever state you are in.

It sounds like you are going to be very well looked after. Lucky you that they have properly looked into all your symptoms - the urodynamics test is not too bad really.
Good luck with it all and keep us posted (at least you will get out of turkey cooking this christmas, ) xxx

surewoman I have been thinking I may have an enterocele but I asked the uro-gynae consultant specifically about that and he said definitely not. Now I'm not certain how you can be definite from a vaginal exam, especially when I have a pretty good pelvic floor but the end result is the same. The symptoms don't match what he has found on examination.

Rectal prolapse is a strong contender. There's definitely signs when I'm on the toilet. I can generally get going but there's very little sensation and it's hard to tell whether I've passed a pea sized amount or a normal poo. I can't push the last bit out and it's not stuck in the rectocele. I have to wriggle a bit and hope it 'falls' out :(

Symptoms have definitely worsened in the last 4-6 weeks. I'm still happy to move slowly to make sure that I don't end up with the wrong surgery but it's really getting me down nowadays.

Good luck to all with surgery planned.

Misery - TMI ALERT - You have the same symptoms as me, I have little sensation that I want to go until the last minute and then when I do go I think I have finished but then only to find that alot of it is still there but with no sensation, and it is impossible to get clean, I have to have a shower and get the remainder out :( I also have a red mass that protrudes and is sore which I have to push back in, and when I am walking especially if carrying heavy shopping (I have no car) I can feel it starting to protrude. I dont know if it is internal piles or like you think a rectal prolapse, I find the whole thing very upsetting and do not think I have been given a proper diagnosis. Yesterday I went back to the doctor and she is referring me back to the colorectral man. I am booked in for a posterior repair in December, 10 months after seeking help, but to be honest I have no faith in any of the consultants I have seen.

Fen hope your feeling ok and glad it went well for you.

tinkxx65 we do seem to be walking the same path except there's no way I can get the remainder out, shower or not. It gets stuck too high up :(

I haven't got a diagnosis yet but all I can say is that the uro-gynae absolutely refused to do any surgery to repair rectocele/cystocele until he had advice from the colorectal surgeon. His letter says

I am not entirely sure repairing her prolapses will elevate or correct her rectal symptoms. I have suggested that Mrs XXX to be reviewed in your clinic and advise me whether to go ahead with surgery or not

If colorectal decide surgery is required then they will try to do a joint operation.

I've been passed from one clinic to another for over a year but I can wait. There's no way I want a rectocele repair if it doesn't sort out the problem

Misery, I had a large recotcele & apparently an enterocele too. My consultant said that it is difficult to diagnose an enterocele from a vaginal examination, particularly if your uterus is still where it is supposed to be. As it turned out I did have an enterocele & he repaired it along with the rectocele & I am a changed woman.
I had to splint every time I wanted to poo & sometimes I had to actively push the bits of poo out if that makes sense. I used to have terrible problems with small poos and also had difficulty knowing when I needed to go & then be overwhelmed with an urgent need to go, to find I only had something the size of a pea in my rectum.
My top tip, while you are waiting to be sorted out, is to eat a tonne of vegetables - don't just take laxatives & softeners - what you need is bulk. The bigger the poo, the easier it is & you don't get the awful thing tinkxx is talking about where you can't get properly clean, because there is squidgy poo still trying to come out.

If any of your are in the South of England I would definitely recommend my consultant, Christian Phillips, who works out of Basingstoke.

Fen - really glad to hear you are doing well.

Thanks Sure, that makes sense and has put my mind at ease.
I was initially pretty sad about having a date so close to Christmas especially as my children are young and need a happy Christmas but actually decided it made sense as my husband will be off work anyway for the Xmas period. Plus my mum has offered to have us all to her house in the countryside, just have to get there - 2hr car journey 3 days post op probably won't be much fun.

Misery I had a similar issue with getting colorectal and urogynae to liase. My gp initially sent me to see only the colorectal surgeon. He ran loads of diagnostic tests on me and diagnosed large rectocele but refused to operate due to me being pre menopausal. According to him I could be left too tight for sex and he wasn't prepared to take that risk on a younger woman. Stupid man is all I can say. Fortunately for me the fanjo physio asked why I'd never seen urogynae and referred me to them. On my first appt the consultant, whilst looking down there, took my hand and said 'don't worry we can fix this'. Think she became my hero at that moment! She said that a woman has a right to a healthy sex life at any age so his reasoning was rubbish.
So long and short is she is operating regardless of what he said. Hopefully your 2 departments can come together soon and work out what's best for you. Btw, have you had a biodynamic test? It tests all the rectal muscles, from the sphincter to about 10cms in.

Misery - I have that problem too - I sort of feel that it is stuck at the top and the bottom. If it is high up there is not way of getting it moving, and I think the straining has made everything worse. It is hard to describe really, all I know is that something is wrong. My test results showed I had low pressure at rest and squeeze and my colorectal consultant has said there is a real possibility that I will be fecal incontinent after the rectocele procedure, however my gynae consultant does not seemed concerned - well she might be, but has never discussed it with me.

Hi,

I'm just bookmarking for the moment so I can read up later. I had a rather alarming experience on the loo yesterday (3.5 months post partum with 3rd) and it's looking like I might fit in here.

I have only have barium xray and colonoscopy so far and that was over a year ago.

I saw a fabulous gastroenterologist 8 months ago who put me on prucalopride which helped greatly and was going to send me off for a defecating proctogram and the test with the balloon once she'd reviewed my response to the drugs but she didn't do my review and the one I saw decided to discharge me as it was no longer medical. Luckily I'd asked my GP to refer to gynae so things were progressing along that path.

My original GP was hopeless. I kept asking for referral but she kept sending me off with movicol, fybogel and senna. It took 4 months to get to have an xray :( My new GP is great though and I really feel that she's on my side.

PostBellumBugsy I have to be very careful with fibre as too much bulk causes complete blockage. I've got the drug/fibre combo right at last but physically I'll need some help.

Appointmet with colorectal came through for early next month so that's not too bad. Next appointment with uro-gynae is early January

Hi again, three posts in one day :/

I have just rang my gynae secretary and have been given another appointment for tomorrow!!! I cant believe it :). But now I am in a slight panic. As I have said in previous posts I am unhappy about my cystocele, the consultant just said everything was saggy at the last visit and has never actually said to me that it is a cystocele, but in the letter that has gone to my doctor it says I have a mild to moderate one. She did not see me again and just booked me in for a posterior repair. Anyway I am now hoping that I am not being paranoid. Would you ladies mind describing what your cystocele was like. I have three large lumps/bumbs, the rectocele one protrudes slightly out of my fanjo but the other two are inside, but when straining are at the entrance. I have a constant sore like feeling and when walking and again when carrying feel like it is all going to pop out. I dont want to have any operations that are not necessary but will be very upset to have the posterior and then need another one further down the line. I am waffling sorry. Anyway sorry for the me me post. Just wanting some advice really as to whether to push for both being done considering it is obviously falling down.