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.

Ohno have you tried lying down and feeding on your side. I use to do this with mine at night time.

Footle - please do not ever disappear as you are our guru on post menopause and we will all be hitting it over the next few years!!!! xxx

Gail - my urogynae said that they recommend a three step wee procedure

1. Leaning forward, elbows on knees, don't rush it.
2. Pressing on abdomen where the bladder is, pushing downward then

leaning backwards and trying again

1. Walk about a bit and then go again a few minutes later, even if only a

dribble Above all, take your time, no quick trips to bathroom prior to leaving house, and no pushing with pelvic floor. It might trickle out but slow and gentle is the way. Hope this helps xxxx (seems to have made a difference to me, as have longer stretches between pees now)

OhN0 - just remembered that I used to put baby on a pillow on my lap which spreads the weight a bit for you and puts less pressure on pelvis, also fed on side when in bed but not too successful for me as I have small boobs and had to literally lie on top!!! [grin grin]

Day 13 post op: Venturing out for a walk today, can't wait to get out of the house!!
Fen: Good luck today, let us know how you get on.
Hairy: Good luck to you too,wil be interesting what other advice they have to offer.
Sure: So good to sleep through the night again. I have for the last two but am waking very early.
Gail: ToT (Transobturator sling)is v similar to a TVT (Tension free vaginal tape)but with a shorter tape I think. There are two stitches in the groin area level with your fanjo rather than slightly higher in the pubic hair.

Hello ladies I have been lurking for some time and found these threads really useful. I went to the GP last Oct with urinary symptoms was diagnosed with an irritable bladder. The appointment with the incontinence lady was at the end of Feb and I was given a pelvic toner and vesicare. The vesicare made me really dizzy and after numourous trips to GP and three medications later (all of which I could not tolerate) I went back this am and asked them to check for a prolapse because I have never been examined. After a good rummage GP said that I have a large bladder prolapse, small rectal and slight uterine prolapse. She fitted a pessary which fell out within an hour (how cavernous is it in there fgs)
Although I am really pleased that I can stop taking the medication I am feeling quite low about this and have no idea about these pessaries and if the actually work. I am 37 and have namechanged.
Have any of you felt this with the initial diagnosis?

Bladderama - so sorry you have been going through all that. Try and get a referal to a urogynaecologist as they are the only ones fully able to help with all prolapses. Sounds like you will need surgery, but it is really worth it in the end as it will end your cavernous situation and get rid of bladder problems. You will need to have a urodynamics test if you haven't had one already which tests for stress incontinence as that might need sorting out too. Welcome to the fallen fanjo club - there is lots of support here and nothing is TMI x

Skini - I haven't got any stitches with tvt on the outside - the incisions are so small I can't even find them now and are right on top of where my pubic bone finishes, (in pubic hair) so do not rub on anything. I think they put glue over the incisions as I am still peeling bits off! (incisions are prob about 0.5cm). How are you getting on with the tot? I have had no leaking at all but have only just started moving about. But, can wander around the shops and not need to go to the loo in BHS or M&S atall!!! yeh!! xxx

Thankyou Surewoman for the welcome and lol to there being the bonus of a non-cavernous fanjo at the end of all this!
I don't have a referral yet but I guess that that will be the next step.

All of you ladies sound so in control and supportive of each other

Welcome Bladderama, I am fairly new to this thread and I must say if you have any sort of question someone on here will know the answer. They are great :-)
Sure, so far so good! I am a little tentative when coughing/ sneezing as not sure how much/if it will hurt/ do damage but haven't had any leaks so far....lets hope it stays that way :-)
Have been for a little walk today and am tired now and feeling a bit draggy (if thats even a word!) but it was great to get out of the house. Hubby is taking me to the bike shop at the weekend to look at a new toy as an incentive for when I am fully recovered. Can't wait :-)

Welcome Bladderama

Sure , I am doing that rolling forward & back bit, remember it from pregnancy. I just can't understand why they say nothing has changed with the Cystocele since the Op I never had these issues before my repair so something must have changed, the bladder must have moved if only slightly & is definitely worse when sitting up.

Skinikki, thanks for the explanation, I was going to have a tvt but they pulled that after the consultants weekly meeting due to Uro results, I'm quiet pleased about that as not had any leaks since rectocyle repair.

Hello Bladderama! I've never had a ring pessary but do know that they are not supposed to fall out! It's the wrong size and you need to go back to get it sorted out.

Well, I'm feeling , , and all at the same time! I was right all along that the lump at the front was not right - apparently I still have a urethrocele, but the surgeon does not want to touch it because if she does it might stop me weeing.... However, she has said the other surgeon 'made the wrong decision' and I still have a rectocele, and as I still have symptoms she has offered me a repair plus perineal repair and a 'tidy up'. Waiting time ten weeks (if she cant get me in sooner) and recovery time six. I felt so relieved that she listened to me and took into account how I feel, but am feeling dread that I have to go through it all again, and am angry that I need to. (Although the other surgeon never felt that a perineal repair was necessary - it was when I said I felt that you could still drive a bus up there she took notice and agreed.) I have to say I feel much more confidence in her - I just hope this is the last round! I was hoping to be able to retire as a full member of the 'Fallen Fanjo Club' around now and just visit as an honorary member like Footle.

And you will all like to know that when I asked her about pfe's she said yes, I do need to do them (as should all women), but that I don't need to see the physio, I can just carry on with my gadget (so that's one less set of appointments I have to trail my sorry self to) .

Fen - what a day! Mixed feelings I know but I'm so pleased that you have found somebody you can trust. 10 weeks and you'll be on your way and joining Footle. PFE's - good to know we should do them anyway as I have started back on mine daily on the stress programme. I pop it in when DH gets me a cup of tea and I just sit drinking it while the machine does its stuff and I clench along with it.

Any thoughts anyone on regular use of oestrogen pessaries. My prescription has run out - I know my GP is reluctant as I get migraine but being menopausal I wonder whether the benefits of use would outway the risk.

As for earlier mention of ring pessaries - I found one helped enormously but a bit icky and tricky getting in and out. Definitely need to be a tight fit.

Fen so glad you Got some answers & an Op even if it should have been done originally, just think by Xmas you'll be dancing round the Christmas tree

Fen I am thrilled for you, you will finally get what you need no more (8) for you :)

Sorry no experience of pessaries ring but I think the ladies are right and it was not a god fit. Head back to GP Bladderama. Oh and Welcome!

The ladies using the PFE machines would you recommend them. Which ones have you got How long do you use them for and how often. The reason why I am asking is I have started back doing my PFE's and just do not have the same control as I did before op. Also I can not do very many at all or I ache soon afterwards.

Also I am very interested in what oestrogen pessaries do? Please could someone explain?

Waves to all

Someone mentioned a night out I would definitely be interested :)

Hello
I am new to this thread, so I am afraid I haven't had a chance to read previous posts (and threads 1-4!) to see if my question is addressed elsewhere

Can anyone please advise

I have a prolapse following birth of dc1 nearly four years ago. It is a womb prolapse managed by a ring pessary

Day to day is ok - makes me mildly uncomfortable to have sex. Hate doing a poo as hate the sensation my insides turning inside out, but otherwise manageable

After my dc was born i saw a gynae who said the only 'fix' was surgery, but to wait and finish having a family before I did that. Also said I should have. C section if I had a baby again. Also had physio which had no affect or improvement.

Anyway now pregnant with dc2. Am petrified giving birth will make this condition worse. Dc1 was a very quick delivery, I couldn't push properly, had ventouse delivery. Am really worried this will happen again.

Midwife and gp have advised me to have a Caesarian.

Saw a consultant this week who was rude, patronising and dismissive. Said things like "I am no gynae, but imagine all the damage is done. Unlikely to get worse with vaginal birth". He suggested I was avoiding birth because of the pain factor. He made it sound like I was pushing for a c section. I explained that he was contradicting the medical advice I had been given. We left it that he would "think about it" - with me in floods of tears.

Sorry for long post, but wanted to explain clearly.

Has anyone had experience of vaginal birth with an existing prolapse?

Did it get worse?

Would you opt for a c section?

Can I insist or better not to go against his wishes?

Am really scared, in a panic and don't know what to do next

One so sorry to read your story. Unfortunately I don't have the experience you are seeking. I do however remember talking to a very patronising consultant when pregnant with DD2! I would go back to your GP and ask to be refered to a different consultant someone preferably with prolapse knowledge so they can understand your circumstances and talk through your options without the sarcasm.

oneday I follow this thread religiously (i will need the op soon prob) i am 52 and have just found out 2 years ago I hav a rectocele - gynae says "don't get constipated and don't push" that was it - thank god for my physio . I hav had my menopause 4 years ago now (young apparently!!) so Sure yes still interested in sex (yo for u and me Footle!!) just cos u go thru the meno does not mean all feelings stop - I am still a woman iykwim . Enuff of ranting and ravin but do have a c section - I would not (if I were you) have a vaginal delivery!! Don't let them put yu off it's your right to hav a c section - it is such a small scar and no more "damage" - however this is only my opinion!

Gotta - good for you!
Oneday - no real advice to offer other than go back to see your gp who sounds more understanding, explain what you've been told and how you feel about it, and ask what to do next. Got to be worth it surely? Man sounds like an idiot! If you could go elsewhere without too much trouble it might be worthwhile, as soon as possible. (And explain WHY you've gone to ask.)

Pip - I was told 3 months of pessaries, 3 months rest and then another 3 months of pessaries and that would be it. It's supposed to help 'invigorate' the tissues and make them more like they were pre-menopause. (Why in earth I was told I needed them when I'm not menopausal as far as I know I still haven't worked out!) might be worth a go, but IME I would ask what else can be done in the meantime. I have learnt the hard way (as lots of others have too) that the NHS is very good at time wasting and cutting corners!

Some of you will remember that my mum broke her hip a while ago - she had a half hip, but still has a limp and a lot of pain. When she went back, she was told the surgeon she had didn't do full hips and that she would probably need a full hip replacement in 12 - 24 months. Sounds familiar doesn't it???

Bladderama - you will find probably all of us on here have felt very low about our respective prolapse issues. I definitely have and continue to, not only having to put up with the physical symptoms but the emotional impact of not feeling 'right down there' and concerns about resuming 'a normal active life' post repair. You are not alone - there's a wealth of experience on this forum and I have benefited greatly from people sharing their experiences and offering support. As far as I know oestrogen pessaries are used for women around menopause to help strengthen the cells that have weaken due to lack of collagen - I do not know if they are prescribed for younger women or how successful this treatment is.

Pip - I first bought an TensCare itouch Sure Pelvic Floor exerciser about a year ago to try to alleviate rectocele symptoms. There are three programs - stress, urge and tone. I use the stress for 20 minutes a day. The information leaflet recommends 20 minutes and no more as there is no evidence to support it being more effective if used for more than 20 mins. I bought the itouch from Amazon after reading the reviews and because it was cheaper than the Kegel machine. I have started to use it again because my GP has diagnosed a small cystocele and he wants me to give PFE's a go before he refers me back to the consultant. I had the rectocele repaired in March so want things to settle down a bit before I'm seen. I find the machine is helpful to really engage the muscles and you can work with the machine. Just a word of warning - build up the settings gradually - I got a bit carried away and my muscles were really sore for a day or two.

Oneday - I am sorry that you are having these worries while you are pregnant. It beggars believe how awful that consultant was to you - Pip's advice is spot on. Don't stand for it - ring your GP and try to get somebody better who can give you proper advice. If midwife and GP have recommended a c section then their expertise should be taken seriously. I want to punch that consultant! Good luck.

Oneday - so sorry you are having such a nightmare. I myself haven't gone through prolapses until after having babies. However, a friend of mine had ventouse and a nightmare birth with ds1. She was absolutely terrified when she got pregnant the second time and wanted a c section, but her gynae advised her to go ahead with a vaginal birth if possible for two reasons, (i) to lay to rest the ghosts of the previous trauma and (ii) every birth is different, she could probably manage fine (even with all the terrible prolapses she had). Well, she did manage a vaginal birth for dd2 and went on to have a third ds3 (also normal delivery). Her youngest is now 3 and she has just had all her prolapses sorted out, tvt, perineum rebuild, etc. etc. and is back in fine working order. She felt for her it was psychologically healing to go through two straightforward births and really has helped her to forget about her first nightmare. Don't know if this info helps put your mind at rest at all. Feeling for you. xxx

Wouldrather - I've got the tenscare i-touch off amazon too. Very easy to use and am looking forward to being stitch free to get back to it. Bedtime routine with my book!!! Lol!

Fen - sorry you have got to go through it all again (like me ) but.... it is defo worth it, especially if you feel you can really trust this next consultant. The recovery this time has been a lot less painful, I've felt more in control (probably as I know more about it all, thanks to MN) and also have known what to expect. So worth it, I feel quite happy and relaxed and haven't spent days in floods of tears this time thinking I was ruined forever! (actually haven't felt sad at all) So, just think, by Christmas you will have graduated from the Fallen Fanjo Club with honours (and we should all try and meet up for a glass of X-mas cheer!!!) xxxx

Done too much today - went in to school to say farewell to all the lovely children moving up, and of course ended up staying and doing things. Aren't kids so lovely??? Always a bit sad to see a class move on a year! Back on the Ibo and bed, so quiet day for me tomorrow. And.... I have driven the car . Felt fabulous to be free again!!! (one day short of my 4 weeks, tut tut)

Said things like "I am no gynae, but imagine all the damage is done. disgusting horrible idiot.

If they don't have tge knowledge then they shouldn't be giving an opinion. I am hoping 'having a think' is a code for will go away and talk to someone who knows what they are on about.

As others have said defo go back to tge gp, don't know if it's worth asking him to get you also referred back to tge original consult for advice?

Ime consults are amazing at their little bit of expertise, otherwise not a lot of good.

Please do not panic. Speak to your mw again and see if there is anything she can do from her end.

I had a fast birth too, in fact a ventouse with dd. they just had a guide her head slightly and then I pushed her out. My second well I was very scared it would be so fast I would get caught out and have the baby in the car or on tge floor etc so booked a home birth just incase. As it happens I did decide to go to hospital and ds was born 30 mins later. It was again a fast, intense birth but it was better in lots of ways. I'm not telling you to go for vb just saying tgat every labour can be different as well as birth. Make sure you have your dp instructed well to get you into hospital straight away if you do go into labour and get them to record on your notes tgat a csection should still be performed if you go into labour.

Good luck, and make sure you take someone with you to your next appt, just incase you can't say what you want too.

Fen - I took so long typing my last post I hadn't managed to read yours. Sorry to hear about your Mum and as you say yet another reminder that it is not a perfect system - something we need to all bear in mind and challenge anything we are not clear on. I keep saying it but it doesn't seem to be a lot to ask to have good, clear, accurate, relevant information and good practitioners...... aaaaaahhhhhh - still at the angry stage ... I'm looking forward to moving onto Sure's more positive frame of mind. The weekend looks sunny so that will be lovely for everybody. First BBQ of the summer perhaps?

Wouldrather - my mum's far more philosophical about it than I would be! (She's that generation I suppose.) it's more that it really illustrates that there should standardised care once the best method of treating something is found. After all, that's what the care pathways are supposed to do isn't it? Amazing that people are still given differing and even conflicting advice, sometimes by members of the same team!

Fen - I agree, just look at my two consultants; same hospital,same team and completely differing views on procedures and sutures!!! (and in my opinion, one excellent the other a load of crap!). Hope your Mum is OK and you too x