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.

oneday - my first was a disastrous birth. After being in labour for 14 hours I was taken to theatre for an emergency c section and whilst there they had a last go....... resulting in a failed ventouse followed by a panicked forceps delivery with third degree tearing. My second baby (an accident!) was 14 months later and I managed a vaginal birth with no problems.

It didn't make the prolapse any worse, that didn't happen until 20 years later. However, had it been possible to avoid a second vaginal birth I would have taken it but back in the day they wouldn't let me. I spent the second birth reminding them to look after my pelvic floor, what was left of it. They did a good job second time round. I understand your fears and I hope you get the c section you have been advised to have.

Which brings me to my next question - I am going into hospital tomorrow for my op which is both hooray and eek at the same time. I have a question for you which I forgot to ask at the pre-op. Do I have to shave my lady garden?

Fen - your poor mum. I am not usually a fisticuffs sort of person but I would like to give the consultant that thought it ok to put her through two ops in 24 months for no good reason a firm slap.

I'll update on here as soon as I can post-op.

Livelong - as the nurse said to me (all po-faced) 'we don't shave unless that's what you usually do'.

Good luck tomorrow Livelong x I didn't have to shave the ladygarden :) I had asked at the preop and the nurse said it is now considered old fashioned, but think some hospitals still do it so guess its a matter of hospital policy.

Can I ask ladies who have had a posterior repair, did you feel during recovery that you needed to splint again during bm due to swelling etc? I feel just now that I need a.bm but that its kind of catching, the same way as it did before the op.

Lifelong, good luck & no shaving required
Roseanne maybe being blonde today but what's splitting & BM? Then I can maybe answer your question lol!,

Hi Gail, sorry for the shorthand! Splinting is using finger etc to push on the bulge to allow you to effectively pass a bowel movement (bm) because otherwise it gets stuck.

Roseanna - I would try a glycerine suppository if you have one. My sympathies!

Livelong, try not to worry, the day before is the worst (I went to work so it wasn't too bad, but managed to set my alarm for the pm time, not the am time as I was in a bit of a panic - I woke up anyway, thankfully!) You'll find once you're there, it goes quicker - a bit like going to the airport to go on holiday . Good luck!

Thanks Roseanne,

The answer to your question is yes, I don't know if it's just because were so used to doing splinting & the doubt that a BM will come out right i did tend to still try to help, habit really. I thought I could feel a bulge coming back down there but it all healed fine & dandy 8 weeks on.
I still take the odd Laxido sachet...

Livelong - best of luck for tomorrow xxx
Roseanna - I have only had two bm's without suppositories since op (4 weeks ago) as it still feels as if everything gets stuck and I do not want to ruin it with pushing/straining etc. (no chance of splinting or manual help as all sewn up still!!!). I have been on a long course of iron tablets though as was anaemic so I hope once I am tablet free things will become easier. Lactulose and water are my other best friends

Thank you so much as always ladies - will give the suppositories a try x

Lifelong. Good luck for tomorrow. I did not shave and they did not ask me to thank goodness.

Roseanna. I use flaxseed (milled) on my cereal in morning it really helps with regular bm's and ease of passing them. Sorry if tmi! I would def recommend it.

Oh and drink plenty of water.

Thank you for the comments about the ring pessaries, I have had awful thrush all weekend so am going to refuse a bigger another one and ask for a referral to the urogyny. I just hope that they don't fob me off again I am sick of it.

Fengirl that is awful that you have to go through another Op roll on christmas and that dancing around the tree! Hope that your mum is ok too.

Oneday I can really empathise with how you feel. I had a perineal repair a few years before I unexpectedly fell pregnant with my last dc. The labour for the previous DC was 40 minutes (lived 25 minutes away) and I have a history of PPH so decided that the only option for me was an ELCS. It was the most awful fight with the NHS to get them onboard and caused me more stress than the pregnancy/birth. I did have an ELCS and the first time my midwife saw me afterwards she burst into tears saying thank goodness you didn't deliver naturally because she knew how much more damaged I would have become and how poor my recoveries were after my previous DC's. I can't advise on what would happen with a prolapse but would say follow your own instincts they are always the right ones x

Pip a night out sounds good to me too

Livelong all the best for tomorrow xx

My mind is boggling with all of the conflicting advice from the health professionals, flaxseed oil, suppositories...

Hope that you have all had a good weekend it has been so nice to finally have some sunshine.

Bladderama - sorry to hear about the thrush. I was plagued by it after all the ab's I had. If the single dose doesn't clear it up, ask for at least a week's course (I needed two, typical me!) When you go about the pessary, really let them know how you feel about things. Pain, effects on your daily life (in my case getting tired and grumpy with DC's) and work, along with effects on you sex life are all things they SHOULD take into account. Don't let them put you off!

Thanks Fengirl and ouch to being plagued by thrush a few days has been bad enough!

I am considering taking DH with me for the appointment (what century is this?) I have PMI but need the GP referral to kick things off. Just crazy

Happy to report success with the suppositories (first time I've used them) and no splinting required so thanks again ladies :)

Bladderama - was in the same situation as you re needing a gp referral for pmi, and chose not to take dh as I felt it was terminally embarrassing enough without dh there too. Curiously, he was very miffed at me not wanting him to come, and I kind of think it might have meant less messing around in the beginning if he'd been there. Good luck whatever you choose to do x

I've just spoken my GP who was really supportive and he is sorting out a referral letter for me plus signed off for another 4 weeks light duties. Feel quite relieved that I will finally get to see the surgeon who did my op, he's a uro-gynae and does these repairs regularly. I have my suspicions that he will say wait a while for the cystocele repair and in some ways I'm happy with that as long as he keeps my case open and I can contact him directly should it worsen. The rectocele repair in March feels good.

Bladderama - hope you get an appointment soon.

Roseanna - :)

I've just had my first appointment with the gynae physio who has confirmed a mild cystocele and rectocele. Despite me having pelvic floor muscles like iron I have to follow a six week exercise plan (exactly the same as the one I already do)

She feels that the cystocele is not too much of a problem and can be managed through exercise but that the rectocele is more of an issue. It was barely noticeable at examination but the symptoms I experience aren't good and she isn't sure that exercise will help with the rectal prolapsing that occurs as well. She thinks it will end up being a referral back to a colorectal surgeon for sorting it out but we'll wait and see.

Not especially positive but at least I've been doing PFE properly :)

Would - that sounds good!

Misery (I tried to find a way of shortening your name that was a bit more cheerful but didn't think you'd like being called arse !) I spent a lot of time being sent to do this, that and the other. It sounds very cynical (sorry) but why can't you also be referred? Why not get on the waiting list ASAP? My hospital wanted to send me for another round of physio until I objected - and I didn't even have a physio saying my muscles were good. (I do have a neurotrac pelvitone that I use though.) If you feel (as I did) that you need the op, push for it. It's not something that someone does lightly, but nor is putting up with symptoms day after day. Forgive me if you think I'm trying to push you. If you're ok with the current pace that's great - but I would hate to think you've agreed just agreed because you feel you don't want to make a fuss. I ended up writing a letter literally 'throwing myself on the mercy' of the head of the gynae team. If I hadn't, in the words of the nurse, they 'wouldn't touch me for at least a year because of all the problems I had. No-one deserves to be made to wait. Sorry for the epic rant! (I'm on your side tho!)

I suppose Misery is better than Arse :)

I guess I've agreed because I'm not certain what's best. I didn't want to go for a colorectal solution if it was gynae in origin and have a repair fail. I'm seeing a gastroenterologist as well and my next appointment there is the end of August. They are keen to arrange a defecating proctogram so things are moving from that side as well. I just wanted to be sure that all bases were covered so asked for a gynae appointment as well.

I also need a bit of time to adjust to my medication before anything major takes place. I'm on a fairly new drug to improve bowel transit times and there's quite a settling in period.

It took 9 months for my previous GP to take me seriously and refer so I can wait a week or two

Fen/Misery - I have never been referred for any physio at all. My GP sent me straight to a consultant (first time round) who put me straight on the op list (maybe because the enterocele was so large?) but even after that I have still not been sent to see a physio prior/post either of the other ops. It does seem so crazy that in some areas they go down the NHS recommendation list (gp, physio, gp, referral, gp, pessary, physio, gp, referral, surgery) while in other areas you are able to go straight for the surgery without all this pissing about (excuse the french, but it makes me cross as it is such a waste of time when surgery is the inevitable outcome any way). I just wish that NHS could agree across the board the stages prior to surgery that we have to go through; it all seems so vague. xxx

Oh, on another note, I took my boys to the beach today and.... I did not need to go to the loo the entire time and no leaking!!! Didn't get back till 7.30 pm! Hurrah - the cystocele repair has made a massive difference and the tvt definitely works as we went for quite a long walk too and normally (Pre-op!) I would have had a leak or two and been desperate to go to the loo the entire time!!! I had not realised actually how much all this had impacted on my life in the way I had stopped doing so much and going out and about due to lack of toilet facilities and the worry of being caught short. What a difference, so worth all the hassle and months of worry, so hang in there girls it is worth it in the end xxx

Me too Sure! It sounds like Misery has got it covered and is waiting for someone who can take control in her case - always difficult in complex cases. (I hope I'm right Misery?) I had ibs so know how difficult it is to tell what's normal when you have other things going on too. (A case in point is that I've only just gone back to the constipation/going to the loo loads cycle after all the ab's upset my stomach.) that's when you really need someone who knows what they're talking about and how to go forward.... Hope you're doing ok!

You're right fengirl1. I suspect it's straightforward in terms of the rectocele itself but I've had an impacted bowel for nearly a year as well and I've just started on resolor. I don't think anyone will even think about surgery until the constipation issue has been resolved for a while.

Morning all.
I had surgery yesterday afternoon. They told me in the recovery room I have had anterior and posterior repair. I am so happy.
Tea just arrived will post later.
Hope everyone is well.

Livelong - welcome back to the land of the living!!! Hope it all went ok and you are not in too much pain. So glad you had both anterior and posterior done - that's good news (did you leave the consultant a message as suggested?? lol! ). Happy healing vibes going your way xxx