Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc part 7

[gottagetthroughthis]

This is thread 7 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
Thread 6

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.

Tinx, how's your cold? Really hope you're on the mend. After all the organisation for this op it makes me really nervous that there are so many bugs around to catch that could mean cancelling it.
You asked about pain relief and I think it depends on the hospital and probably whether you're private or NHS. I spoke with a lady yesterday who said she was discharged with morphine but she was private, somehow doubt the NHS will do that! I hope they do though, can't imagine ibuprofen or paracetamol doing the job for the first week.
I've got my pre op on Thursday, what are the questions you wished you'd asked?

Troubled - I really didn't need anything stronger than paracetamol and ibuprofen once the packing was out and I didn't need the full doses either, I was able to go down to 3 times a day once at home and phased them out altogether between 2-3 weeks post-op.

Wanted to tell you ladies about the app I have been using on my phone, it's called Kegel trainer. You set it up to send you a little reminder every time you want to do your exercises, then you press start and it takes you through a short routine, which progressively gets harder. I only started it a few days ago, but it really helps me concentrate, normally I either forget altogether, or my mind wanders after about half a minute and I don't do enough of them.

Bladder, my bladder seems to be behaving itself (besides weeing sideways occasionally still), do I think it was the combination of the urethrocele,having been laying and a very full bladder!

Oops posted too soon! Tink and troubled, I was also given codeine - the first time round I needed it, but not the second. You can get 96 ibuprofen at a pharmacy and 64 aspirin (if you're ok to take it!) I would advise having a decent stock of paracetomol too as there's nothing worse than being in pain and not having anything - although, to repeat myself, this time round the pain was much more manageable.
I'm going back to work next Wednesday (eek!) but not full time, just four hours a day to begin with, but then full time after the holidays which I think will work out ok. (I just have performance management to worry about now....)
I have thought a lot about the lifting question and have decided for my own peace of mind I'm not going to lift heavy bags of coal (20kg) or move any of my heavier bits of furniture (a pain as I'm trying to revamp the house ready to put it on the market). I did move a bookcase a couple of days ago and the ache after was enough to worry me.
To all those worrying about it, we will ALL be ready for Christmas eventually! (I hope!)

Hi all

Still got my cold :( thought it had gone this morning, but am back to being bunged up this evening.

Trouble - I wish I had asked how long the operation takes, whether I would be up to visitors on the first day, about pain relief - I did ask how much it hurts and got told the pain would be worth it as I would be a rejuvenated woman at the end (which for some reason really pissed me off) I wanted to ask how they were doing the operation but totally forgot so am hoping the consultant on the day goes through it. I did ask about having a spinal and the nurse looked very shocked and asked me why I wanted one and then said I would have to speak to the anesthetist on the day, but that she would recommend a general. I wished I had asked about having an enema as I am really worried about there being something still up there if you know what I mean .

I have been told I will be in for two or three nights and that makes me think it is going to be horrible - how many nights did everyone else stay.

I am feeling sick with nerves and am not sleeping which is making me very snappy. I am trying to get organised but cant think straight. I am concerned about my rectal prolapse and keep worrying having the rectocele fixed is not going to rectify the rectal prolapse and I am also worrying that having the cystocele fixed will give me other problems - in fact I am just worrying about it all lol. But then I think if the only pain relief you need at home is ibuprofen then it really cant be that bad.

I have my mother coming to stay for two and a half weeks, and my boys are at their fathers at christmas so will have plenty of rest.

Glad you are feeling better fen, and it is great to hear how everyone is doing, calms my nerves reading about everyones recovery. But I am scared and will be glad when I am out the other side and hopefully posting on here that it wasnt as bad I thought it was going to be.

Tink - I was in for two nights after having the op in the afternoon. I was catheterised for 24 hours after, ie till the following lunchtime, then they wanted me to stay in till I had done three wees by myself, which took me into the evening. I was still extremely wobbly on my pins that afternoon and was quite happy to stay in another night, that might have been partly because I lost a pint of blood, I'm a blood donor and it does leave me weak and wobbly. DH came in around the time I came back from recovery and it was good to see him. I actually enjoyed my stay, the bed was comfy and had an electronic mechanism for raising up the head and or foot end, the nurses were lovely and so were all the other women on the ward, we all had a lovely time chatting on the second morning when we were all post-op. The matron came in at one point and found all six of us playing with our phones and told us off for ignoring the no phone signs. But the nurses told us to ignore her. They had problems with someone putting videos of patients on youtube apparently. The mind boggles.

I know it's not hard not to get stressed about it, try and just focus on other stuff (Christmas) is th only suggestion I've got. Glad you've got help organised for afterwards, that makes a huge difference. Oh and regarding the enema, I was given one to do at home the night before the op, it was not the most pleasant thing I have ever done, but at least you know it's all clear afterwards.

Hi Tinx - I can remember being really anxious before the op (rectocele repair in March) and felt a strange sense of relief to find myself finally in a hospital bed recovering. I was not offered an enema but found my nerves naturally sorted things for me. I had the opportunity to meet the anaesthetist and consultant before the op and could briefly ask questions then. My OH was given a number to ring to check about visiting. It may be worth you jotting some questions on a piece of paper to reassure you.

I was given a carrier bag and told I could take a dressing gown and slippers plus something to read. My first op got cancelled at the last minute and I felt distraught without a mobile phone so the next time I took one in. No restrictions on the ward I was on regarding mobile use. I found it comforting to be able to text. When you pack your hospital bag put the things you need to hand at the top. It can be difficult once the bag is put in the bedside locker to access it while you are cathetarised. I have suggested on here keeping a toothbrush and paste in a separate plastic bag and have it to hand with babywipes etc. I had to ask for a bowl so I could clean my teeth. I don't think this would have been offered to me the first night and it helps to feel fresh.

As for pain relief my time in hospital was focussed on pain relief - rounds of monitoring and dispensing. I was cautious of the liquid morphine because I was so scared of constipation and found paracetamol and ibruphen were enough for me and they started me on a laxative, can't remember the name but something like milk of magnesia. I was pleased I stocked up on glycerine suppositories at home (marvellous tip from this thread). I only needed them a couple of times but kept things going! I also found using a little vaseline really helped keep things supple. Sorry if TMI but very practical. I would add that I didn't have any external or low stitches around my bottom.

I have healed perfectly and have had no bowel issues at all since the op. I just wish they had repaired the small cystocele they identified in March. This is now larger and I am facing another op in January. I too am nervous and I've not posted here for a while as have been wallowing. I feel guilty about feeling low about this when a friend has been struggling with a much more serious condition.

Here's to 2013 and fully recovered bodies .

Hi Wouldrather, I always get you and Whoknows mixed up, dont know why lol. Sorry to hear you need another operation, makes you wonder why they just dont do it all at once. I am meant to be getting both done but am worried they wont do the cystocele as they say it is mild (I dont).

I am confused about what happens when you go in, what do you mean they gave you a carrier bag. My bag I have packed is getting bigger and bigger. I have a dressing gown, two nighties, slippers, my clothes for coming home and obviously I will have the clothes I am in when I get there plus a coat. I then have all my bits and pieces like facewipes, travel shampoo and santiary towels etc. My friend said it looked like I was going away for the weekend!!!

Anyway today I am cleaning the house, tomorrow I am shopping, having lunch with friend on friday, picking my mother up on Saturday, dropping the boys off on Sunday and then have monday free for last minute panic and then the op OMG time just flies.

Oh one silly question, did you girls shave your bikini line, I am unsure what to do, I mean I normally keep it tidy, but have a tendency to get a rash if I do not loofah it every day while in the shower and have been thinking that that might not be possible or comfortable.

And thanks for the glycerine suppositories advice, have put them on my list.

Hi Tink - I'm another one who has only had rectocele repaired and been left with a small cystocele and might need another op, not surprised you get us muddled up.

I ended up taking a huge bag in, but really, apart from underwear I could have gone home in the same clothes I arrived in. Don't take jeans, they won't be comfortable afterwards, jogging bottoms or similar are a good bet. A few pairs of big knickers are needed so you can wear a pad after the surgery. I didn't use much in the way of toiletries, flannel, toothbrush and paste, comb, dry shampoo. DH took my coat away when he dropped me off, but it wasn't the middle of winter then. They give you a bag when you actually go down to theatre to put your dressing gown and slippers in (you walk down in a gown, so you do need those, or some sort of slip on shoes, flip flops, whatever).

As for bikini line I suppose it depends to what extent you loofah whether it hurts or not. Maybe let it grow for a few days now while still loofahing, then by next week you should be past the rash stage. I only shave/loofah the very edges of mine, so just stopped bothering. I do trim the whole lot short with clippers though, makes it easier to keep clean and was certainly glad I remembered to do it just before going in adds that to the list of things I said I would never discuss on MN I was able to wash all external areas in the shower perfectly well with a bit of care and no real discomfort, but I didn't have any external stitches.

Yes - similar postings to WhoKnows. Hi WhoKnows - I have been lurking recently and not posting.

I was given a carrier bag and the short list of things I mentioned at my pre-op appointment with the nurse specialist. My hospital like somebody to take the overnight bag in when they first visit you on the ward. Each hospital is different so don't worry too much but as WhoKnows said you don't need much. I had a cathetar and packing in the first night and this wasn't taken out until the evening of the day after the op - so was in their gown and net type pants for most of my stay. I made the mistake of taking PJ's in and quickly had to put an SOS out for a nightie. I won't do that again. The important thing is to prioritise the things you will need to hand as you can't move much.

I didn't have a shower while I was there. I didn't feel like stripping off and just used baby and face wipes - also a hairbrush was good to have to hand. Once the cathetar was out I produced my 3 pees from the evening through to the next morning I asked to go home. I kept asking and got discharged in the afternoon so stayed in a total of 2 nights most of which I was confined to bed. It was lovely to have a shower at home. You could definitely go home in the same clothes you go in with as you're soon put in a gown, clothes folded up etc. I cut down my bag by leaving my 'going home' clothes at home but actually ended up going home in the clothes I'd worn to go in. The lockers aren't that big.

Hope that helps.

Just wondered if anyone found it easier to use moist toilet tissue post op? I have a little at home for my young kids and it made me think that it might be a bit more comfortable so perhaps I should get a big supply in.
I'm having a perennial repair as well as posterior prolapse (and poss anterior) so will have a lot of external stitches.

I never thought of that Troubled. You are supposed to avoid any soaps and perfumes on the stitches though. That might be a question for the pre-op.

Troubled - I had a perineal repair (no more wizard sleeves for me!) and I had a subcutaneous stitch so only one knot. If you want to get moist tissues I would use non-perfumed, sensitive ones - although I had a good spray round with the shower head every day, and had no problems with infection there at all.

Hi Tink - I took nighties x2, dressing gown and slippers, trashy magazines, mobile and charger, toothbrush, shampoo and face wipes, small towel, hairbrush (and clip for hair as mine is long - very handy when you feel rubbish for a quick tidy up!), lip salve (very useful), and suppository x 1 for first BM (very necessary for me and I used it in secret on day 2!). I wore the clothes I arrived in to go home. I also took a bottle of water but didn't drink it. With regard to bikini line, just a tidy up as I was past caring at that point, and longer pubes were more comfy with the pads!!! (sorry TMI!). I took my own pads but then used the big fat ones the hospital provided. Oh yes, some cough sweets or similar are also handy as the anaesthetic can leave a nasty taste in your mouth and give you a bit of a sore throat! Oh yes, a neck pillow to sit on in the car on the way home! Can't think of anything else, other than to wish you (and the others) good luck with it all xxx

Hope everyone esle is doing well xxx

I took a big bag of Opal Fruits (or whatever they are called now) and was very glad of a bit of extra sugar and taste in between hospital meals.

Fen, that's really good to know about the stitch. I had imagined it would be like it was after my episiotomy which was pretty messy and so sore, I cried every time I went for a wee for about 3weeks :(

A big thank you to everyone, your advice has been great and I am now organised. Just taking in a few things when I first go in and a friend is going to bring the rest in when they visit.

I am not sleeping at all well so might go for the general anesthetic so at least I get some sleep lol.

Off shopping to get a dressing gown today and the opal fruits :)

Thanks again xx

First post from me on this thread, so hello
I am pretty sure I have recto & cystocele. I thought I was the only one in the world who had to sometimes often use a thumb in the fandango to help poo in the right direction I think my symptoms (having read some of yours) are mild and live able with really but wanted to say hello and thank god I can actually talk to others about it without feeling like a freak! I wonder, has anyone else had problems with mooncups? My urinary symptoms are minimal, occasional urge and less frequent slight leak if I get urge and can't get to a loo in time. I noticed with a mooncup it considerably worsened my symptoms, heavy feeling, can't release to pee properly with flow problems. I have a mirena now and no periods, so at least I don't have the mooncup problems any more. If I look in the mirror, I can see both anterior & posterior bulges just behind the vaginal opening. I guess what I'd really like to know, is have any of you been similar and did it deteriorate, am I to expect things to get worse? Is surgery a last resort for those experiencing severe problems? Just feeling really about my decrepit fandango these days

Hi Nice, and welcome! You'll find lots of support here from some wonderful ladies who'll be happy to offer words of wisdom and support - don't know how I would have managed without them :)

I think its safe to say that everyone is different re how quickly things deteriorate. For me, I noticed symptoms at the beginning of the year and have deteriorated very quickly, but for others its a much more gradual process that can take decades. Try not to worry about surgery, there are alternatives you can try first like pelvic floor exercises and pessaries, although surgery could offer a more long term solution. Be prepared though - nothing happens quickly in the medical world I've found! Why don't you make an appt with your go and get properly assessed so you know what you're dealing with. The manoeuvring to complete bm's is a classic sign of prolapse so don't forget or be embarrassed to tell the gp - they will have heard it all before :)

Tink - I found dry shampoo very useful for the time I was stuck in bed and couldn't shower.

As for me, had the appt with the new consultant yesterday. She was lovely and v supportive and I felt like she really knewher stuff. Had a very thorough (!) examination and she found stitches far inside that still hadn't dissolved from the rectocele op in June - gave both of us a surprise! She cut out the surface ones, but said she could feel more under the surface. I've to have no further surgery for at least 4 more months to allow everything to heal. For the SUI she has offered me the choice of either tvt or autologous sling and gave me leaflets with pros and cons so I can decide. She also is sending me for a repeat urodynamics test to make sure there isn't a valve problem as well as a muscle problem in the urethra. I'm also being sent for a defecating MRI where I will be pooing gel while in the scanner. OMG. Once all that's done I have to go back and see her at the multidisciplinary clinic to determine whether any work is needed bythe colorectal guy at the same time.

Sorry for the massive post! Hope everyone else is doing well x

Hi Roseanna - well, that all sounds like progress to pooing in the scanner! Good news that the consultant was so sympathetic and knowledgeable.

Hello Nice - welcome to the thread. You sound very much as though you are where I was a year ago, I had a cystocele and rectocele following forceps delivery 8 years ago but they weren't giving me any problems other than the occasional bowel movement stuck in the u bend and needing a helping thumb every now and then. My rectocele deteriorated suddenly in May and I had surgery for it in September, with hindsight I might have made a few lifestyle changes that could have avoided it. I was not being very diligent with my pelvic floor exercises, I am overweight and I had taken up running, I was very unaware of the many things in every day life that can put excess pressure on the pelvic area, a lot of which are the good for you ones like running, high impact aerobics, heavy lifting etc. If I was you I would really concentrate on this aspect, google Michelle Kenway, she is a physiotherapist specialising in this area and gives out lots of useful advice. It would also be a good idea to see your GP and ask to be referred to gynae physio so you can get some proper advice about all this stuff from them too. You may well be able to carry on indefinitely the way you are, but there are definitely things you can do to improve the chances of it all staying liveable with. In May mine got to the stage where it was poking out the entrance a bit and therefore uncomfy when walking and I go the really heavy dragging feeling if I was on my feet a lot and most evenings. I also couldn't sit on hard seats. I had to give up running and was having a lot more problems with stuck BMs. As for sex, hmm. All of which was enough for the GP and I to decide that surgery was my best option.

Re the mooncup, I couldn't get on with it because the interior bulges meant that it didn't seal around the edges and it leaked. I don't remember any discomfort particularly but it is 5 years since I tried it now. Like you I have a Mirena now and therefore no need.

Hi everybody! Haven't posted for a while but I have had a look a few times to see how you are all getting on.
Just a word of encouragement regarding the operation for the rectocele. It is a over a year post op now and I have to say they did a brilliant job. I have to concentrate on not becoming constipated ( pshyllium husks, lots of water, linseeds, ground sprouted flaxseed powder, fruits and veg) but no trouble or having to splint. So there IS hope for you all.
The problem i still have now is from the TVT removal a year ago, I still have a Seroma in my right pubic area which is causing havoc and am seeing the consultant in a couple of weeks. Will probably have to have a small op to remove it.
Good luck everyone, stick in there!
Jackie xxx

Hi Thatsnice, and good to hear from you Roseanna and Jackie.

Roseanna if you don't mind me asking. what problems are you having? You have bowel problems if I remember correctly, did the rectocele repair not help at all. Sorry if I am being nosy, its just that I am paranoid they are doing the wrong operation on me, or that the colorectal surgeon should be involved and that because they haven't got their act together I am going to end up having to have two operations, one for the rectocele (on Tues) and another later on for the rectal prolapse. At least you seem to have found a consultant you can trust, which is a big plus.

Take care all xx

Thank you Roseanna & Who for your suggestions and info. I have had them more noticeably (the cystocele particularly) since my son who is 3 1/2 now, so hopefully I can just jog along as I am for a fair while more. I did mention it to my gp after my son was born but he didn't ask to look and was quite dismissive saying to do pelvic floors and come back if it got worse. From what you guys are saying tho, that is actually sound advice (pelvic floors I mean), so I shall make much more effort to do them regularly as I confess I am hit and miss. On a side note.. those with rectoceles...are you able to do extra loud man trumps in the morning with all the gas pooling in the enlarged rectal pocket? just me then? I'll get my coat...

You've made me spit out me cup of tea laughing Nice! Nothing is too much info for this thread, however that is one symptom I haven't come across before.