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.

Basically - sounds like you have been having a pretty horrific time and quite painful too. My Father had a stoma for 6 months after a bowel op, and he found it surprisingly easy to manage. If you do have one, at least you will be spared the really painful BMs post op which for all of us have probably been the worst part. Just look ahead to how fantastic you will feel when you are 'out the otherside' so to speak, and try not to worry too much (not easy I know). It sounds like your consultants know what they are doing so you will be in safe hands.
Good luck xxxx

Thank you surewoman - if they don't do the stoma then the post op BM's TERRIFY me... Do they give anything laxative wise to make it easier if you don't mind me asking?

And sorry for the hijack!

Basically, hi, i'm just recovering from rectocele repair, I'm not sure about the septum part but I didn't have bowel damage so a bit different. I would just say that I haven't really had any problems with bowel movements post op, they have stung slightly but that is all. I started drinking fybogel a week pre-op and took lactulose for a fortnight post-op plus eating bran flakes, wholemeal bread and fruitand veg as normal (about 4 a day is normal for me).

Ah apparently I have to be on a low fibre diet pre op if they do the stoma an high fibre if not! Lactulose sounds like a good plan tho :)

Hope you're recovering well!

Hi Surewomen, thanks. - Have spent today recovering in bed.
DC father has taken them out for the day, I might forgive him for not having them over the holidys in spite of having asked him 3 months ago!
They have enjoyed being at home anyway and not fought too much, tv is my friend.

Basically, the movicol prescibed to me has been great keeping motions soft and my first poo was not too bad.
I can't tolerate cereals as they irritate my bowel but luckily love fruit and veg.

You will probably have a catheter immediately post op.
Mine was not at all uncomfortable and I too was worried about peeing but it was fine as was my room mate's.

Good luck and take pain killers as soon as you start to get sore, do not wait until it gets bad.
I also found regular antiemetics (antisickness) meds made recovery a lot easier on the first 3 days.

This seemed informative for rectopexy.
www.oxfordpelvicfloor.co.uk/PDFs/LVMR.pdf

I also have had no problems with weeing after the catheter came out, the hospital kept me dosed up on anti-emetics and painkillers for 48 hours and I was fine with paracetamol and ibuprofen at home.

Bumb - glad you're getting a break today, it is very easy to overdo it. I am in the stage now (3.5weeks post op) of needing to get more active but still not being able to actually do much, or so it seems.

They're estimating 12 days in hosp currently so hoping that's plenty of time on strong painkillers! They also mentioned an epidural for first 48-72 hours for pain relief but I'm concerned about DVT risk with that - did you all have anything blood thinning post op as a preventative?

Also glad you're getting a rest bumb - with a 22 month old DS I know how precious that is! :)

Has anyone used that pelvic toner that is advertised on here? If so whay is your verdict?

Hello
My name is Jo. I have 2 girls, aged 3.5 and 18 months. My nether region is a write off. I have thought this for a long while (since having DD1) but only just plucked up the courage to go to the doctors. I have post-natal depression. It turns out that I have a rectocele. I have been referred to a consultant called Abdalla Fayyad and I have an appointment in a week and a bit. I have been doing a bit of research and I'm scared that, if I have surgery, sex will be painful forever more because of scar tissue. However I'm not currently psychologically capable of having sex because I am so embarrassed of it all down there. It is broken. Can I please ask anyone who has had a posterior repair whether sex is enjoyable, obviously once it has healed up etc. Thank you. x

Stuck this on the old thread: here it is again!

RCOG are inviting submissions from professionals and service users on a new Patient Information Leaflet on Pelvic Organ Prolapse. Closing date is 31 October.

www.rcog.org.uk/womens-health/consultation-documents

It's right at the bottom on the page

Hi Leonie, I'm having a rectocele/posterior repair without a mesh. In fact my urogynae has never suggested a mesh but I will double check at my next appointment this week.

Jo/ autumn queen, you've made me nervous as I was banking on surgery improving my sex life not making it worse :( Intersted to see how others respond.

NEVER let anyone put polypropylene mesh in your vagina. EVER. There are big problems with erosion and extrusion and associated infection. It frequently has to be removed. The RCOG leaflet I posted about earlir on the thread makes reference to this procedure and says that it is currently not done except as part of a research study. It is not NICE recommended.

I've read a lot of bad stuff about vaginal mesh, ie the ones that they use to strengthen the vaginal walls, it sounds as though you are unlikely to be offered that now in the UK, but not sure if the concerns extend to TVT to the same extent, it still seems to be being done routinely. I have only been treated for rectocele so far and I asked about the mesh and was told they would not be using it, it was too risky.

As for post rectocele sex life Autumn, I'm only three weeks post op and nowhere near ready for that yet I'm afraid .

Cardamom - I have looked through that leaflet, it seems quite good, the only thing I noticed was that it doesn't mention TVT at all. Also, it seems as though they want comments from professionals not public? I will look again though.

Nelly - I haven't tried the pelvic toner and I don't recall anyone else on this thread over the last 6 months or so mentioning it. Someone had an electrical one, like a TENS machine, but can't remembere who it was.

Nelly - I'm not sure which pelvic toner you mean but I have used a TENScare itouch battery operated toner. I had a rectocele repair in March but have since developed a cystocele which will be repaired in January. I've found it really useful in disciplining me to do regular pelvic floor exercises. I'm finding it less effective now the cystocele has got bigger and it all feels a bit of a mess (pretty sure my uterus has dropped now as well) - back wall repair has been a success and remains firm.

Welcome to all new ladies - Autumn I wish I could post something positive but have been struggling with further complications. Big hugs all round.

No, it's service users as well who can comment. I had some problems with the leaflet.

The vaginal tape is distinct from TVT, which has a good track record. And it's also distinct from absorbable collagen mesh which is often used in anterior wall repair and which, again, has a good track record.

I used an electronic pelvic floor device - NeuroTrac Continence. Have found it to be really good. I was far too damaged and too weak to manage pelvic floor exercises on my own, and anything mechanical would have been useless as well.

It was the declaration of interest form which threw me Cardamom. I think the problem for me with that leaflet is that largely thanks to this thread, I know all that info already, so I am reading it less critically than I would if I was just starting out on this journey. I have the same problem with reviewing documents for my work. I will go back to it though, have only skimmed so far. Thanks for the clarification about the meshes and TVT.

I think that means we can read it more critically as we have more experience. There's things I thought should be included that were missed out (TVT/colposuspension, more emphasis on pain as a symptom, the psyhcological toll), some stuff I thought should be left out (that bit about having your vagina sewn shut? WTF is that doing in a general leaflet?, women should not be encouraged to routinely go for new surgical treatments - the whole mesh fiasco they allude to is a case in point), and others where I thought the emphasis should change (less emphasis on hysterectomy and more on uterus conserving options, less emphasis on women of child-bearing age being directed towards non-surgical options - we can and do have surgery).

Agree that the statement of interest from threw me too! But at the top of the website it says they invite comments from service users....

Hi all...been back to the surgeon again and we've discussed the fact that the rectocele (no mesh) has failed, bladder symptoms are worse and now my cervix has come down too. He's referring me back to the NHS to a multidisciplinary team to try and work out a strategy and maybe have some specialist testing done. Pretty nervous tbh - the thought of explaining it all from scratch to people I've never met, the tests, the traipsing back and forth for tests, the time it all takes...don't know if I have the energy!

Just for info - my surgeon was thinking put loud about things and mentioned mesh in passing, so I think it does happen in the UK, but maybe only if the initial repairs fail?

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