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.

Thanks yellow and roseanne. Yellow - how scary. I have no idea what it could be. I'm glad you're being sent to the consultant so quickly - does this mean you will see him/her on Monday or that the referral will be made on Monday? If it gets worse (more blood, pain, any other symptoms) go back to A&E. Ah - I see that you went to the emergency doc, rather than A&E. To be honest, I'd just go to the A&E unit attached to the hospital you had your surgery at. That way you'll get access to the gynae team you can assess you.
You poor thing .

Hi Cardamon. And thanks. The doctor said he will speak to my gp tomorrow. However, although I was NHS, I was, thankfully, sent privately. So, I have access to the consultants secretary,and have rung and left a message for her to contact me tomorrow.
A friend who is a nurse said their is a chance the blood is from the stitches breaking down, I hope she is right. Still, touch wood, no other symptoms. Didn't go to a and e, as to be honest, have little faith in my local hospital, but also the emergency doc is in the actual hospital, so can do immediate referral if thinks it necessary.

Sounds like you have all bases covered yellow. Fingers crossed that it is something utterly trivial! X

Yellowhorse hope that you get an appointment soon, I did have quite a bleed just before the stitches came away last time.

Cardamom hope that all goes well tomorrow will be thinking of you x

Feeling really grotty today

Cardamom - wishing you loads of luck for tomorrow. Hope it all goes according to plan and that you will finally be fixed and a (((0))) club member!!! xxxxx

Cardamom - hopefully this will finally be it for you. Take care and good luck.
Bladder - hope you feel better tomorrow. It seems endless when recovery is slow but there is light at the end of the tunnel. You're nearly there.
Troubled - hope you hear v. soon.
Yellow horse - as others have said, hopefully it is the stitches.
Roseanna - big hug to you - I hope things settle down and heal soon.
Sure - think I've finally joined the ((0)) club.
It never ceases to amaze me what women have to deal with.

Cardamom, bugger indeed, the mesh does sound like the best solution now. Everything crossed it works for you hon. Good luck for tomorrow. x

Thanks all . Hugs and healing to everyone (sorry that sounds really hippyish!) XX

Hi there, I am new to this thread and was looking for some advice. I have finally plucked up the courage(my youngest child is now 10) and made a doctors appointment for this friday.

I've had stress incontinence all this time which has now developed to urge incontinence. I literally cannot run/cough etc without peeing myself (or hear a tap running). So I've decided enoughs enough. About a year ago I thought I had to get a grip (I know, I know all too little too late) and really went for the pelvic floor exercise regime thinking that would help (did lots of googling, got pelvic floor exercisers, have contually done exercises etc). My pelvic floor feels alot stronger as a result but the incontinence has not improved.

I suppose what I am dreading is that the doc just refers me for physio for more pelvic floor exercsies. Is this a possibility? I suppose I'd just like to be prepared for what the doctor can recommend. I just want to be able to do things without weeing myself, the thought of just being told to do more pelvic floor exercises fills me with dread.

Sorry for the essay but any advice as to what I can expect at the docs on Fri would be much appreciated. Is it likely that I'll be sent away with a pelvic floor exercises leaflet ? Or will they possibly refer me elsewhere. I have no idea what to expect as havent discussed it with friends in RL and dont know anyone in similar sitation.
Thanks for reading, and in anticipation of any advice.

Hi Stunts, I think you need to ask to be referred to the continence clinic, they can do a thorough assessment of the causes of your problem and then give you options to improve things. Do you have any other symptoms, such as aches and pains in the pelvic area, bulges where there shouldn't be, it would be worth giving yourself a little exam and listing anything you are concerned about and make sure you stress how much it is impacting your life (problems with work, sex life, exercise, any of it).

The continence clinic would ask you to keep a drink and urination dairy for a few days, give you an examination, and then do some (undignified but not painful) tests involving electrodes and weeing into a commode all wired up to a computer. Many of us on this thread have been through this so feel free to ask away with any questions.

Hi, many thanks for the quick reply, its really kind of you. I don't have any bulges/pain vaginally, but i do feel a bit bulgy around the bumhole area - not sure if that could be connected?
I dont drink alcohol or caffeine as I know these can be connected to bladder weakness, my pelvic floor does feel a lot stronger than it did a year ago, I can actually stop a wee in mid flow - it just hasnt made a difference to the stress/urge incontinence for some reason....
Continence clinic sounds v strange - am so embarrassed - just hope I dont meet anyone I know! Time to grit my teeth and get it sorted though I know.

I was on here a while ago pos consultant's appointment in November and I finally got a physio appointment for today. I have been given some exercises to do until my next appointment when I am apparently having the works checked. I was so embarrassed having to explain the fact I pee when I cough, laugh, fart, have sex in fact anything that involves pelvic pressure and the fact I can't get clean enough after a BM. There was no mention of a rectocele in my notes but she says there is definitely one which is bulging to the vaginal entrance along with the urethrocele. It all looks a lot more broken than she had expected from the consultant's letter, surgery is definitely on the agenda but at 35 I am too young as it will mean a series of ops over the rest of my lifetime.

blueberry a lot of us here are in our 30's. Obviously I don't know the specifics for you but in my case the first consultant I saw (colorectal) ran loads of tests on me, diagnosed a large rectocele but then refused surgery because he deemed me too young. I was later referred to a urogynea who after examination took my hand and said "we can fix this for you", I nearly burst into tears. I am now waiting on a date for a rectocele, entrocele, cystocele and perenium repair. This will all be done in one operation. This doesn't mean to say you should have surgery but it should be an option for you if you want it, regardless of your age.

Thanks Troubled - the too young for surgery came from the gynae I saw but the physio thinks I will need surgery in the next year or so.

Hi all, quick update at 5 weeks post op for rectocele & perinea repair:

Had brought my 6 week check up forward due to new pains in my buttock and pain passing wind and pooing (and sneezing, randomly!)

Typically (and happily) the pains were vastly improved today, but my consultant had a very good look anyway and said she can see nothing to suggest there is a problem. She says the repair is working well and that I am healing beautifully.

She removed some more stitches and pushed against one quite high up, which was quite uncomfortable, so it looks as though the stitches are the culprit. It has been fine tonight and I have not needed any painkillers at all.

I have to go back in 2 weeks for my final check and to have the last of the stitches removed if they are still there, but for now all is good. I have been given the all clear to resume normal activites, picking up my son, driving, hoovering (boo!) and even SEX - eeeeekkk!

My consultant used a speculum during the examination and the good news is that it did not feel too tight, nor did it hurt. She was waggling it around in there quite a bit though, so there were a few times when it was pretty uncomfortable and my vagina ached for a while afterwards. It is only 5 weeks post op though and I will be expecting my OH to be a more considerate and tender lover than a plastic speculum!

Cardamom - I am sorry you are still having trouble and hope your operation went well today.

*Blueberry - I am only 33 and there was never any mention of me being too young for surgery.

My consultant did say that in an ideal world I would have finished having children before having surgery, but that it would not have any impact on conceiving in the future.

She did say that I would probably need an episiotomy to deliver vaginally, or that a c-section would be recommended to protect the repair.

I am not intending to add to my family, but things do change and little accidents can happen, so it was good to know.

Why do they say you will need operations over the remainder of your lifetime?

Hi Losh, he reckons TVT and another 30 years + of downward pressure will cause deterioration in 15 or so years and it will need redoing. We are done with our family, DHd has had the snip and I have been medically advised not to have anymore too. I will see how the physio goes and see what she thinks we need to do before she hands me back to the consultant. When I have the op she will see me post op too.

Stunts good luck on friday it does sound like you will get referred to the incontinence clinic I think that most of us on here have been down that route.

Blueberry I have had an anterior,posterior, perineal and repeat posterior repairs and am 38. I am really glad that I did this as soon as I could face it because it does take a lot out of your body to heal and build new tissue again. So sorry to hear about your bladder troubles I can relate to the frustration but do not have stress incontinence so cannot offer any advice on the TVT but others have had good success with them.

Losh great that you have had a vast improvement that is fantastic and good luck with the S word!

Troubled still no date for you

Still ouch and grumpy here

Hi all, just popping in quickly to say the last of my stitches came out today - op date oct 2nd. Hmmm, what to do now?
(and I rode out in fri for nearly two hours, it was brilliant. )

That is fantastic news fengirl

Cant help but ask....what did you ride?

Oh Bladder, behave yourself! a HORSE.... Looked like John Wayne's much younger sister that night mind you.

Hi all, I found this thread a few days ago and have spent that time reading it and the previous ones. You have given me loads of info on prolapses esp the recovery from surgery.

A little about me, I was diagnosed with a mild rectocele after my 2nd child in 2007. I thought no more of it as it wasn't bulging and I wasn't showing symptoms although I suffered terribly with chronic constipation but never attributed that to the prolapse. I also had an anal fissure tear which took 7 months of hell before it healed. Fast forward to 2010 when I fell pg with my 3rd child. All went well until I was 36 pregnant and al of a sudden I felt like something was falling out. Consultant confirmed prolapse. After my 3rd was born I asked about surgery and was fobbed off that they only carry corrective surgery once you've gone through the menopause. I left her office in tears.

Before I could look further into it I fell pregnant on my 4th. After he was born everything took a turn for the worse. I felt so loose down there and could hardly contract my pelvic floor (have always worked really hard on it) I spent day after day crying. Wouldn't let my husband down there and our sex life took a nose dive as I was so loose I couldn't satisfy him that way. My consultant did a check at 6 weeks post partum and said my pelvic floor was beyond shot and to see a physio at 12 weeks. After doing some research I decided to skip the physio and go straight to a specialist in prolapse repair. He did a good examination and diagnosed me with a grade 2-3 rectocele, a split vaginal muscle on the back wall and next to no perinium. He was shocked I was left in this state as the perimium was torn on my 2nd child and never stitched closed. Its basically like I've just had an episiotomy. My 4th child caused the split muscle as I was made push him out too quickly plus I had a syntocin labour on him. Its the split muscle that has caused the feeling of looseness not poor pelvic floor. The gynie made the comment that my pelvic floor was very strong for someone who'd just given birth 3 months previous. He sent me a way to work on my pelvic floor for the next 3 months which I was devasted with. Those 3 months are up now and I've my follow up appointment tomorrow. My pelvic floor has improved 200% and I think the split muscle may have started to knit back together as my husband can feel me the whole way up and not just at the entrance Does anyone suffer with lack of contraction when having an orgasm? I've only started suffering from it in the last few months and its really frustrating.

I'm worried about the recovery time on the surgery as having read on here it can take months. I suppose I was a bit niave as having had a severe episiotomy on my first which really didn't take long to heal I just assumed it would be the same this time round although I didn't have stitches right at the top of my vagina. Also how long is it before I can drive again as I live rural and my kids go to school 15miles away so have to drive them and husband can only take 1 week off work and I don't really have anyone else to help me out.

Part of me is feeling that maybe I should not go ahead with the surgery or maybe just have the perinium repaired and see if that would help although I'm sick and tired of having to take laxatives to go to the loo.

One last question I don't normally suffer from a bloated stomach but again have read here that some of you have suffered with a majorly bloated stomach after the surgery. Does this happen everyone and how long does it last? I would hate to think my hard work at shifting the mummytummy will have been in vain.

Thanks for reading and I wish you all speedy recoveries and diagnoses

Hi Funmum. I am 5 weeks post op for rectocele and perineal repair. My consultant gave me the all clear to drive yesterday, but it does seem to vary quite a bit. I think the main thing is that you check first with your insurance company as there may be an exclusion on your policy following surgery. Other than that it depends on how you feel and if you feel confident to manage a car (and potential emergency stop).

Having said that, I am fairly sure that pretty much everyone on here has been told to do absolutely nothing for 2 weeks post op. I think this is really important. I was told that if I rested properly in those first 2 weeks I would heal far quicker in the long run that if I did too much, too soon.

Not to scare you off surgery, but I was also under the impression that the recovery would be similar to my postpartum recovery (had internal and external stitches and botched perineum), but it has been far harder. I did have some issues with stitches causing me pain, but even without that I was very tired for those first 2 weeks.

Trying to work out the ages of your kids, it looks as though you must have at least one and probably 2 at home during the day? One of the main things is that you are not allowed to lift anything heavy following surgery. My son is 29lbs and I have only just been cleared to pick him up again. I would have found it difficult if I hadn't had help when I got home from the hospital. Would it be possible for you to hire some temporary help for the second week? Maybe an au pair and/or cleaner?

Regarding bloating, I was bloated after surgery but I put it down to being backed up - I ate my own weight in food the first couple of days following the surgery but wasn't going to the loo. I had to have an enema in the end! My tummy is still podgy now, but I had assumed it was due to the weight I had gained since the op. I prefer the idea of it just being bloated actually!

It is a big decision to undergo surgery, but I suppose it all comes down to how upsetting you find it to be in your present situation. Good luck with your decision!

I had a terribly bloated stomach immediately after the operation and for about a year, I think it gradually went down but it was a shock as nobody warned me about it!! When I mentioned it to the nurses on the ward as I was discharged with my jeans half done up, they said "oh yes, it is all the air and inflammation, it will go down gradually..:"

Thanks losh and swisscottage for replying to me. God losh 5 weeks with out being able to drive would kill me. My nearest shop is 10miles away so really heavily on the car. I was thinking of moving in with my mum during the day for the 2nd week but any longer wouldn't work as hubby starts work at 6am so would have no way of getting down to her. We've looked for a cleaner but there's none that does this area (im in Ireland btw) and we've no space for an au pair. Can hardly fit ourselves in the house

I have to kids in school (age 7 and 5) and 2 babies at home (19 months and nearly 7 months) so lots of lifting of the babies.

I've been thinking none stop about the surgery and what it is exactly thats annoying me the most.

Swisscottage that bloating sounds awful. You would never think you would suffer bloating from that type of surgery.

Any way I had my follow up appointment today and things seem to have improved greatly in the 3 months. My rectocele has gone from a grade 3 to a grade 1 to 2. The split vaginal wall muscle has started to knit back together and all this is purely from doing my pelvic floor exercises. The gynie was thrilled with the work I've done on my pelvic floor and can't believe I've had 1 baby never mind 4 lol. My biggest issue really is the non existent perinium. My sphincter muscle is exposed and its really very delicate down there. Its that muscle that has been causing me the agitation and not the rectocele like I thought. Its also why I feel completely wide open and loose (its because I am wide open THe gynie said my perinium repair is very complex so has referred me to another collegue who is better equipped to deal with this type of repair as its not straight forward like a normal perinium repair. He reckons we should leave the rectocele alone as its not as bad and with the other repair done I should have very little if any symptoms. I have to say I came away from the appointment so up beat for a change. Also a perinium repair only has a 1 to 2 week recovery time instead of 6-12 weeks.

Its horrible to think that all of this would've been avoided if the bloody consultant stitched me up after my 2nd child when I suffered a 3rd degree tear (although consultant referred to it as a graze) Would hate to see with he constitutes as a tear.