Pt 7 (Feb13) Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc

[WhoKnowsWhereTheTimeGoes]

This is thread 7 (again - see below) 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.

With apologies for confusion in thread numbers - the previous thread was called part 7 but it was actually the 6th thread.

Here are the previous threads:

Thread 1
Thread 2
Thread 3
Thread 4
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.

Hello all, I've also not been on for a while and I'm still catching up with all your posts. I had a successful anterior repair in February and was back in this morning for a posterior repair. I'm uncomfortable to say the least - I feel like I've got a rolling pin up my bum!

Sympathy on the chickenpox; my DD (3) had it for my first op and DS (1) has it now. How do they know? And DH has to work the next three nights. Urgh...

Clares_ I would agree with what MrsC says, I was advised to have mostly bed rest and lift nothing heavier than a half full kettle for two weeks. Only then start gradually building up to heavier things and more standing over the next month or so. Driving may feel fine but if you had to do an emergency stop you could cause yourself damage, I was told not to for 6 weeks. If I was you I would stop lifting laundry baskets, shopping etc for another couple of weeks and get as much rest with your feet up as you can manage. I couldn't stand for more than about 15 mins for the first couple of weeks, and walk for half an hour. No advice about the bleeding really, although increased bleeding can be a sign of infections, so if there is any bad odour or pain, maybe go and see your GP.

I was told to rest every time I did something eg breakfast, rest, shower & dress, rest, make lunch then rest, watch telly all afternoon, go to sleep, eat dinner bed. That was it for the first few days. I read a lot and watched a lot of cookery programmes for the first 3 weeks, gradually doing more pottering.

I made a mistake in sitting at the computer to check my e-mail, after a shower and tidy up, on my first full day at home. Could not get to the sofa with my tea and lunch fast enough and had to lie down, unable to eat it. Took a couple of hours to sort myself out.

Neoprene - hope you have a good recovery and commiserations to you and all the others dealing with chicken pox :)

Thanks Dahlia. I don't remember the anterior being as sore as this. I also nearly passed out earlier.

Can't wait for all this to be over.

Hi Neoprene - cross posted with you earlier. Hope the rolling pin feeling subsides soon.

Amazing how different the advice can be: I was told not to lift more than half a kettle/1kg for 8 weeks and then to ease back gently. Even now 3.5 months post op I still avoid really heavy lifting and I still occasionally fall asleep mid afternoon!

Tinkxx please don't worry yourself too much about the proctogram, after everything we have all been through it is actually quite bearable. I'm having my 3rd one tomorrow morning. I'm not nervous about having my nether regions prodded and poked, but I am terrified of what they might find and equally scared they find nothing if that makes sense? My quality of life is so much worse than it was pre surgery. I don't actually think the surgery was to blame but do think something else was overlooked. I know the feeling of sitting on the loo crying all too well. If they cannot tell me what's wrong then I'm not sure what happens next and that really scares me.

neoprene all the best with your recovery. Are you still in hospital? Can you ask for stronger painkillers? I religiously took Diclofenac, Tramadol and paracetamol for a few weeks post op to keep on top of my pain, although I have to say most of it came from my hemorrhoidectomy so I'm quite sure yours will ease far sooner. But don't be afraid of taking pain relief, it works!

Rectocele repair - I had paracetomol and ibuprofen in hospital and at home for the first week or so. I had oramorph for the first night in hospital and needed codeine the second night. The stingy swelling pain was much greater for the first few days than I had anticipated - I expected it to be more like the first few days after my first baby when the original damage was done, but it was more concentrated. I think it was the swelling that caused my tiredness when trying to use the computer as there was a feeling of pressure in my lower abdomen that could only be relieved by lying down.

Anyway, five months on, I have been back to the doctor - still sore below. Turns out I should have taken a booster of vagifem for 2 weeks as the new lower 10mg dose is not really up to it if I just take it every 3 days. Lack of communication between me, the doctor and the chemist fluffing up the instructions. I have just realised that I have had to deal with the effects of being taken off the pill, surgery and perimenopause all at once, and have managed some sort of sex life, so maybe things are not so bad.

Troubled I am so sorry to hear what you're going through.

I'm certainly no stranger to pain relief and am caning the paracetamol and diclofenac. I was only in hospital for four hours as it was done under local anaesthetic but I had a pretty rough night - and it takes a LOT for me to have trouble sleeping.

Haven't had a poo yet...

Dahlia well done on the sex front! I'm looking forward to wanting it again.

Hi girls. I've been reading up on the thread since I last was here. Sorry to those of you who are having trouble.

I saw the surgeon today. She will not operate, I left being a crying mess, the first doctor I saw gave me the impression that they would operate it. Surgeon said it wasn't as bad as I expressed it (ahem?) and basically implied this was normal and might get better with pfe and more laxatives. Fml. I asked for her to show me one scientific article that confirms that pfe can make prolapses better, cause I can't find one, she said it's based on her clinical knowledge.

I don't know. Maybe it's normal to have your rectum sticking into/out of your vagina. I'm kinda dissapointed. After I started crying she said she'll look at me in the autumn again but she wont give any guarantees of them operating because I'm so young and my problems aren't bad. Maybe I'm silly but having to push your poop out through the vagina to me is bad enough.

Sorry for TMI.
rebels

Hi rebels, This happened to me. First gynae surgeon said couldn't do the op as not sufficiently accessible, despite my rectum pushing my vagina out of my body! I went straight back to my GP, crying with anger and frustration as I walked in to see him. He was great he re examined me agreed that I had a very obvious prolapse and referred me to another gynae surgeon. I am now 7 weeks post op and doing well. Ask for a second opinion!

Thanks charlierabbit for your response. I think part of the problem is that to the surgeon my vagina probably doesn't feel very odd while I'm in the chair with my legs up. I can still feel a difference myself but I've had my ladyparts all my life. Problems start when I sit down on the toilet and I can't see how she possible can judge my problems as not enough by examining me while I'm lying down. When I sit down for number 2 even my cervix is just inside the opening and I can't remember it ever being like this. Maybe I should contact the other hospital in the county and see if they will consider me. I am very certain my problems aren't as bad as others but it's still bothering me.

Agree rebels - sitting on the toilet is so different to lying down and coughing - you need to be good at the pfe and stool softeners whether you have an op or not, but they don't do the same thing!

I didn't find that the rectocele op was a magic fix, but that, combined with the constipation control and pfe means that I go normally about 50% of the time and that is a whole lot better than never! In fact it happened for 7 days in a row last week and I thought nothing of it :)

I am sure it is better to sort out a smaller prolapse earlier and work hard on the other things to prevent further damage, rather than wait until it has deteriorated and the op is the only thing left to help (if it does)

My gynae told me not have the operation for the pooh issue, as it would probably not work, but to do it in order to correct a defect and make me feel better about myself. He was really a very boffiny unempathetic type of consultant but was probably right. Also, I was a private patient. Hope you get a better second opinion.

PS - on the flow charts for rectocele (sorry - can't remember where I saw this) they always go for stool softeners and pfe first, so worth getting that box ticked before you see the next consultant.

I too thought that the surgeon couldn't tell the scale of the problem when I was lying down, however both my GP ( who I asked to also examine me while I was standing and he did!) and the 2nd gynae surgeon said that the lying down position and cough is preferable and gives the examiner a better understanding of what is happening. The consultation with the 2nd gynae also highlighted that I needed a hysterectomy as well as a repair. It is always worth a second opinion. you can't lose anything by it.

rebels I'm another one who's been through the fobbed-off mill, partly because my prolapse never seemed to present itself fully during exams. I even started thinking I should photograph it when it did it at home. I never did but might be an idea if you can stomach it (and have something password-protected to keep the photos on!).

I am 2 days post op for posterior repair and am in a bad way with the pain. I staggered up to my GP last night and collapsed sobbing on her floor. She has given me something stronger than the paracetamol and diclofenac I was sent home with and this has knocked me out nicely for last night and this morning.

I'm still in so much pain that going to the loo is nearly impossible. I can't relax my pelvic floor enough to wee unless I've contorted myself into an all-fours position over the loo and even then it's taking several attempts to empty my bladder.

I still haven't had a poo and because of all the pressure and the rolling-pin feeling, I can't even tell whether I need to, despite all the laxitives. When I've tried, it's been so painful I've started blacking out and had to stop. (and I had two 9lb+ DCs on just gas and air!).

Has anyone else had this and/or can reassure me it will get easier? So thankful for this thread and you lovely ladies.

Neoprene, I can only say by my experience (after anterior and posterior repair) that I managed number 2 on day 4 post op..... Was rocking about on toilet for several hours on phone to husband at work, asking him to get me suppositories... Senecot wasn't doing anything, syrup of figs and even prune juice... But I feel I have it managed now, by cooking up an enormous amount of veg and either pouring gravy on it at evening meal, or blending for lunchtime soups.... For me, dulcoease caused massive cramps and bloating.... My neighbour called in yesterday and I described how my bottom felt so hard around the bum/perineum area and she said it was just like that when she had episiotomy... (I amused my own episiotomy just giving birth lol and they said "oh, we'll just leave it to heal naturally"- yeah, thanks for that!)...... It really does feel like your gonna pop your stitches out doesn't it, when trying to poo in the early days... I still hold tissue against me so I feel like I'm supporting the area whilst I go... It's very worrying thought, as I find bright red fresh blood on it after I've been:(

(Bloomin iPad and predictive text, meant to say I caused my own episiotomy, not amused!)

Thanks Clares. My anterior repair was a doddle compared with this. The pain has really knocked me sideways this time.

All I can say is thank god for this forum, it's my only source of help since my op 3 weeks ago x

Neoprene, I am 4 weeks post op today and I am so much better than I was. I managed a 1 and a half hour shopping trip today (with a sit down in a cafe in the middle!) I didnt do a bm until either day 6 or 7, I can't remember but it seemed like such a long time and I had to really strain to get it out but once I had it just got better and better. I still take the odd painkiller here and there, today I have so far just taken one lot of ibuprofen. My main worry now is that I will be on my own with the kids next week, the 4 year old is ok but the 2 year old is hard work!

Oh gosh, I do feel for anyone with young kids....un/fortunately I waited 11 years to get it done, so at least mine are able to look after themselves and get to school etc x

Hi there... I had a posterior repair on the 13th may 2013, now on week 5 of recovery. Not seeing my consultant till 12 weeks time. Need advice on what I should be doing or maybe easier to say what I shouldn't be doing. I manage walks for half an hour, and if I stand for too long my left leg at the top and my left buttock goes numb - any ideas why?
I run a pub with my husband, so not yet back pulling pints or cleaning the pub. DH won't let me.
Thankfully our children are teenagers so they help where they can.
My girlie friends booked a four day trip to Center Parcs .... Not sure what I can go on or do, as don't want to undo the repair work. Took me years to pluck up courage to have this done.

neoprene I didn't manage to go until day 4 and by then was in agony from the boating in my belly and the pressure down below. But as mrsclairet said it gets easier and easier. Apparently it's not just the posterior repair that causes this sluggishness it's the anaesthetic too; the bowels just become lazy.

edinburgh I had the numbness too and was told its perfectly normal. All to do with nerve endings coming back to life as swelling subsides. It's a bit unnerving though!

Mine was just under a local anaesthetic though!

Today has been the worst so far (3 post op). I could only wee by contorting myself on all fours over the loo and by this afternoon I couldn't even do this. I was standing in the bath, in a puddle of my own wee and screaming in pain because I was desperate to go but relaxing my pelvic floor to pass anything was excruciating (I actually started blacking out when I tried). DH called the hospital and they told me to go to a&e. Long story short, I now have even stronger painkillers and a catheter. Anyone else had to have this?

MrsC I also have small children (1 and 3) so I feel your fear! I'm guessing you're about 4 weeks post op which is still very early days. After my anterior repair, I still wasn't walking much or lifting anything other than a half-filled kettle. I think you'll be fine on your break but do take ot easy (definitely no bike riding!).