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.

Thanks summertime, I have just dropped off the stone at the hospital this morning to be analysed. I asked the nurse and she said it will take a week! I will have a look at that link you posted.

Hi there,
I am very nervous. Has I am going into hospital on Monday for surgery. Has anyone felt like they have spd or going into labour with the discomfort. Standing any length of time is uncomfortable. In my job I have to stand for solid 4 hours. This is taking over my life. Also concerned about looking after my 10 month old son and my four year. Any advice anyone can give would be gratefully received.

Hi Welshdragon - what procedure are you going in for? You will definitely need help with your DCs afterwards, also the housework, shopping etc.

You are one of the first reviews I have read that is giving confidence. How are you doing now? I am having surgery on Monday

I am having postier repair and sacrospinous fixation. All I took in was it is bladder and bowel. Before know I have kept getting told it is scare tissue from having my daughter and having to mend the tear after using there tools. Is it very much like recovering after a c-section?

Well, I had a posterior repair without sacrospinous fixation nearly a year ago, I'm not sure what the difference is in terms of recovery. I'm also not too sure about recovery from a c-section as I have never had one of those. My problems also date back to the delivery of my first child by forceps.

What you are looking at is probably one or two nights in hospital, once you get home you need pretty well total rest for the first two weeks, lying down as much as possible, just short walks to keep your musclles moving and prevent DVT. No lifting anything heavier than about 1lb in that time. Over the next month or so you gradually build up walking etc, but still avoid pulling, pushing, lifting anything remotely heavy. This means you need a lot of help around the house, shopping and with the children. You really don't get back to more strenuous stuff (lifting children, running etc) till at least 12 weeks and you are normally told not to drive for 4 to 6 weeks. With a job involving that much standing you will probably need at least two months off. You will also have some bleeding and mustn't use tampons for the first 6 weeks or so, so need a stock of towels, you will almost certainly need paracetamol, ibuprofen and possibly laxatives as well as any medication you are sent home with. I hope all this isn't too far from what you are expecting, the amount of information people get given by their hospitals seems to vary enormously.

Hi Welshdragon. I had a posterior and anterior repair plus hysterectomy 5 weeks ago. I feel really well now, and didn't find the recuperation period too onerous.

I certainly was not told to lie down as much as possible for the first two weeks. I was told to take it easy, rest when I needed to and avoid heavy lifting. Phsyio recommended that I go for a 5 minute walk daily for the 1st week, then build up by 5 minutes or so, to 30 minutes by week 4, 45 minutes week 5, and an hour walk a day by week 6. I was also told I could drive after 2 - 3 weeks, which concurs with everything I've read online, so not sure where you heard 4 - 6 weeks Whoknows.

I work part time, so am back at work now. My children are older, so no lifting involved there. You will definitely need extra help with childcare and housework, but for me the recovery was far easier than I had imagined. I'm going back to the gym next week, after my six week check up.

Please don't worry about the surgery, it will be far easier then you imagine. Just make sure you have lots of help lined up for the first 2-3 weeks, so that you can rest when you need to. Listen to your body, and make sure everyone around you is aware that you need extra support.

Like you, my job involves being on my feet. Yesterday was my first really 'long' day at work, and despite being tired, I felt a thousand times better and in far less pain than I would have pre-surgery. And that's heavy only 5 weeks after the op!

I was in pain for the past 4 years, and am absolutely delighted I had the repair. I wish you the very best of luck for the procedure, you will be fine. The advice I was given was to 'potter about the house'for the first 2-3 weeks, then ease back in to routine very slowly. I still wouldn't dream of lifting anything remotely heavy (tough I know with a 10 month old ) and don't do any vacuuming.

Feel free to ask me anything you want to know - the whole procedure is pretty fresh in my mind .

I was not allowed to drive for 6 weeks (it was on my discharge papers) and many other people on the thread at that time were being told 4 weeks Elderflower. The times off work have been true for many of the ladies on this thread too. Pottering around the house in the first couple of weeks, with lots and lots of rest in between is about all you can do, resting lying down takes the weight off your repairs. Having been on this thread for about 18 months, there is a huge range of recovery periods for different people, the single most important bit of advice is listen to your body and if it hurts, stop whatever you are doing.

Yes, I think I did mention the phrase 'listen to your body' in my post Whoknows .

I don't think there was anything controversial in my post, nor anything going against received medical wisdom. I have not heard of anyone being told not to drive for six weeks, and for some this may be a very difficult prospect. I was told to rest when I needed to, and to remain reasonably active.

I do appreciate that this is a support thread, and that there are many varied experiences here. That does not make my very positive experience any less valid.

Sorry, didn't mean it to sound like that, it's late, and I'm very tired. I was agreeing with you about "listen to your body?".

My original post represents what I think is a fairly average set of advice I have gleaned from many other people on these threads, plus lots of advice sheets etc from googling, like this one NHS advice which says 4-6 weeks for driving. I sincerely wish everyone had such a positive experience, but it is harder for some than others.

Anyway Welshdragon - please post with any more questions you have, and good luck!

Thanks, Whoknows, I'm a bit tired too! This is a really good thread, I looked at it pre-surgery and felt a bit terrified. Then I looked again post-surgery and felt that I shouldn't post because I didnt really have any major problems!

Just wanted to give you a little positive story Welshdragon. I think any of us who've been through it may have some useful nuggets of information.

Take care.

It's good to have positive stories !

I must go to bed, I'm supposed to be studying, but MN always lures me in.

Hope that all goes well welshdragon

Good to hear a positive outcome elder

I think that whoknows has offered some very levelled advice and as a lady that followed those recommendations I still ended back up in surgery within six months. It is so important to not overdo things and compromise the surgery, the recovery gets more difficult the more the more you have as a few ladies on have found. I so agree with the advice to listen to your own body and I do think that it takes it out of us more than any of us anticipated.

Still not sure what is going on with my bladder, I have also got chronic backache and pelvic pain again hoping that it is just a blip. I guess I will find out at my next appointment with the gynae. The GP just looked worried and said that it sounded prolapse related but that she didn't want to check so straight back to the gynae and I am trying to stay positive.

Has anyone got any advice for me for after the surgery on Monday 9th of September?

Thank you everyone for your support and positive feedback. Where has everyone had there surgery? Just currently enjoying every waking hour holding my little ones. I don't drive wish I did. My husband would say yes I do I drive him round the bend.

What happens on the day of surgery? What do I need to take in with me? Sorry for all the questions. But don't have anyone I can ask.

Hi Welshdragon, have responded to your kind pm. In my case I stayed in hospital for two nights. I brought in the usual hospital bag plus sanitary towels.
I went in at 8am, and was brought down for surgery after lunch. I had spinal block anaesthesia. After surgery I had a catheter in place, and some packing in my vagina. That night I was given plenty of pain relief and felt that lovely elation you get after a long-dreaded procedure is over.
The following morning the catheter and packing were removed (relatively painlessly) and I was able to get out of bed and go to the bathroom myself.
The next day I was able to have a shower and left hospital after lunch. I had some abdominal pain and tenderness (then again, I had a hysterectomy, which you're not having so I'm sure that was largely responsible).
I did feel quite 'knocked out' for at least a few days, and needed lots of rest, but was well able to get up each morning and 'potter about' to use that dreaded phrase .
The bleeding I had was minimal - just needed a panty-liner rather than pad. I still have some discharge but I think that is considered normal for at least 6 weeks.
The most important thing to have at home is support! Make sure DH knows that you are not the 'old you', the one who copes with everything. Take a nap when you need to, and relinquish the household chores. Don't rush back to work.
Again, feel free to ask me anything. I had my surgery in Dublin, but am sure the procedure will be very similar where you are. Best of luck. x

Thank you elderflowergranita. It is reassuring to here that there is a percentage that this operation works for. Has I was starting to have doubts to having this done.

It worked well for me too, I just had a rectocele repair (in Hampshire), nearly a year ago , and my recovery was uneventful, my hospital story is pretty well the same as that of Elderflower. When I was discharged I too was wiped out but I had a lot of difficulty sleeping, DH moved to the spare room for a while so I could read and MN in the middle of the night in bed and I snoozed a lot during the day. As for activity, I found in the first week half an hour on my feet was absolutely enough in one go, so for example, get up, go to the loo, wander into the kitchen and make some toast, have a shower and then lie down for a bit again. I couldn't sit comfortably in the first couple of weeks except leaning right back on the sofa with cushions behind my back. The pottering around is weird, you can wander round freely but you must resist the temptation to start picking things up (I was told nothing heavier than a half full kettle in the first fortnight). It is important not to stay in bed all day because of the DVT risk.

You need to remove all nail varnish before surgery, or they will do it for you. I would recommend cutting your toenails now, so you don't need to bend and do it in the next couple of weeks. I would also recommend trimming the ladygarden (not shaving), makes it easier to keep clean afterwards.

Pain relief - I only needed paracetamol and ibuprofen for the first couple of weeks, but others on the thread have needed stronger painkillers and had them from hospital. Many people also need laxatives - your bowel movements are likely to be significantly disrupted for a few days, ask in hospital, depends to some extent what your usual pattern is there I guess.

You also need to be aware of the signs of infection, temperature, bad odour etc, and go to the GP if that happens.

Longer term, I needed help around the house for a couple of months (I work very part time and am also the main houseworker / child carer for two DCs then aged 6 and 8) and I still avoid the very heaviest stuff (shifting heavy furniture etc). I used online supermarket shopping and arranged the deliveries for when DH was at home. I also did my entire Christmas shopping online while I was off work. I was back at work after 7 weeks, but did short days for the first week or so, I have an office job and the sitting was still a bit uncomfortable at that point. By about 12 weeks I was back to normal, it was Christmas, so I remember the timings.

Welshdragon the repair of the prolapses has changed my life and it is now so much better. I can be the woman/mum that I want to be. I do not regret a moment of this journey. It is very daunting and and I think that all of us lost sleep on the lead up to repairs but it does make such a difference to us. Please do not be put off by my ongoing troubles, I know that I had complicating factors in addition to the prolapses and as my consultant tells me every time I see him, I was a mess.

I would recommend packing a small toilet bag of things to keep next to the bed for the first night when you do not get of bed. I had some facial wipes, lipsalve, toothbrush and toothpaste etc and it made me feel much better to have access to them. Also pack slippers that you can put on easily because it is not that easy to bend and fasten shoes/slippers.

Good luck will be thinking of you tomorrow x

Thank you everyone. Just got all my little one uniform together.

Best of luck for tomorrow Welshdragon. Will be thinking of you. x

Hi everyone, hope you are all well. I'm a 42 year old mother of 2 boys, 4 yrs old and 2 yrs old and I've just found out that my bladder and bowel have prolapsed so I'm waiting to go in for surgery to fix it. I'm terrified Will be worth it I know but any advice on what to expect would be greatly appreciated, thanks in advance...

Hi lindamagoo

I had a rectocele repair at 49. Fortunately, all my 'children' were away from home so I had nothing that had to be done if I didn't want it.

With young children, I would say that you need to get as much help lined up as possible. I spent the first week reclining and looking after myself (showers, cups of tea, lunch etc with frequent rests was all I could manage) and gradually worked up to choir practice after 3 weeks (who knew that padded seats could be so uncomfortable!) If you have a full freezer, internet shopping lined up, child care etc, you can always do more if you feel ok, but it is sorted if not.

My consultant said I would be back to ballet class after 4 weeks! I did try it just to prove a point and it was ok, but the running around bits felt funny, so I didn't do that. Also everyone moved my barre for me and made sure I didn't get carried away. It was half term after that and so I didn't go back properly until 6 weeks, when I felt much more able to do it (gently).

Cooking was kept to a minimum ( a lot of Waitrose stick-in-the-oven stuff) and I really could not be bothered with it for some time afterwards, but that might be just me.

The op was not a magic transformation for me and I have worked really hard on pelvic floor dysfunction and sorting out my problems with constipation since. All together, 8mths on, it has worked really well and I am very glad that I did it.

Thank you summertime, I'm dreading it with the kids being so young and my 2 yr old is still very clingy but hopefully my partner will get a couple of weeks off work to help me out. Yes I think I will become acquainted with the online shopping and make life a little easier for myself. Glad your doing well now

lindamagoo best advise I think is further up this page - listen to your body.
Summertime's response above reminds me how totally different we all are. I had both posterior and anterior repairs in march and can honestly say it took me 5 weeks to be able to sit comfortably on an upright chair. My consultant told me not to lift anything more heavy than half a kettle for 8 weeks and avoid anything over a full kettle for a further 4 weeks. My youngest is 3 and I refrained from lifting her for about 3 months, even now 6 months down the line if I carry her for too long I get a dull ache down below.
The internal stitches usually dissolve around 6 months, I was told, and there must be a reason for this, i.e it takes your muscle that long to bond firmly together. So take it as easy as you can, the longer you do the more chance of a long successful result.