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.

Thank you TrOubled, I'm guessing my 2 yr old is in for a rude awakening when he realises mummy won't be carrying him all the time anymore, might do him good as he's far too clingy. I'm really dreading the op and just hope it's soon so I can enjoy Christmas with my family but knowing my luck it will be in December.

Hi Everyone,

Been some time since i posted - I see a few familiar names and IYSWIM.

I posted this about vaginal dilators as a separate thread, but haven't had much traffic, so I thought I'd stick it here too:

To cut a long story short, 3 lots of major surgery to repair multiple birth injuries have left me with both pelvic floor spasm and tight bands of scar tissue in my vagina. My physio wants me to start using femmax dilators to stretch things out and desensitise.
Anyone used these? Any words of advice? To be honest, I am utterly ground down by this whole saga, and this is the last thing I want to be doing. I'm already using the Neurotrac stimulator every evening, but that's kind of OK as I can mentally switch off. But this, where I've got to concentrate and actively seek out the painful and tight bits? No thank you .

Be really grateful to hear from anyone who's used these!

Hi Cardamom. No experience of that myself I'm afraid. I'm not sure who recommended it, but I joined a FB support group a few months ago and it is full of very kind, knowledgeable ladies (some are professionals in this field), if you use FB it might be worth giving them a try? It's a private group and they approve memberships when people join.

FB Prolapse Group

Thanks .

Hi cardamom, it's good to see a familiar name.
I'm afraid I don't know anything about dilators but I too have pelvic floor spasm. Like you have had a fair bit of surgery down below - first op aged 17 and more since, the most recent you know about, and I think my pelvic floor has just gone f**k you. Anyway my consultant referred me for manual therapy, and it helped a lot. Definitely the most intimate massage I've ever had but the lady doing it put me totally at ease. I am also seeing a different physio for bio feedback as my pelvic floor within my bottom is in such spasm I cannot empty my bowels properly.
PM me if you want names. X

Bloody hell Tr0ubled . Nice to hear from you, but sorry you are still needing to post. My friend had very extensive surgery for haemmorhoids and her bum went into total spasm as well. She was on dilators. (Maybe I'll give her a call - why didn't I think of that sooner?!) You poor thing. I'm happy with my physio (we had the same surgeon, as I recall, so maybe we have the same physio!) and she also does some trigger point therapy, which has helped a bit. I have the reverse problem with my bottom- muscles too weak. At some point I'm going to have to bite the bullet and do electronic stimulation up the bum to get those muscles working too. But just not now. REALLY can't face it now.

Oh - another update whilst I'm here. I'm due a 4th operation!! WOO HOO!!! Not. It's only a very small one to sort out a skin tag on the back wall of the vagina. On the one hand I just want to scream. On the other, being knocked out under a general will give my surgeon the chance to check all the repairs more thoroughly than he can do when I am awake. I'm so scared and paranoid that things are failing/will fail that I quite fancy that type of reassurance. It's at a time of my choosing, and I'm going to put it off for a few months yet.

Just want to say that I may have survived a gentle ballet class at 4 weeks, but certainly agree with Troubled about the sitting down upright.

Hi, it's nice to hear from people, this board sometimes goes so quiet!

troubled - you said that sometimes you still get a dull ache if you lift your little one for too long, does this mean that the op hasn't totally worked? The other day I walked for quite a while and did some housework, changing beds etc and then I had the horrible feeling like someone is pushing something up your bottom and I'm really worried that it means the op hasn't worked.

The consultant said at my check up he could have tightened me up a bit more which has left me feeling a bit neurotic! I am seeing him again in october. I am also now having a scan to see if I have got kidney stones, I am glad that is finally being done as it might explain the trouble with my bladder over the summer.

Good luck to those having ops, my son is 3 today and 3 months down the line I tell him sorry mummy can't lift you, I only lfit him when I HAVE to eg in and out of the bath etc.

I am considering having surgery for a Rectocele. Does anyone have recommendations for a London based surgeon I could consult privately? Or conversely is there some one I really should be avoiding! I would love it if things to go back to more or less the way they were before my 3 DC but I also want to be careful not to make them worse.

Please feel free to PM me if you prefer.

Thanks for your help.

Umm ,apologies for jumping in here but could I ask a bowel based question ?
When I had a TVT done some 8 years ago they did a minor posterior repair . So I guess that was a small retocele ? Or not ?

Anyway ...I have suspected that all was not quite straight forward on the route of evacuation for some time . A recent major op and constipating pain killers have of course left me in a pickle and highlighted this problem .

Couple of questions - does fact that solid bulge in perineum appears when constipated indicate possible rectocele problem ,or is this normal ? ( I'm not given to discussing bm in RL -) )

is it >>ahem

Rain - I had a rectocele successfully repaired last year, but not in London, if you have any other questions please feel free to ask.

Ginger - no such thing as too much info on this thread . It does sound like a possible rectocele to me, is there a bulge visible in the vaginal opening? While there is no harm at all in the short term using your fingers (it is referred to as splinting) long term you might develop other problems, especially if you have prolonged constipation. Many of us on this thread have been there and done that.

If I was you I would go to the GP (perhaps check if any in your practice specialise in Women's Health) and ask to be referred to they Gynae physio. They can give you help on managing it and stopping things getting any worse, some forms of exercise, heavy lifting etc can all make it deteriorate. I had mine for several years, managing as you have done with no other problems, but it deteriorated last year and became very uncomfortable, that's when I had surgery.

MrsC - Although my repair (a year ago next week I think) is considered successful by both me and the surgeon, I do still get a little bit of acheyness down below if I stand for too long (very occasional now) and certainly at three months I would still take that as a sign to take things a little bit easier, but not as sign of failure. I was told it is six months before it all reaches the stage of being as strong as it's ever going to get.

Hi Troubled - glad you're getting all the right things from physio, hope you see some improvements soon.

Thank you whoknows I'm currently very laid up recovering from op and visits to GP and sorting any possible rectocele problems not on agenda at present .

But suffering greatly at present with the dreaded constipation .
Taking lactulose and have added movicol ....but the stool softening element of these surely only works on the stuff in process of being formed .
It's not going to soften that great hard boulder which is in situ as it were and holding everything up ,is it ? >>hopeful

Rain - have PMed you.

Ginger - yes it could be a rectocele. But if it is a bulge in the perineum, i.e. the bit of skin between the anus and the vagina, and not the back wall of the vagina, I'm thinking that you could have a gap in one of the pelvic floor muscles - either a tear that never healed, or an area of extreme weakness. Not all surgeons check for this. I had a 3cm gap in my muscle as a tear wasn't stitched correctly and so didn't heal properly. I got a hard lump in my perineum when doing a poo, and I got the same hard lump if I ran or did any other high-impact exercise. Basically the muscle either isn't there or isn't strong enough to support all your internal bits and bobs.

I think you need a proper assessment from a specialist gynae surgeon. I'm sorry . If it's just weak, but intact, then specialist physio can help. If there is a gap, it can be repaired.

Thank you cardamomginger for your helpful replies ,and others as well .
Footle umm ,the thought of shoving something else up there is a little shall we say counterintiutive .
Or very scary .
Are they quite small ? >>> weak voice

Ah Footle ,nicely put . Thank you.

This is not the moment for genteel behaviour yup ,amazing how pain ,hospital stays etc quickly sweep away one's default setting of prudishness and inhibition .

Partner has produced glycerin suppositories - been with him 20+ years and didn't know what he kept in his washbag - so there we are ,who'd have thought we'd come closer over BM's .

Wish me luck....

footle I'm wavering . What if it makes it worse ? Softens not enough but irritates/activates too much ?

wimp

I can vouch for Footle not being the poo troll! . Good luck Ginger

Thank you CardamonGinger for your reccomendation.

Does anyone know if a rectocele is best repaired by a gynacological surgeon or a colorectal surgeon?

rain a colorectal surgeon will fix it via your rectum and a gynae via your vagina. I initially saw a colorectal surgeon for mine but he refused to fix it, luckily the gynae dept didn't share his opinion. I think most ladies on this board have had gynae's carry out their surgery. Also, fyi, I had mine fixed by the same surgeon as cardamomginger.
footie your description of clinging on to the slippery suppository had me Rofl!
cardomon I'm so sorry for your ongoing troubles and for the prospect of more surgery. I have a tag too but it's external and apparently can be removed under local, however I'm not keen yet for another stitch in my fanjo!
mrs c I really hope my surgery has worked, certainly I no longer have a rectocele bulging outside my body however due to the scarring and muscle spasm from my hemhoroidectomy it is now harder to open my bowels than it ever was. I almost wish I still had a rectocele so I had the ability to splint and push it out. Sorry, way tmi. I think the aching is perfectly normal given the amount of healing but also as I have this stupid spasm going on.