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.

Well done edwin. Rest up. 10.30 coming round for a one hour procedure going in at 8.30 sounds OK. Hope the blood loss thing is nothing. XX

thanks cardamomginger bleeding seems to have slowed down so the nurses are much happier with me. Really looking forward to getting shot of the catheter and pack at 12 noon now.

Have they done a full blood count on you Edwin? I lost more than most people apparently, so they did test my blood the next morning and said they would give me iron tablets if necessary, but it wasn't. I was a lot comfier after the pack came out BTW.

Thinking of you edwin and hope you're feeling good. I was actually so surprised by how ok I felt the day after my surgery, the only things causing me discomfort were my catheter, the pack and also 2 different lines in my arm, one for my drip and the other for IV antibiotics. Once they were all removed I felt surprisingly good.

I came back home yesterday afternoon and it is fantastic to be in my own bed and also to be able to have my children come and sit with me, I missed them a lot. On the other side I think my hubby and I may fall out rather a lot, he's already tired of me calling downstairs and seems to have no understanding of the support I need. I had to virtually beg him yesterday evening to come and sit with me for half an hour just so we could be together. Guess men just don't get that emotional support is important too.

Thank you for all your support with my poo saga, where on earth would I be without this wonderful place to share far tmi and receive emotional support instead of disgust! Sadly both yesterday morning and this morning's bowel movements were no easier than the first. Each time I am in agony, initially it is a sharp pain as the open wounds are being stung and then it changes into a kicked in the whole groin ache. I have landed up taking a Tramadol on top of my paracetamol and naproxen and even then it takes over an hour for the pain to subside. I spoke with both my surgeons and it is almost definitely the operation on my bottom that is causing this level of pain and I've been told it may take at least 2 weeks to subside.

cardamom how are you doing now you're a couple of weeks post op?

Xx

whoknows no, no blood tests, it's calmed down a lot so I don't think they are worried anymore. They've just taken out the catheter and pack and it has made a big difference to my comfort. Although taking the pack out wasn't the most fun I've ever had.

Tr0ubled glad to hear you are back home in your own bed. I've been offered Thursday or Friday for discharge, I will probably go with Friday because although I miss my dc terribly, at 15 months and 3.5 yrs I'm worried about them bouncing all over me when I get home. It must be lovely to see them though and I'll bet the were thrilled to see you! I suspect the novelty will wear off for my dh as well after the first day or so.

I can feel poo building up and starting to worry about getting it out.

Edwin - hope the pack is out now and you're feeling a bit more comfortable. I agree that an extra day in hospital can make all the difference! When I went into and came out of hospital I read 'Maisy goes to Hospital' with my DD (she's been 14 months, 22 months and 28 months at each of my surgeries). It helped her to understand about me being away and that I needed to recover afterwards. Might help??

Tr0ubled. So sorry about the pain . Do you have/can you get hold of any Instillagel? It's a local anaesthetic gel supplied in syringe-type dispensers of around 10ml each. I've found it really good to help take the edge off things post-surgery when squirted onto a maternity towel. Just wondering whether a bit of that would make at least some of the stinging pain where the wounds get stretched pain a bit more bearable. Unfortunately, it's prescription only, but if you wanted to try it, you will have been given the contact numbers for the ward and the nurses will probably call your consultants to discuss it and issue a prescription if they think it could help.

I had a check up today 3 and a half weeks after surgery. I was TERRIFIED. But so far it all looks fine! I've got a thrush infection, which is why things have been so sore and stinging so much, but have pills for that, so nothing to worry about. There's quite a bit of swelling still, and obviously we won't have a proper idea of where things are at until about 7 months from now when all the stitches are finally dissolved and it's just me holding things up. But, for now, it all looks really good. We had a look with the ultrasound and the collagen mesh he'd used is nicely in place, which is great news. He got me to cough during the scan and we could see that things only moved a tiny amount. My surgeon was smiling away, almost bouncing in his chair with excitement . He pronounced my vagina and pelvic floor to be akin to that of a woman in her late teens or early 20s, who's never had children - not bad as I'm 41 and everything had prolapsed to all buggery .

And I got a hug from him! I know that a hug from a male gynae could be seen as not quite the done thing. But this was very appropriate and lovely!

Do I dare to let myself feel optimistic....????

Go Cardamom!

Edwin just relax (I know, easier said than done). Maybe take a magazine into the loo?

Troubled - I had DH bring a dining chair into our bedroom so people could sit with me without having to sit on the bed, helped me feel less cut off. Feel free to vent on here and we can hold your hand.

Most definitely!!! :) Sounds like a really positive appointment cardamom, so pleased for you.

I spoke with the colorectal surgeons nurse and she said I probably should try to harden my stools a bit as the excessive pain could be because they are so loose. I'm also leaking, which not only is pretty disgusting it's also making it impossible to keep the heamorrhoid wounds clean. So she's suggested I reduce my prune juice intake and only take one sachet of movicol per day. Bit nervous to reduce it that much as obviuously if they're too hard then I'll get lots of pain on my entrocele and rectocele repair so I think I'll adjust it slightly and just cut out the prune juice.

As a matter of interest how much we're most of you doing 4 days post op? I'm basically lying in my bed but feel as though I ought to do more.
X

Troubled - very little, in bed most of the time, I was only staying up fr half an hour at a time, long enough to go to the loo, potter for 5 mins, have a shower and go back to bed. You need to get up every few hours and keep your legs moving because of the DVT risk, but otherwise rest, rest, rest.

Thank you!
Oh dear Tr0ubled. It's so hard to get the balance right. After my last op, my system went into overdrive and I had 30 episodes of diarrhoea in 24 hours. At one particularly low point at 5 a.m., I actually though I was going to poo myself to death. Your system has been mucked around so much. You will find a pooing equilibrium again and 4 days is still very early. Not that that makes it any the less horrible for you now. .

Oh and at 4 days, I was still in hospital, spending much of my time in bed. Sitting in a chair for a little bit to have a cup of tea and read the paper. Doing small amounts of pottering and generally feeling like I'd been hit by a bus. And that's pretty much what you should be doing too! What exactly is it that you think you 'ought to be doing' ?? XX

Not sure!! Just when I have the pain under control I feel a little lazy! How crazy is that! I've spent the last 6 years running around after my family and finally I have the chance for some rest, guess I'm just not used to it! X

Not been on here for a while so great to see all the new faces (but sorry you have to be here iykwim).

After the failed recto repair and tvto last year, I was booked in for a defecating MRI and urodynamics with a pessary meantime. The pessary has been working pretty well so far, so decided to cancel the MRI, get a tvt and just manage the recto side of things for a while with the pessary. Problem is, have been having quite a lot of bleeding between periods, so went back to ask if there's anything the could do for that. Had a hysteroscopy, pipelle biopsy and mirena coil fitted last week. The coil was expelled on Saturday (just couldn't believe my luck). So now awaiting both the biopsy results and a date for tvt, novasure ablation, a further hysteroscopy (first one looked ok, but consultant said he just had time for a quick look because I had it done with a local instead of GA and was in agony). So...that is a really long way of asking if anyone has any experience of an ablationand tvt and the same time?

Troubled - take it easy and drink lots of water x

Hi Roseanna, you have had a bad run with this haven't you (sorry, bad pun, oh god that's even worse), you know what I mean. Glad the rectocele is under control for the time being anyway. That's the only bit I have any experience of but hopefully someone else will have some answers for you.

No advice to give roseanna. Hand holding and hugs XXX

Thanks ladies (lol whoknows!) ... trying tojust take a breath and think it through logically at the moment without getting ahead of myself with what ifs, but the waiting is hardest I think. Once I have all the facts I think I'll be able to cope a lot better. The one real positive has been the consultant...he's been lovely and going out of his way. Kept apologising bless him, even though none of it has been his fault - just a run of bad luck really. I so want this next surgery to be my last. It's been over a year since the prolapse issues started and I've just had it now. Sorry for the me me me post....just good to vent!

Hi everyone,
haven't posted for a while, lots of stuff going on here and been a bit down and trying to stay afloat. Hope all of you that have had your ops are doing well and your bits aren't too sore and are healing well:)
Anyways, went back to see the GP yesterday who still didn't ask to examine me!
Tried to explain to her what I was talking about which is a bit hard when you can't point at what you mean and she won't bother to look:) So she gave me a referal letter for a colorectal surgeon. I mentioned that I thought it might be better to see a urogynae and went through all my problems again and she started rambling on about them being better equipt to deal with sphincter damage which I don't have, I have no perineal tissue left worth mentioning which she would have noticed, if she bothered to look but my sphincter works just fine thankyou very much, one of the only bits that does. Told her I didn't want a colorectal referal and she was a bit snotty but said she would post me out a letter to make an appointment with a urogynae.
All she would offer me other than that was advice on eating five portions of fruit and veg a day along with a helpful demonstration of the size of each portion, more lactulose, an offer of anti depressants? and to ask when I had had my previous prolapse repaired??? erm, never, cos I never had one before, and you have my notes on the screen right in front of you... Oh and she asked me how old the baby was because did I know that I couldn't lift her if they say they will do an op. Seriously I think she was having a senile day or something. I had the 'baby' (who she knows) with me, she is 3!!! Was a very strange appointment, think I have peed the doctor off but not really bothered, I want to get my bits fixed and I will annoy who ever it takes to get it done. Giving her a week and if I don't have a referal letter will be back on the loony womans case but think I will be seeing a different doctor after I have it, she was a bit to odd for my liking.

Sorry Troubled, have only just had chance to get back to this thread. The cushion really alleviates my pain, by raising my pelvis, I think. i am still having buttock pain 6 weeks on, and suspect it was because my vagina was hitched up using ligaments, drilled through my pelvis. As well as the other repairs, of course. no one has confirmed the pain is due to the drilling, but i do know drilling through bones is very painful generally for a number of weeks. obviously i suspect the holes are minute for ligaments, but probably enough to cause discomfort for some weeks. The cushion makes sitting bearable for half hour or so now, but even laying on the sofa is nicer with a cushion under my bum!
At four days I was not doing much, but I was home alone so had to do a certain amount for myself like making lunch, drinks etc. I also did three five to ten minute walks a day. My husband us self employed, and no work means no money, so he had to work.
My consultant told me to little things like making drink etc to make sure I didn't just sit about to put a risk of DVT into the equation.
I am only now, 6 weeks, in allowed to do pelvic floor exercises. I do feel my bladder and bowel are not awfully reliable yet, sadly. I can't stop my wee while doing it at all. The other end, when I need to go, need to go.
Am fairly active now, but do find I get tired. I have alot of stress going on in other areas of my life too, which can't be helping. They keep me awake or having disturbed sleep, which probably doesn't help either.
Just to reassure anyone about to have surgery, I had no pain when doing a poo after the op, it my bowels refused to open in hospital, I was sent home with movicol, which then made everything so loose, I could barely make it to the lo. No pain what so ever though.
I am reading what to me are horror stories on here of people's stitches not dissolving for 6 months or more, is that due to the type of operation, or just standard? My consultant said they dissolve 3-4 months after the op, and obviously no heavy lifting until then. Nor, horse riding, which for me will be huge disaster as I have a riding holiday booked in July! Plus my work doesn't involve heavy lifting on daily basis,but the doors there are really heavy fire ones, and involve alot of yanking, so this could be a concern too. Helpppp!

Sorry if I scared anyone with my talk of stitches not dissolving for 6-7 months!! These are the deep, deep stitches used to hold the deeper layers of tissue together. The ones used to close the outer layers dissolve in 6 weeks. It's generally the outer ones that cause the discomfort. I've never felt any of my deep inner ones. To be honest, I don't think it makes any difference how long the deep ones hang around for. We will mend and form scar tissue regardless of whether a stitch is still there. Yellowhorse perhaps yours are 3-4 month ones? Anyway, sorry!!

Well done charley. You must have felt so frustrated during the appointment. Amazed you held it together! Hope the referrals come through soon.

Oh Troubled my eyes are watering reading your posts that sounds awful for you, hope that you and edwin are recovering well and taking it very easy.

Cardamon that sounds like really postiive news for you. You have had an awful journey with this.

Roseanna you are inspirational. I have everything crossed (well that I can right now) for you that they truly get to the bottom of things and that this is your last surgery. Am so pleased that your consultant has been really supportive it makes such a difference.

Yellowhorse that sounds utterly painful but remember it is worth giving yourself the extra time to heal properly as frustrating as that is.

Charley what an appointment! I had to demand an examination as well which took 10 months and then the GP (a different one) was horrified and apologised so keep going it will be worth it.

Am really struggling here. Am 4 weeks post op and still totally wiped out, for those of you who have had further repair surgery did you find the second recovery more difficult?

Hi Bladder. I think some of it depends on what the second lot of surgery is and whether it is more or less radical, requiring more or less healing. Another thing to factor in is that your baseline in terms of energy, strength, etc will be lower going into the second surgery than it was going into the first. So, yes, I think you may very well be more tired second time round.

I think the psychological impact needs to be taken into consideration too. How much mental energy you have for all of this is key, I think. When I had my first surgery in November 2011, I had a lot more psychological oomph to try and get through it. The second surgery in June 2012, which was a planned one that we always knew I'd need, I still managed to gear myself up for. But this third one, last month, which was a 'surprise' one, I've found it really difficult to psych myself up for - both in terms of the surgery and the recovery period. My mental and emotional energy is much lower this time round.

I remember at 4 weeks post operations 1 and 2 still feeling knackered in the extreme and needing 1 nap a day. I got quite a bit more energy at around 7 weeks, but then things started hurting again as the muscles that had been repaired finally woke up and started trying to work again. And pain is very tiring.

I can't remember whether your surgery was through the vagina or through an open abdominal incision (sorry!). Sometimes I think that the more 'hidden' nature of vaginal surgery doesn't do us (or our DP's, etc) any favours as there is no obvious visual reminder that we've actually quite major surgery and need to take it easy!

It's fine to feel wiped out. Sleep. Rest. Listen to your body. XX

And, in the spirit of following my own advice, I am now off for a nap .

Thank you Cardamom, I didn't anticipate needing a second round of surgery and it was just a day case so I thought that it would be fairly minor. Got admitted after the surgery for a night and when I saw the cons of Friday he said that up to six weeks was a normal recovery for this type of surgery. My mistake really for not asking the right questions etc.

My DH is away at the moment so I am home alone with the DCs and I think that is not helping, I have got a blood test tomorrow to check my iron levels to see if they are a bit low.
Sorry for the winge as with all of us I just want to feel better again and live a normal life.

Never need to feel sorry for having a whinge bladder, hope you turn another corner really soon and return to feeling bladderific.

yellowhorse what type of cushion do you have? Is it a ring one or just any cushion? With regards to your pain I have heard how the ops involving ligaments can have a more painful recovery. I was a '?' for a sacrohysteroplexy and the surgeon said they would inject cortisone during the operation whichever would help with pain for up to 6 weeks. Could it be they did the same for you and it's now wearing off? If so then perhaps you could ask for another cortisone injection.

edwin how are you feeling now 2 days in?

I'm so up and down; just occasionally I can control my pain to almost non existent but most of the time, like now, it's a constant ache. And then when I poo it is still agony, the majority of the pain I know is coming from the heamorrhoidectomy which I am told may take at least 2 weeks to start to feel better. Yesterday I went twice and on each occasion literally had to crawl back to my bed and lie on my side; the pain is exactly like the 2nd stage of labour and if I was able I would have gas and air to help me through. I rang the hospital as I hoped they could advise a way to help and for the moment they have suggested that I use Tramadol continuously so it is always in my system as opposed to just using it as a top up when needed. We'll see if it helps.

Hi all, I had a pretty bad night last night, really bad pain which kept me awake most of the night. I had morphine at 5am which made so much difference and I'm now back home. I hadn't been able to poo in hospital despite lactolose and a suppository but I've just managed to go at home with no pain. The relief was fantastic. I think it's probably harder to relax enough in hospital to go as people are constantly in and out of your room. All in all I'm not too bad, I have lots of drugs which I'm taking regularly. Looking forward to seeing the dc's when they get home from nursery.

charley I think I would be asking for a second opinion from another doctor too, that one doesn't sound quite the ticket

yellowhorse my consultant has said 6-8 weeks for my stitches to dissolve, this was for a straightforward anterior and posterior repair

tr0ubled have you asked about a prescription for morphine? i was given some this morning and it gave me a good couple of hours of complete relief, I asked about a prescription and she said they couldn't because they need to monitor you afterwards but my GP may be able to, it's just a thought to allow you to have a couple of pain free poos

Thanks for all the kind wishes everyone.

Bladder, I did find the second surgery much more tiring in terms of recovery and the third just wiped me out even though they were much more minor day case type surgeries. I think having multiple general anaesthetics does wear you out more than you realise. Try to get loads of rest...I know it sounds trite, but it does help a lot.
Charley - your doctor sounds like a weirdo - I would run a mile to another gp lol

Edwin - sounds like a nightmare...feel for you x