Pt 8 (Oct13) Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc

[Bladderama]

Welcome to thread 8 (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 - an earlier 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
Thread 7

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.

Hi, I'm one week post op for anterior repair and tvt. As all of you have been told to take it easy and get as much rest as poss or first two weeks. Thankfully hubby has been home to help out with school runs etc but goes back on Monday. Will I be ok cooking and doing school runs (approx 3/4mile walk both ways) twice a day? Also, regarding lifting etc, was told not to life a full kettle or Hoover for four weeks, what can I lift without damaging anything? Little worried about over doing it but then I need to take care of my two boys. Any advice greatly appreciated. Thanks

loubl do really take it easy and I took the stance of don't lift anything heavier than about a pound in weight although my cons said about 5lbs I was being on safe side. I don't know how any of you with young kids have managed to have a recovery for yourself. I found it hard enough ignoring what the rest of my family couldn't be bothered to do!! And it is really hard to not do anything to start with but I found I got used to it after a few weeks and the time went too quickly in the end!! spent hours on this thread - invaluable.

Cant remember who it was posting but I have found that BMs have been the most challenging thing to get on top of and still resort to softeners etc to keep things moving without straining too much and I find that quite depressing as am still often thinking about repair 3 mnths on and didn't think I would need to (naïve? sp). And yes I still do far too much vagina watching haha! Lock yourself in bathroom is the only sure fire way of not being disturbed.
I go for physio next fri and cant wait to see what advice/help I get about PFs - will keep you all posted with hints and tips!
To those asking about lumps I too felt things were lumpy and hadn't worked for several weeks, then I felt I had more of a hard lump kind of where rectocele had been but further up (sorry cant be bothered to put things delicately anymore!) I felt like that for a few weeks and resigned myself to that being the new improved vagina and at least if I didn't have to splint, while I was aware of the lump it was liveable with, but that has now gone to so I think it was just swelling. Ironically things now feel 'softer' there, it makes me keep looking to see if the rectocele is back but I guess if you don't have to splint then it isn't. Sorry this is so long but just wanted to try and cover as many peoples questions as I could.

Just a question -does anybody know why a mesh is suitable for abdominal hernias that men mostly get but causes problems when used for prolapse surgery. I know nothing about surgeries but I know of several men who automatically have a mesh to support the abdominal wall hernia and although my surgeon just said they rely on scar tissue strengthening things for prolapses to me is seems it would be much better having a proper strengthening thing. Why does have risk of erosion in us ladies? Wish I had asked surgeon this?

Thanks lotsofquestions guess I'd better take things easy then
Tho maybe that's easier said than done! How long can you take stool
softners for? I'm still using but it's only been a week, had no idea I may still need them in 3 months time, was also hoping to have forgotten about it all by then too. Can I ask when you started driving again? Also have you attempted ironing yet? Was thinking I may have to hire some help for a few weeks as hubby will not want that job when he gets home from work.

Lots It does cause problems. it's just not talked about so much within male circles.

Also they are now realising that taking mesh through the vagina to do a repair raises the chance of post op infections. Because you can't get the vagina totally sterile, bacteria can be dragged in with the mesh.

One of the big potential problems with some non-dissolving mesh is erosion of the vagina which can cause severe constant pain . Also once it's in it is almost impossible to take out, because the body forms scar tissue around it. The mesh can also contract down over several years causing pulling & pain.
Just Google "mesh problems" and "men's mesh problems".

Hi everyone, I am back. Have not been on for ages. Update good and bad, did not have bowel cancer as such, had three yucky polyps removed that are the sort that turn into cancer so have to have a check every three years now, so that was the good news. Bad news is I still have some sort of rectal prolapse along with a rectocele and now to top it all my uterus has decided to head south, plus my perineum decided to lose most of the muscle (not sure where it went :-). So am booked in for a Laparoscopic Hysteropexy, perineum rebuild and Starr procedure in March. Noordingarygirl - I see you are waiting for a similar operation, scary isnt it.

I had the rectocele and cystocele repaired Dec 2012 and it failed. My advice to all those recovering, is to do nothing for as long as possible, I did far too much, because I think it is easy to forget that you are still healing inside when you are feeling better and it is second nature to most of us mums to cook and pick things up. If I do decide to go through with my next operation, I plan to do as little as I can away with for 12 weeks and will never ever lift any heavy again. I

Hi tinkxxx, very glad it wasn't cancer. But so sorry you probably have to have major surgery all over again.

When you say, 'do nothing for as long as possible', how much nothing do you mean? As someone 4 days post surgery, I'm struggling a bit with understanding 'do nothing' or 'take it easy'. Is that basically lie around most of the day, occasionally getting up to make myself tea? Or is pottering around the house a bit, setting the table as DH is cooking etc?

Thanks for the info lotsof about a sense of lumps and bumps inside, it was one of the things I was worrying about.

Greeningthedesert - You have had quite a bit done, so I would do NOTHING at all for at least two weeks and then for the next 4 just potter about, but still do no lifting or bending if at all possible. Like I said I think it is easy to forget we are still healing inside when we start to feel better. I have told my two teenage boys I will not be cooking, cleaning, shopping etc for 12 weeks this time around lol. I wish I had took a picture of their faces when I told them.

greening yes I interpreted do nothing as exactly that, I sat around most of the time interspersed with walking round the house up and downstairs to keep circulation going as was concerned then about DVT. I did potter with setting table and v light dusting at surface level only but no bending to do dishwasher, put washing on etc did get one of my family to put washing on a table so I could then hang it surface level on to the dryer indoors - I did try to help with bits and bobs but my teenage boys were - just that! and didn't really know what needed doing DH was good for 2 wks and then got fed up with it all grrrr so I did find after about 3 weeks I was standing and chopping veg and stuff for tea but again did no lifting of pans, plates etc. My DH managed to hoover about once a fortnight (just!) but I did have my mum come and help with the cleaning for the first few weeks and I had done such a spring clean before hand the house just about survived but by the 5th week was minging and marital relations were also v strained ( Men would never cope if they had to do what we do day in and day out!!!). and if I ever have it done again (fingers crossed not) I would do more freezer meals and book a cleaner. I didn't do any ironing for about 7 weeks (thought I would milk that one abit haha). But after about 8 weeks went back to shopping although was and still am v careful about making sure bags aren't too heavy. think check out girls think Im mad cos they pack a bag of about 12pts of milk (got 3 growing boys!) and I simply take them out and put them loose in trolley. Have gone into detail as I remember thinking exactly the same thing about what to do!
regarding BMs just keep on taking until you are able to go without straining. Im still struggling with that one as my BMs used to be pretty good apart from the obvious and now they just seem to not have got into a routine and so then I panic about getting blocked up and take something again so I think it is a bit of a vicious circle! I am seeing physio next week and will see what she says and then maybe go back to GP for some more advice or a bulk prescription of laxitives .
in the round thanks for your reply - interesting I shall take a look sometime although my DH had a hernia repair about 11 years ago and has never had probs and my SIL had the TVT tape for stress incont about 7 years ago and neither have had any probs

I am very interested in the how much you should do question too. I had an op in May and have got to have another op in March, I'm not sure if it's classed as being a failure but the surgeon said he didn't stitch it tight enough. I'm sure I read somewhere in all my research on the net that the 1st two weeks are the most important. I lay on the sofa for 2 weeks doing nothing apart from a very short potter round the shops after about a week but after 4 weeks I didn't have any help so I had to pretty much go back to normal looking after my (then) 2 year old and 5 year old.

I am 6 weeks now and beginning to feel more normal. Mostly get tired and achy after doing too much but am still off work so just pottering around, basic house work and the like. Those who are further on from me and have physical jobs, I am wondering how long you took off work? Really worrying about work now and judging when I should take the plunge.

I go back on Monday after 6 weeks, feeling very vulnerable. Work has carried out risk assessment and I am phase return doing very light duties. My boss has even allocated me a desk and chair with cushion. Not sure if she was taking the pee but I think I'll be glad of it. What is am afraid of is still being on laxatives and work environment for toilets is right next to office and you hear a lot is all I'm saying. It's a genuine fear and something I only thought off. God along comes another worry.

homebird that's what I am worrying about and there is only so much that my job can be altered. I shall find it very hard not to just roll my sleeves up and do the whole job once i am in.
happy poor you, still worrying! Perhaps you should say that you can't start the working day until you have had your daily poop at home....I am sure you will be ok. Just remember to do the bare minimum and don't stay a moment after your hours and if it doesn't go well you must go back to the gp if you need a bit more time.

I will Dragon. I feel my anxiety levels rising already. Like you I'm just afraid of getting stuck in and regretting it. I think it's worse as you can't physically see what is wrong and on the outside I look fine. I'm just afraid of people seeing this and expecting me just to get on. I wish perhaps I took longer off now. If it is too much I shall just take off again but then this counts as two separate illness and I will hit triggers for a little talk. Maybe I should have went to occupational health.

Hello. I'm back. Lost the thread for a while but I've caught up I think. I'm now 9 weeks post cystocele repair. I was told my uterus had dropped morning after surgery but hadn't been repaired. Saw GP today who has signed me off for a further 8 weeks. She says she will sign me back onto light duties slightly prior to that if occ health and manager and my physio agree that I could manage. My cervix is so low it's very uncomfortable nearly all the time, standing isn't pleasant and even sitting isn't good. I had my post op last week, 2 weeks late, and he has said that yes uterus has dropped considerably and I'll need it taken out! I've to see him again 22nd April to go back on list for more surgery. He won't operate sooner due to needing to let things heal first. I had physio today so I've a neurotrac STIM device to use but as I said to surgeon we all know nothing is going to help. Not entirely sure I can work like this as I'm very uncomfortable and verging on painful to sit or stand etc. I have a holiday booked soon and I'm concerned about the logistics of going while off on sick leave. The physio is going to speak to surgeon and see if a pessary would be an option to aid me getting back to work. It's all such a mess :(

Tinkxxx gosh ours ops are really similar except I have no uterus left - my cervix just fell out in May. And yes, it's damn scary. All that fettling VERY near your spine is the primary worry for me but also the mesh issue too.
Greening it looks as if my letter to the hospital has got me to the top of the list now so anxiously awaiting a call, hopefully tomorrow, with new date which should be in 3/4 weeks time maybe. And I will be having my original consultant too after being told it was going to be one of 2 others.
Happy PLEASE PLEASE PLEASE try to take it easy and ask to leave early if you feel even slightly tired/in pain/just plain old had enough. However, I totally understand about being signed off twice etc from work. I too will have that worry as I work for a local authority and they are cutting jobs everywhere so I really don't want to give them an easy target. I do want to leave my job (due to all the crap surrounding cuts etc) but I'd like to leave when I am ready and not be pused IYKWIM.
Dragon if you can take more time off - do it. I am sure we probably need more than we take but being superwomen we just grin and bear it. After returning WAY TOO early last time, I will be off for as long as I can get this time round as I just don't want any more surgery. It's only a few weeks off work/at home compared to yet another op.
Flouncy I have had a pessary in for a few months now and although it had to be changed/re-positioned a couple of times (and sometimes I have to push it back up a little myself!) it has stopped my cervix making an outside appearance again. It does get uncomfortable every now and again, especially after too much walking/need of BM/too much housework/bending & crouching etc etc but it's served me well as an interim measure. Wouldn't want to live with it long term though.

nordinary really pleased you have an end in sight and with the original consultant. What's all that about? I hope he says a big sorry to you for all the mucking around. I really am in two minds about work. I have the consultant on the 7th so will speak to him then perhaps.

happy you can self refer to occupational health if you like. As for a little talk, get a doctors note if you need to go off again and they are pretty much stuffed, particularly if you then ask for occupational health to become involved. It will remove the need to discuss your health with your boss and they won't want to go against a doctor's note.
Try to enjoy the next few days and don't let the buggers get you down!

Flouncy , glad your back. It is horrifying what you are facing at the moment. Isn't it a shame the didn't just fix everything in one operation rather than face it again. I hope the pessary works in the mean time at least just to relieve some of the pressure.

Noordinary I really hope they get their finger out and that you wont have to waiting longer. The waiting is horrible. I'm glad that you have found someone else who faces the same kind of operation. Obviously not glad for tink that you face this op but hopefully you can support each other as I have found support with Dragon as our op were very close together.

Dragon as for work, well it's fast approaching. I will see how the first few days go but I must add I only work 3 days a week since having my boy so not as bad. However i do find they manage to squeeze fulltime job in part time hours. If I'm not right I will get a Dr note but don't want it to go against me when I need to go for interview.

Greening I would try and do no lifting or squating for the first 3/4 weeks. I know it's very hard to do but the more rest the less chance of recurrence. Just fill kettle enough for one cup.

Loublu I would leave ironing for a few weeks. It said week 3 to try sitting ironing but no lifting laundry basket or board. Making ironing difficult if you can't set up.

Mrsclairet have you date for next operation?

Lotsofquestions my sister had a mesh put in after she tore stomach muscles during Labour. That was 6 years ago and she has no pain or complications. As my uncle also (obviously not labour) had operation and again no complications. Would be interested to know the success rate.

Phew think I've covered all.

Noordinary - Has your consultant explained the procedure to you? Unfortunately when I saw mine in November I had an appointment later that same day so was in a terrible rush. He examined me and told me that the uterus had now dropped and that I had very little tissue left and that he was going to pull it all up and attach it to my backbone (lovely) and that was about it.

I only found out exactly what procedures I was having when the secretary rang me up with my appointment date. I am scared, I mean really scared. It has all made me feel very depressed and I am so worried it is going to make things worse, which would be awful. I am thinking I will not have the starr procedure but will go ahead with the uterus suspension, but then I think if my bottom problems are not sorted out I will undo his procedure. My main fear is being incontinent and the mesh eroding.

And I cant help thinking, three bits being done at the same time = alot of pain and lots of room for complications. I spend many hours of the day trying to decide what to do.

To all those recovering, take it easy and do NOTHING

Tink I really feel for both you and Noordinary, such a big decision to make. Sometimes when you are in with consultant it can be very overwhelming and to remember everything that was said. I found it was only when I was driving home the questions started coming to mind.

Thank you all for the advice, happy, lots, tinkxxx and mrsclairet. Have tried to take it even easier today.

Happy, I think you should talk with occupational health, in my experience they're really on your side. Also, and this is definitely TMI but I find that movicol (a stool softener) gives me much more silent BMs than laxatives. And much less discomfort ....

Tinkxxx, do you have another appointment with the cons before the op where you can ask your questions? I was really dithering before my op and in the end booked an appointment with the gynecologist who had originally referred me to the urogynocologist for surgery. He helped me to better assess the risks/benefits and come to a decision.

Flouncy, I really hope that a pessary can help in the short term. Bear in mind that some doctors are biased against them even when they may help - my own usually excellent gyn would not even consider one (they're for old ladies, cause infections and sores etc) even when I read how helpful they are to people online.

Hi all, I'm wondering how long I need to take laxatives for before things are normal again? I'm 11 post op for an anterior
Repair and tvt. Tmi but I went the other day when I had taken only 1 tablet and didn't think I was straining but
It felt like a baby's head was coming out from
Where my stitches were. Just awful.
So back on tablets again but not sure how long for. Any advice?