Pt 8 (Oct13) Any old prolapse! Uterus/womb prolapse, rectocele, cystocele, enterocele, urethrocele, incontinence, pelvic floor, anterior and posterior repair, TVT etc (994 Posts)

[gottagetthroughthis]

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
Thread 8

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.

[Spagirl911]

Hi,
Newbie here, just turned 50, no kids, but just had a partial bladder prolapse :'(

The dear NHS are suggesting a telephone consultation to deal with it.... so I was wondering if anyone knew of a good private women's health gynaecological physio in the Surrey/ Hants area?

[rebelnotaslave]

New thread

www.mumsnet.com/Talk/general_health/3029810-Pt-9-Oct13-Any-old-prolapse-Uterus-womb-prolapse-rectocele-cystocele-enterocele-urethrocele-incontinence-pelvic-floor-anterior-and-posterior-repair-TVT-etc?watched=1

[rebelnotaslave]

You should be given a list of places you can choose to be refereed to, plus waiting times.

Is anyone around who has had anterior and posterior repair surgery. I'm 2 weeks post op and have questions. Might need a new prolapse thread this is nearly full I think.

[Nikitasol]

I was diagnosed yesterday with uterine prolapse and then told that it's an 11 week wait to see the gynaecologist at the hospital. What do I do? I can barely walk!

[Notanotherpawpatrol]

I just lost my post
It's good to know that there are things that can be done :) I didn't realise in time to talk to my midwife about it, to be fair I was discharged really quickly after birth and they weren't interested in how I was doing at all. They only wanted to know about the baby. It's my 4th baby and I was really shocked they didn't care about my post natal recovery at all.
Were in the middle of a difficult relocation that seems to be taking forever. I was going to go and see our new gp when we'd settled, but am thinking about going private now. So I think I'll start with a physio and then a gyne depending on what they think.

[Josieannathe2nd]

That's absolutely awful from your GP. Are you still under midwife care? Mine could directly refer me to a women's health Physio. If not you definitely need an appointment with another GP. I do think as your only 3 months post partum women's health Physio should be the first step but you might want to see a gynaecologist as well if you can't have sex. Or think about going privately?
In the meantime you can start trying to do pelvic floor exercises, Hab-it online has some pelvic floor and core stability exercise videos that you can stream and that should help start you off but you really need proper guidance to make sure you are exercising correctly, and doing the right exercises for you to give you the best recovery possible. It is still early days so don't panic about what everything feels like and I think it is still possible to have a good recovery. But no way should way just have to accept things how they are- there's certainly lots that can be done. I feel quite angry at your GP.

[Notanotherpawpatrol]

I seem to have all the typical symptoms of feeling like everything is falling out, feeling like my bladder is still full after going to the toilet, my bowel habits are all over the place and most tellingly, my vagina is full of... I don't know what. I'm assuming it's the wall of my bowel? And it's lying across my vagina. I can also feel the wall of my bladder and further up my cervix seems to be blocked.
I honestly don't know what's going but I k ow it's all wrong :(
I'm wondering if I should see a physio or should I go and see a gyne? It feels really bad, but is it really?
I did pelvic floor exercises all through pregnancy but I feel really stupid. Dh and I can't have sex because it's all so wrong and painful (we've not tried to have sex, but it's painful already)
I tried to talk to the gp about it who was useless and just said 'these things happen, sometimes we just have to deal with it' he was a male gp, I came out and cried thinking, you don't have to deal with any of it. It's my body that's been ruined. I feel so stupid for having another baby. The Dr probably thought it serves you right for having a 4th.
I just feel so crap about it all.

[smellsofelderberries]

Not, I'm here. What's making you think you have a prolapse?

[Notanotherpawpatrol]

Is anyone still around on this thread? Baby is 12 weeks and I think I have a prolapse and need some advice :(

[Imstickingwiththisone]

Hi smells the physio was lovely! She examined me and asked me to cough so I know she was doing the right things to correctly assess. I felt totally at ease and trust her medical opinion. She doesn't think I have a prolapse! No answers as to whats happened but basically it was always going to go one of two ways after pregnancy and luckily for me it improved. How it has gone from having my cervix next to my vaginal entrance and leak so much urine I couldn't leave the house, I don't know but im very grateful. I knew already that it had improved massively of course but im so hyper aware of how things feel down there now that I do feel changes and they worry me as I remember how bad it was when pregnant. Physio put this down to periods etc although ive not got them back yet.

My pelvic floor in general is weak and I need to take all this as a massive warning to get it all sorted.

Wrt my section, the recovery was great. Certain movements were quite painful but the pain wasn't constant and I was very lucky to be able to get out on walks about 1-2 weeks after. I would definitely recommend it if you decided to have another as I think the psychological effect of regret is as bad as any physical consequences from a vaginal birth that worsens the prolapse. My physio said I made the right decision because the scar tissue from episiotomy wouldn't stretch so could tear, and could tear into muscle. As the muscles in your pelvic floor were torn so badly, it will be such a weak point for you going into Labour again.

You are doing fantastic though smells. Its hard finding time to use a fanjo zapper with a small one that needs your attention every waking minute

[smellsofelderberries]

Sticking, they might, it all depends on their level of training. I've been to one physio who didn't even do an internal exam, one physio who did an internal and said things weren't too bad, and a third physio (who I've stuck with) who graded my prolapse and picked up my torn pelvic floor muscles. It really just depends on their level of training and knowledge. Fingers crossed you get someone good. How's that gorgeous baby of yours? How's the recovery from the c-section gone? If we ever have another baby I'm fairly certain I will have a section as I really don't want to risk further damage as it doesn't look like my issue is going to get much better

Been meaning to come back and post here for a while. Still keeping on with physio and trying to keep the faith but haven't really seen much improvement. Been using my Pericalm for 3 weeks now but not sure it's really working very well. I find it hard to keep the connection and I don't really feel a 'lift' when it's going. Worried everything is buggered. Have another 4 months to get through before seeing my urogynacologist. I am seeing Prof Dietz who is one of the world leaders in research into pelvic floor trauma during childbirth, so I'm hoping he won't have terrible news for me. I'm hoping I can live with this for the next 10 years until he comes up with a way to surgically replace my pelvic floor. Still haven't been fitted for a pessary but seeing my physio again next week so maybe then. Keen to get it as my DD is getting big and I'm finding it harder to carry her!

[Imstickingwiththisone]

I've finally got my referral for physio through and I'm going tomorrow. My GP appt where i requested a referral was really rushed and i was actually hoping to be referred straight to gynae for an examination and then physio for treatment but that isn't the case.

Will the physiotherapist be able to tell what grade the prolapse is?

[Imstickingwiththisone]

That's good news yalla!

[yallamamma]

I was examined in stirrups by a gynae, and was asked to cough and bear down.... It's a minor bladder prolapse, I was reassured and given kegel balls to start doing my pelvic floor exercises with... Phew. I am susceptible to further prolapse because of my hypermobility but hopefully I've got to this in time!

[Imstickingwiththisone]

If you are seeing a GP can you ask for a referral to a gynaecologist? I've been examined when lying down and have read this is how others have been examined. Because the prolapse goes away when you lie down then you can be told there is no prolapse when in fact there is.

If whoever you're seeing asks you to bear down then that's good as it is the optimum position to be in for a prolapse examination.

[yallamamma]

Yep, it virtually disappears when I lie down.... It's on the front wall rather than the back but it is at the very entrance to my vagina, so quite low. I presume the doc will have seen a lot of these and give me a fairly conclusive prognosis??

[sadie9]

Hi Yallamamma, it could be a bladder prolapse rather than the cervix coming down. I had a ventouse and a forceps for my 2nd baby and I think that definitely contributed to my prolapse. I had a cystocele and milder rectocele.
So the bladder wall can be pushing in, called a cystocele or the rectum can be pushing in (worse when rectum is full) called a rectocele. Both can cause a bulge or softish 'lump' inside, which usually goes away when lying down, and is worse when standing. It seems to vary in severity over the monthly cycle, and worse at the end of the day, mine was anyhow.
I couldn't use tampons at all (except the first heavy day) after my 2nd baby. I did find a way to insert them by adopting the pose of someone on skies, in order to get the prolapse to recede. But sometimes when I stood upright the prolapse would pushing it out.
I also had pressure of something 'falling out' as well as bowel issues like incomplete emptying.
Things to remember about prolapses:
It's not life threatening, however it can seriously impact quality of life.
There is surgery available to correct them. There can be reluctance to operate on younger women who might have another baby as they'd need to re-do the surgery and could be more difficult to do a second repair over the other one.
A specialist women's physiotherapist is a great source of help and doing the correct pelvic floor exercises can postpone surgery for a good few years. These exercises do take a few months to see an improvement but it is worth persevering with them. If you can't feel the prolapse that much it's not on your mind. And the missionary position it all goes back into place.
I have had surgery on mine. I had menopause at 47 and it got worse then so had the surgery a year or so later. This improved things hugely.
If you suspect a prolapse don't do any exercise that involves running or jumping, or sit ups or any sort of pushing down of the abdominal muscles as that can make it worse. Don't carry heavy shopping bags, divide up the bags and try not to carry loads over distances (eg suitcases). I remember you have two small kids so you will be lifting and carrying them and nothing you can do about that!
There are women on this thread who had young children and have had the surgery so it does happen.
Good luck with the appointment! Keep us posted as it will help others who come along.

[yallamamma]

Hi all, hoping for some friendly support and advice, I haven't had it confirmed yet by the docs, but I think I'm in the right place....

I tried to use a tampon twice in the last few days, but something first felt like it was in the way, and quite uncomfortable, the second time I failed completely and came across a spongy ball like thing basically blocking the entrance to my vagina. Today it's a little more uncomfortable and I can definitely feel something there. I'm bleeding a little, but this could also be the end of my rather haphazard periods (on a new-ish pill).

Obviously I freaked out, this was completely out of the blue - I don't often have much of a feel down there and DH and I haven't been very active recently so he wouldn't have noticed anything. I'm only 32 and straight away started thinking the worst, cancer of some kind....

After a fairly thorough google search, and a good old browse of some imagery, I think I am pretty confident that i've had a prolapse of some kind. I think it's most likely that the spongy thing is my cervix... and again, a self diagnosis suggests this is 2nd stage/degree?

Anyway, I've got an appointment tomorrow (live overseas though with fairly basic healthcare) so I'm terrified already of how the appointment will go. I guess I would like to hear of what I can expect to happen, what my possible options will be with a prolapse at this stage.... and some reassurance that this is going to be okay. Could it be anything else??

As I said, I'm 32, two young kids. First was a long labour with ventouse delivery, second was a c-section for breech baby. I had bad SPD with both, and truly horrendous vulval varicose veins with the second. I'm not surprised this has happened given that it felt like my insides were falling out from 12 weeks onwards.... I also have hypermobility, which I now know is another risk factor for proplapse.

Anyone here for a handhold?

[BalaRua]

Hi all - I haven't rtft (820 messages! What!) but I see you pop up in active from time to time. Wondered if anyone could help. Is there anyone here who's had a rectal mucosal prolapse? Since having DS, I've had haemorrhoids and anal fissuring on and off but now it feels much different down there - when I go to the loo and sit even for a moment for a wee, there's a pressure and a rather obvious protrusion. However it's not round and smooth looking like a full thickness prolapse but rather looks like it's in 'sections'! It doesn't hurt or itch or anything but feels extremely uncomfortable and I can't pull it back in with just the muscle anymore. Anyone any wisdom here? Thanks!

[Imstickingwiththisone]

Hi smells! I tried to reply so long ago but lost my message and just couldn't be bothered writing it again. It's taken me this long!! Baby is here and we are recovered section wise. I'm doing ok with the prolapse, the urinary incontinence isn't there anymore. I feel it some days but don't on others. I was really good at doing my exercises immediately post partum but they've gone by the wayside recently and I need to get back into a routine. I still haven't had my 6 week check so will only be able to ask for a referral then.

After first DC I could feel a bulge but on the whole it improved except for the odd spell which would get me trying the e stim again but after being given an all clear by Dr I thought it was due to paranoia so was never religious about it. It just gave me peace of mind.

I'm so sorry to hear you have PND smells. I can definitely understand how this would be a factor in your mental well-being. I was so upset when I 'discovered' it on both occasions. I would randomly burst into tears during the day and felt broken. I know mine is still there but it has less impact on me physically day to day and I just tell myself that a lot of women are probably the same as me but don't even know it's there iyswim. It's just at the back of my mind a lot but I know when I get to the point of seeing a professional about it I will be upset all over again. My DP has been great throughout.

I've just seen a feature on This Morning which touched on pelvic organ prolapse but they did it in a typically ridiculous way by titling it a vaginal facelift. The laser treatment that the lady underwent sounded interesting but I've no idea whether it would help a prolapse or just the appearance as it was unclear. It sounded so much less invasive than surgery though.

[smellsofelderberries]

Fauxgina, how are you doing? Have you had your surgery yet?

How's everyone else doing?

I went to see another specialist physio 2 weeks ago as things haven't improved for me, and she said things definitely aren't right. She's graded me with a stage 2 bladder prolapse and she thinks I have muscle avulsion. I am going for a pelvic floor ultrasound to see what's actually going on and I'm really scared of what it's going to show. I've also bought a Pericalm machine (a fanjo zapper) to use as instructed by the physio as she said my muscles are still really weak (which would go hand in hand with muscle avulsion ). I'm also not convinced I don't have something going on with the posterior wall (my bladder feels well supported when I need the bathroom, so concerned it's only my bladder that's supporting the back wall, but have no issues with opening my bowels) and my cervix can feel really low sometimes, so worried everything is falling apart. Hard to know what's normal for this stage postpartum as DD is my first so have nothing to compare it to. Have actually ended up almost being admitted to hospital as I've just completely lost the plot and have severe PND now, and can't really see a future feeling like this.

My physio is fitting a pessary next time I see her- anyone have one of these?

[Fauxgina]

smells so glad you're enjoying that new baby. You sound like you're being really practical about your recovery too. This thread never seems to show up in my "Threads I'm On" in spite of posting on it repeatedly! Very annoying.

I have an update at last though! Hoorah! A repair for all of my prolapses next month, womb out, posterior repair and perineum repair. They will decided on whether to secure the ligaments and do an anterior repair during the operation. I'm nervous but so pleased at last I will have some "action".

[smellsofelderberries]

Sticking, have you had your gorgeous baby yet? I hope you're having lots of lovely newborn snuggles and recovering well from your c-section. How are you feeling? Do you mind me asking, why did you think you had a uterine prolapse after your first pregnancy?

Lamby, how are you getting on? Are you feeling like the physio is helping?

Katharine, good on you for getting your name down. That must be a scary prospect but hopefully with all the physio you have great knowledge of how to make yourself strong pre-surgery, and how to recovery from surgery and protect the repairs for a long, long time to come. I hope you have had some improvement on your leaking!

[smellsofelderberries]

Katharine, sorry, only just seen this reply! I'm feeling pretty okay from the PPH aside of things, and still a little up and down about my undercarriage. I have seen an improvement with physio and at my specialist appointment in early Jan my OBGYN said she doesn't think I have a true prolapse, more just overstretched muscles and that, with time, things should go back to a decent level. I am going to give it another few months of diligent exercises and if things still don't feel great I might ask for a referral to a urogynacologist. There is one where I live who has done a lot of very interesting research into how vaginal delivery impacts the pelvic floor, so I might look at seeing him if possible. We'll see, but the small improvement I've felt already is giving me hope. Things have felt a little worse again over the past few days but I had a big week last week and probably overdid things, so planning a quiet week this week.
I am still going to have a review at the hospital to go over my labour notes. I still don't think my pushing stage was managed correctly, but from my pelvic ultrasound, structurally there is no huge damage and my levator ani ligaments are still attached, which is the huge thing. I will find it helpful to know how future labours will be managed though, and have a few other questions answered.
I'm kind of at a point where things aren't too uncomfortable and I know what will make me feel worse (lots of hill walking, generally spending too long on my feet). I also plan my weeks a lot better now (last week not withstanding!). I only do one chore a day (e.g. today it was doing the groceries, tomorrow I have ironing to do) and if I put on a load of washing I will only carry half a load out to the line at a time, or I ask my husband to carry it/hang it out for me.
Lastly, before this turns into an actual novel, I am really, really enjoying my daughter. She's an absolute dream and we have a lot of fun together, which really takes my mind off it. It was hard to see the light when things first started going wrong as she wasn't really at the stage of interaction yet, but now she's so chatty and sweet and it really helps put things in perspective.

[KatharineClover]

Oh my goodness smellsofelderberries, you poor thing! I also had a PPH with my first son and it completely knocked me for six. How are you feeling now? Have you had a chance to chat with your GP or HV about how you feel? I totally get the feelings of denial and wishing things were different wth my body - I have only just made the decision to put my name down on the waiting list now for my prolapse and perineum repair, and it has taken months and months of ignoring it and just wishing I didn't have it. I hope seeing the women's health physio has helped you? I found out I was doing pelvic floor exercises entirely wrong (fear of leaking meant they were held in a tight position and not relaxed at all, so the exercises weren't effective until I learnt to properly relax them first). After 2 sessions the improvement was massive for me, so I hope you have found improvement with your circumstances too x