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.

Hi everyone - I hope you don't mind me joining you. I've got a cystocele, rectocele, and some degree of uterine prolapse after the births of my first child in 2012 and then twins in 2014. (I'm 36). My symptoms aren't too bad, except for when I go running. Then I'm completely incontinent with urine; and occasionally faecally incontinent too. My perineum really hurts after each run, and it definitely feels like everything is bulging southwards. Other than when I'm running, the rectocele is a bit of pain - I have to 'digitate' (in my consultant's words) every time I poo - and I can't stand up for longer than 15 mins or so, without my perineum hurting. And I pass a bit of urine when I sneeze, laugh etc - and trampolining is definitely a no-go! I have no idea whether symptoms like these just tend to stay the same over time, or tend to get worse? I was first referred to a women's health physio, but the pelvic floor exercises didn't help my symptoms much. I've been referred to a gynae, and have had various urodynamic and anal-rectal tests; I'm going to have a proctogram in the next month or so. My gynaecologist isn't recommending surgery, as he's worried that, if the effects only last for 10-15 years, then I'll end up needing the surgery again in my early 50s, and then there'll be a smaller likelihood of it working the second time. He fitted a ring pessary yesterday, which so far seems OK - it hasn't fallen out yet, anyway. And I'll go for a run later, to 'test' it! I guess my question is whether anyone has had long-term success with managing their symptoms just using a pessary? Or whether it tends to be a bit of an inadequate solution. Thanks all!

I had my urodynamics tests yesterday. I was nervous but it was fine. Of course it was a little undignified but at no point painful or even uncomfortable. I was particularly worried about having a tube up my rear end and told the nurse so. She asked if I'd ever had a pessary which I had and honestly it was no worse than that. I hope anyone else who has to have this doesn't get too worried as I think I'd worried unnecessarily. It does look as if I'm hysterectomy bound though. One step at a time though. Waiting to hear official outcome from my Doctor now.

Hi Mabel, that sounds like a tough situation. I am due for a pessary fitting in a fortnight. I'm 45 and have also been told to hold off on surgery for the same reasons as you. I have however been told not to run at all. I'm a member of a Facebook support group: Assn Pelvic Organ Prolapse Support which is also helpful, and there are a number of women who post on there who have successfully managed their prolapses with pessaries for quite some time. How are you finding things with your pessary?

chatnanny, well done on surviving the urodynamics. A friend of mine had it done and she found it vv embarrassing... Good to hear its not that bad. How did you get on with a pessary if you don't mind me asking?

The nurse talked me through everything and said when she was going to put it in. It just felt slightly cold and only took a second. The tube I didn't feel going in at all. When I sat on the special loo which looks normal but has no flush and measures the output they waited outside. The second time after they'd refilled my bladder through the catheter (felt a bit cold nothing more) the pessary fell into the pan so it wasn't a problem to remove it. The whole thing was nothing to fear. If you've had babies it wasn't even embarrassing but maybe I was lucky with the two members of staff who were very nice and informative.

Actually the pessary is great so far! I'd read so many disappointed posts about them that I wasn't expecting much. But it seems to fit well. I don't notice its presence at all, and I went to a drinks party last night and could stand for the whole evening without any pain or downward bulging (previously I couldn't stand for longer than 15 mins)! I've been on 2 shortish runs....and no leaking! And no leaking when I sneeze etc. I really don't want surgery at the moment - I have 3 very small children and couldn't manage the recovery time or the prohibition on lifting, not to mention not being able to run. So I'm cautiously optimistic that the pessary might be a medium-term solution, but I'll have to see how it goes. I haven't tried sex with it in yet :-/

Hi all hope you don't mind me asking but I'm after a translation of a medical letter and bits on it that weren't mentioned in the consultation!

I was told all was OK. Letter says I have a cystocele which is -2 on the popq score. I've Googled and can't find an explanation, can anyone help me please?

Thanks

Play, I think that means a grade 2 cystocele, ie prolapse is internal but can be visible/close to entrance of vagina.

Check out Assn Pelvic Organ Prolapse Support, pretty sure they have proper explanation.

Thanks colouring I think I've found the answers and think it's a stage 3 or 4 prolapse based on these scales

That took far more Googling than I anticipated he's put me on medication and referred me for physio. I've had physio before and it did nothing so I'm not exactly optimistic! Back in 6 months though.

ptug.pl/wp-content/uploads/2014/09/POP-Q_Reference_Ethicon.pdf

I found this really helpful to understand extent of my own prolapse.

Hello
Mind if I join? I did start a thread on general health but I think this is the place to be.
I had ds2 just over 6 weeks ago. I asked for a c section as i had one previously, baby was back to back and I told the consultant that I thought I had a prolapse. He didn't examine me and said go for vbac and we would sort the prolapse our after. I ended up with a forceps delivery after prolonged pushing. Both of which he said wouldn't be allowed but it seems that the obstetrician on duty thought it fine. About 2 to 3 weeks later i felt a pain in pelvic area and when I had a dig around in have bulges on the front and back internally though nothing protuding yet. I can't get over how angry and bitter in feel. At myself for not pushing for a c section and at the consultant for not explaining what a fix would involve.
I am crying all day every day, don't want to go out. I feel like a failure and just don't know how to lift myself out of it. It is on.my mind all the time. I have booked a counselling session for tomorrow and off to doc tomorrow to discuss getting some anti depressants. He knows in have pnd. I have been referred to the gyne at hospital that specific vaginal reconstruction so hoping he can help though he is the same person who was so base about me having it in the first place.

DH is as ever amazing and supportive. We havent dtd yet and not sure if I can with these bulges - any advice? Not that I feel like it as I feel like a freak but would be good to know.

Sorry I do have 1 other question. Would I be eligible for surgery if I am not experiencing issues with bowel movements and am urinating fine?

I may not be the best person to reply as I think it may have been me that suggested this thread but hopefully someone more at the same stage/age will reply soon. I didn't want you to fret.
If surgery is required for bladder and/or uterus prolapse you don't need to have bowel problems too. If you have no incontinence with urination that's a good sign. I had a small bulge after my last delivery which disappeared with exercise and has now re-occurred many years later. Re DTD - ask about this tomorrow.
I worry that you're crying all the time and am glad you're thinking of PND as a possibility. You're post natal, lots can correct itself and there's a lot can be done if not so don't panic.

Thanks chatnanny. I have had an ok day today as have been busy but about half an hour ago had a wobble thinking ' oh god what if they won't do anything about it?' . I honestly just want to turn back the clock and push for the c section. Stupid I know. I am just so angry and want answers from the hospital as to why I was allowed to push for so long and given forceps when my notes clearly said I was not to. I think at the moment I just need to blame someone. I haven't bonded with my poor DS. I even think that I would have preferred not to have had another child sometimes. Don't get me wrong I love him and wouldn't be without him now but if I knew then what I know now, there is no way I would do it again!

Hello ladies
I am suffering today with pain from my rectocele and back - nothing is touching it, any recommendations and what works best?

Btw sex does not had to be a problem. On a previous thread it was described as the flap ply bit of skin under your tongue.
My boyfriend has only ever know me with it and has no complaints lol

Hi everyone, this slipped off my Threads I'm On so I've only just found it. I feel for you Lamby, I feel like a lot of the obs people don't see the psychological impact it has on your wellbeing when they give their advice. I'm 7 months pregnant with a uterine prolapse. I keep being told that things will probably spring back up afterwards but my understanding is that the baby is keeping things up right now and once gravity has a chance it will all be hanging out. I was also crying a lot a few weeks ago as I felt 'changed' and the pressure I feel as well as the stress incontinence are constant reminders of that 'change'.

I spoke to my mum and she said 'it is what it is' and although that sounds really crap it actually helped me to minimise the issue.

If you're at home with a newborn right now I suggest you get out and about to as many mum and baby groups. Sitting at home made me so much worse, and in fact work days are my best as I have a desk job and am totally distracted but sitting.

Im having a crap day today. Have a cold after having already had a cough for about a month. Had a load of injections today which have left my arm tender. Lots of housework to be done and feeling guilty that my DD is having such a boring day while I wallow.

Hi,
I was diagnosed a year ago with a rectocele grade 2 and perineal deficiency. Women's health physio has reduced to almost zero any urinary incontinence, but I am still affected by the rectocele (sometimes difficulty pooing, and need to push from inside). The perineal deficiency means reduced sensation which is depressing, as in some positions I cannot feel a thing :(
I have been recently offered a repair of the rectocele and perineum (from inside, not with mesh). I was a bit shocked in the appointment (I nearly fainted in the waiting room before hand) and so didn't ask many questions. The consultant left it that I would call his secretary when ready for the op. I am nearly 38, 2 kids aged 5 and 2.

Has anyone else had this op done, and if so could you tell me about it please? I see from previous threads people talking about some ops needing to be re-done in 10-15 years - is this the kind of op that needs to be re-done? I can keep going as things are, but ideally I would like the perineum repaired at least, as it does affect my confidence and how I feel about sex, however I don't want to risk making things worse. :(
Many thanks,

Hi Katharine

I had a tvt put in and a posterior repair i.e. Rectocele repair, three weeks ago. So a bit different to you but the rectocele is the same. My Problems were caused by five babies, the last with forceps.
I am really glad I had it done. My consultant thinks it's worthwhile and so do i. If I can go back to pre- baby anatomy and lack of symptoms, why wouldn't I.
Maybe in the future something will need re-doing- it's not something my consultant's talked about - but if I've got 10-15 years "out of it" I think it's worth it.
The recovery has been fine. Uncomfortable and you have to take it easy for a few weeks, but nothing awful!
Obviously it's up to you but I'm so happy I had mine done.

Hi Kitty,
Thanks so much for your reply, that is really helpful. I've done a lot of thinking about it lately, and I am almost sure I want to go ahead. I still have SPD pain, now I wonder if some of the pain I think of as spd is actually prolapse related, and so the op may help to stabilise things I guess, potentially another reason to go for it.
My first baby was 8lb 11 and my second was 10lb, both with fast labours. It was my second baby (plus stitching job by midwife who didn't seem to know what to stitch to where from the conversation she was having with a colleague) that caused my issues.
Can I ask how long you were in hospital for, and how long until you could drive /work? And how long you had to wait for surgery if in the uk? I have to carry quite a lot of things for my job working in different venues, and move tables and chairs too, so it may a while before I can get back to full duties?
Thank you xx

Hi Katharine

Luckily for me I have private health insurance so once I'd decided to go ahead (with the same surgeon I would have had on NHS- but no wait times) I could just book it in on 2 weeks notice. I'd seen him on NHS and then dithered about going ahead, especially as I was still breastfeeding my youngest, so from him saying op was appropriate to me going ahead with it was about 8 months, but I appreciate that's not very helpful to get an idea of NHS waiting times.

I was in hospital for two nights. First wasn't the nicest with catheter in & inflating things on my legs but second night more comfortable although then I was constipated and that was a bit stressful. Take stool softeners before the op! I didn't and regretted it.

I don't work I "just" look after six kids. All but the youngest are at school/nursery and I had a lot of help for the first two weeks but still had to put on washing etc at the weekend and the surgeon didn't ban me from anything just said be "guided by the pain"! It was more of an ache if I did too much. I drove after two weeks. It's now been 3 weeks and two days and I feel pretty normal and am certainly doing all normal things, no heavy lifting but must admit have picked up my crying toddler for hugs a few times as he's poorly. But I try to go to sit down and let him climb on me.

I don't think you should be carrying things of much weight sooner than 6 weeks post op, but if you can adjust your job so you don't have to do that part then 3-4 weeks off may be enough- but everyone is different and you may disagree when it's you. Personally I found post-baby stitches more painful and traumatic than this has been. At least you aren't handed a newborn at the same time, like you are with birth!!
With this op the stitches closer to the surface are meant to have dissolved by six weeks but The deeper ones take three months apparently.
Good luck , I hope once you've decided you don't have to wait too long!
Kxx

Thank you so much Kitty, that is really helpful. I'm glad your recovery is going well. I really think I am going to go for it, but the final bit of courage I need to call the consultant's secretary is eluding me at the minute. I think I need to set myself a deadline to call by and just bite the bullet!

Hello all, checking in for the first time if that's okay. I'm just over 5 weeks postpartum with my first baby and have discovered this week that I have a bladder prolapse. I'm so angry- I had a straight forward labour with just over an hour of pushing, drug free water birth with no interventions and only a 1st degree internal tear (massive PPH with retained placenta but that's another story). My DD was only 3.3kgs at birth so not very big. I am fit and healthy and was super active throughout pregnancy- walking a few miles a day and doing my pelvic floor exercises throughout. I haven't had an office diagnosis yet but I suspect it's a stage 2/moderate prolapse as I can see and feel the bluge right at the entrance to my vagina. The good news is that I am seeing a women's physio on Thursday, only saw the GP on Friday, so I'm pleased I am getting the help so quickly. I vacillate wildly between sobbing hysterically and wishing I had never had my daughter, which I feel horrific for even thinking, being SO SO angry that my midwife was directing my pushing and telling me to push when my contractions had finished, and that she didn't see my contractions had slowed and weakened when I got in the bath and suggest some different positions to help, and then sometimes feeling optimistic that I might be able to really improve my prolapse and have some sort of recovery. But everywhere I read talks about prolapse management, not recovery, and then I feel utterly shit again. I remember feeling like I was tearing up the front when she was crowning and was shocked when they said I only had a first degree, and now I'm wondering if it was all my muscles tearing inside that I was feeling. Probably
Right now I'm struggling to care for my little one. We also both have thrush so breastfeeding is painful. I suspect I did more damage over the past few weeks with terrible posture, carrying way too much and too much activity. We were hoping to have another 2 children in quick succession but that looks like it's probably out the window now, if I can ever bring myself to want to get pregnant again as I am now terrified of labour (c-section also v scary).

I feel so utterly broken and useless. My little one has started being really fussy and I can't help but think it's because I'm crying all the time. I'm scared to do anything in case I make my prolapse worse. I can't really see a way forward right now and just keep wishing I'd never had her

God, that last bit makes me sound like a terrible, terrible person. I love my girl so so much, I guess I just wish I'd been much more informed of the potential risks of certain labour positions, midwife led pushing and how damaging certain posture can be post-natally. I feel quite let down in that regard by my healthcare providers. I just hope I can be the sort of Mum I always thought I'd be to her, feeling pretty lousy at the thought of not being able to run around with her at the park and like I'm letting her down so much by being so upset by this

Smellsof, the only the I can say is it gets better. I was in the same situation as you a couple of months ago when I had my son via a forceps delivery. Horrified, tearful, angry and bitter are feelings I had every day, every hour even. I was tearful all the time and it was on my mind all day every day. Like you I also wished I could turn back time and not had another child. I posted on here and everyone was so supportive. I realised I needed to talk to someone about the constant tears so took myself to the gp just before my 6 week check. I asked to be referred to a gyne and for advice on feeling low. As my tears were due to the prolapse we agreed that I wouldn't get any medication until after my appointment as it may turn out my prolapse was not as severe as I was imagining. My appointment is next week. In the meantime, I booked to see a counseller and this worked well for me, I sat and cried through the first session and the few I have had since then have been just chatting. I realised recently that I have been thinking about it less and less and not obsessively looking in a mirror to remind myself of it and hoping that it has magically disappeared. I downloaded an app to remind me to do pelvic floor exercises and it helps knowing I am helping things along. My other thoughts used to run into thinking I would never feel like sex again, never feel attractive etc and that sex would be painful. I finally managed to pluck up the courage to dtd this week and didn't fund it painful. A little stingy but that could be the cut they made. On the other hand, I didnt have a lot of sensation though i will take that over pain any day.
I hope this helps. Feel free to ask any questions, I will keep an eye on this thread.
Btw, I have since found out that this is very common even in women that have so called straightforward births. I had a c section with my first so this was all new to me.