Opting out of vaginal repair surgery

[TutuB]

Ladies, I wonder if any of you have backed down from vaginal repair surgery? I have a Grade 2 rectocele (and cystocele) but the latter isn't bothering me and the consultant has recommended an operation to repair it. However, I've been reading some horror stories on this topic and I'm seriously re-considering having the surgery and just living with my symptoms. Is there is a non-surgical solution out there I wonder? Any replies from ladies who have perhaps had the operation and fared well afterwards would be much appreciated. Apparently, lots of women suffer from some form of prolapse after child birth but only a small number decide to seek medical intervention. Many thanks from one worried older but very healthy mum! TutuB

I had a full repair done and have not looked back. I was 34. The cystocele did not bother me either but the rectocele did! The R was smaller than the C. I think the C held the R in check. If I'd just had one done I think the other would have had room to grow iyswim.

No mesh for the repairs either. Just very strong stiches. Recover was swift and I couldn't be happier. hth .

Me too, TiedUp . I couldn't really go on the way I was and not had the op.

The op itself went well, I was a bit uncomfortable for a few days afterwards and then had to take it easy for six weeks or so (I think?). However, after that, it's been great.

Love my "Designer Vagina"! Now in my 50s and can still star jump and trampoline. (no stealth boasting here!)

Depends how bearable your symptoms are.

Have a look at the POP group on Facebook.

Broadly options are:

Do nothing for now (except of course your pelvic floor exercise s NOT just kegels - see HabIt website)

Pessary/Sponge etc

Surgery

All options have pros and cons, but personally I would say that surgery should always be a last resort - it may well need to be repeated every decade or so, each time with less to work with. It is also surgery with all of the risks and recovery that entails.

Thank you ladies. Your replies have helped me. I'm still in two minds about having the surgery though. I'm having the pre-op check up on Thursday so time is of the essence but I'm tempted to put it off until I've considered my options further. Some posters here have had quite a bad time after surgery which doesn't always work apparently and could encourage collapse of other organs. I've looked at the non surgery websites and they consider the condition "nature's pessary". I'm very fit and go running and all sorts. I have no incontinence problems. I do sometimes have to "digitalise" in order to go to the loo but that's pretty much it. TutuB

I had it done 25 years ago, privately- Grade 1. I was told there was no urgency and I deliberated for some months before agreeing to have it done- but I did feel uncomfortable with a heavy feeling all the time.
I had a 2nd op a year later as his approach had been a bit conservative and there was still some vaginal 'slack' to take up.
I have had - touch wood- a good outcome. I did have to have help at home- DM and DH between them for 6 weeks because I had a DD aged 2 and a DS aged 4- so no heavy lifting or anything for at least 6 weeks.

The only problem I had after the op was needing a catheter for a week due to post-op swelling.

My advice is to only have it done by someone who really knows there stuff and is doing the op regularly- that was the advice of my GP who warned me not to go with one consultant as they didn't have much experience.

You ought to be very careful running- I was advised never to do any high impact sport and my attempts at jogging some years later resulted in a slight deterioration so I had to work very hard with pelvic floor exercises to get it all back again.

Other organs do not usually collapse unless you have a hysterectomy as the uterus gives some support to the walls.

I thoroughly recommend the website of Oz physio Michelle kenway- there is loads of info there about what exercises to do that will not affect prolapse.

Thank you so much for your responses. I think I will try the Habit dvd exercises and see what results they bring and if no change I may then opt for the op. Will also have a chat with my GP about it. I'll also have to rethink my fitness options. These older hips will probably thank me for not running haha! Thank you ?

I do sometimes have to "digitalise" in order to go to the loo

I wondered how I could describe this "nicely" and you have done so perfectly!

Haha I had to chuckle when I read your comment OllyBJolly - I only expressed it that way because that's how the consultant described it!! That's probably the medical term for it perhaps ....
Still pondering on which way to go. I could probably manage the symptoms now in my early 50s but I wonder how I'd cope in older age, and what if I were incapacitated? Oh decisions decisions ...TutuB

Watching with vested interest....

Ooh WineCowboy, are you going through the same thing? I wish there was a support group for this sort of thing. I've spent hours trawling the internet ...TutuB

I had both repairs 10 years ago, they have gradually regressed back to where they were prior to surgery.
But, I have a good sex life, no pain, and no bladder issues. I'm not prepared to risk any of that for a bit of a bulge, and statistically repeat surgery often doesn't have as favourable an outcome due to scar tissue from previous op.
I self referred to women's physio which was fantastic- I thought I was doing pelvic floor exercises effectively, but I wasn't working nearly hard enough!
Incidentally, even after surgery you have to be really carefully what you lift, so for me there are currently no advantages to having an op. DH isn't complaining either .

Hi piggychops, thank you for your post. I agree, no point risking another lot of surgery because of a bit of a bulge. And at the moment I don't have any bladder etc issues and have exercised throughout - I did three 10ks last year. An op may result in leakage and who knows what other issues. I'm not sure I want to risk that. And sex is the other thing - I'm separated but still living with husband though house is on the sales market - a long term partner/husband would look favourably on a prolapse but what about a new lover and can they feel the lump on entry - sorry TMI!! TutuB

OP I think you need to be clear in your own mind over what outcome you'd want. Presumably you asked for a consultation over your problems as they were bothering you in some way?
I was told that a rectocele was the easiest to repair. It's not true that having the operation might make other things descend- I don't know where you have read that. What can happen is vaginal vault prolapse after hysterectomy.

I had uterine prolapse- grade 1- a small cystocele and a small rectocele. It was the uterine prolapse that worried me the most, having had a grandmother who suffered a grade 3/ 4 in her 70s- I didn't want it to get that bad over time.

The slight rectocele didn't bother me but I was advised that by doing it at the same time it would give more support all round.

Now you have said you are early 50s it's worth bearing in mind the effects of the menopause. Loss of oestrogen will invariably make things worse over time. If you aren't already using local HRT ( vaginal) for dryness then it's worth thinking about it and some drs want women to use it before surgery to help the tissues heal and be more tones.

You also- sorry to sound bossy- need to stop running. I saw a physio after my attempt to jog and was told no jogging, star jumps, or anything that meant both feet were off the ground ( and then high impact as you landed) ever! I was also told never to lift anything over 1 stone - and I have my own limit of about 5-6 lbs just to be safe! It's a life-long management thing if you want to avoid it getting worse.

Only you can decide how bad it is now and any op is always a risk- I think those of us who had the op felt that there was no option- we decided to take the risk.

OP- just had some other thoughts which are: if your problems aren't actually a problem- which they don't seem to be if you can run 10K and not find them bothersome- then there is no point in having anything done, is there?
Before I had my ops, I found even walking brought on symptoms- a feeling of a marble at the 'entrance' and just a fullness that was not nice, as if things were about to fall out.
I wouldn't have even run for a bus let alone 10K!

All I'd say for you think about is- it may well get worse with age post meno, ops like this may be increasingly rationed on the NHS as it's a quality of life issue rather than life-threatening, and as you get older the risks from a GA will increase though that is not so much an issue nowadays.

Bless you pinkfrocks - that is so helpful! I've decided not to rush into surgery at this stage but to take further advice from my GP and also start doing the Hab It dvd. You are right: my symptoms are manageable and do not cause me distress. Stupidly I thought the op would just involve a "nip and tuck" and it's only now I realise the full extent of it. I have to digitalise occasionally when I go to the loo but that's pretty much it. By the way I've gone through the menopause already a few years ago and am not experiencing vaginal dryness or anything. Thank you so much pinkfrocks for your good advice! TutuB

I have a large rectocele which I have thus far refused surgery for. I've had it for about 10 years.

It is slowly worsening and I think in a few years I will have to get surgery but I am very concerned I actually will just be trading one set of problems ofr another.

At the moment I have to push in the rear vaginal wall to evacuate my bowels nearly every time and I either don't have the proper sensation I need to go but 'I know I do' Iyswim, or I get absolute urgency and loose bowels. I do get a bulge feeling sometimes as well. I'm concerned I will still have problems with my bowels and being only 40, I'm also concerned the surgery will need repeating. I've already had a vault repair post cervical cancer surgery which was successful but recovery wasn't fun and Im pretty phobic of hospitals since having the cancer surgery.

I'm a runner and not prepared to give it up which I know is not great for my pelvic floor. It's great for my mental health though so on I go. I get terrible urgency when running which I am sure is related to my rectocele.

I think it's a difficult decision for anyone OP. I was lucky enough to have private medical cover so knew that once I'd made the decision I could have the op within days more or less rather than join a waiting list of months or longer. I did wait for a few months after seeing the consultant before taking the plunge. I was always aware of it and tampons were a no-no as they were not comfortable.

From what I had learned there is only so much that physio can do. I had electrical stimulation via physio to try to tone the muscles as well as doing PF exercises for months. But if the ligaments have stretched which they had with me, the only cure was to shorten them and hitch the uterus up- as well as take out the slack all round.
Things are not as good as they were 25 years back when it was done but I doubt anyone would think it needed re-doing and it would be harder to have more surgery.

There are some research papers on the use of vaginal HRT for prolapse ( showing the benefits) and it's worth thinking about this - even if you don't think you have dryness ( unless you are having sex you may not even be aware of it ) or the deterioration of your pelvic tissues which can happen slowly years after menopause. One reason I use systemic and local HRT is to protect my pelvic floor from atrophy. A few things to think about!

There's a poster on here called Gussiegrips who has great advice, esp about exercise. Anything which increases intra-abdominal pressure is bad, so running, aerobics etc.
Swimming is good, yoga too I think, Pilates you have to do a lot of modifying esp on the abdominal stuff.
Pinkfrocks please can you post the links to the vaginal HRT research if you have them, as I have a docs appt on Fri about my impending menopause.

Here is the link to a really good support group on facebook - mentioned by a pp - you can ask anything, there are loads of lovely women all willing to help

www.facebook.com/groups/184143085606/

Piggy I 'm struggling to find the paper I read but here is a similar one. I think the one I read was a BMJ paper

www.bcmj.org/article/hrt-older-women-it-ever-too-late

see about half way down the above piece

www.nhsinform.co.uk/health-library/articles/p/prolapse-of-the-uterus/treatment/

here- look under the HRT and oestrogen heading, it talks about research that showed HRT reduced the need for surgery- that is the paper I found ages ago so there may be references at the end of this link- or you can google.

The message seems to be that systemic HRT may not have any effect but topical = vaginal oestrogen may.

Thank you.

I'm signed up for these newsletters and this came today- thought I'd share- loads of other good stuff on the site.

How to stop prolapse getting worse

www.pelvicexercises.com.au/prolapse-getting-worse/

You're a start pinkfrocks! Thank you again.