Surgery to repair prolapse?

[Reggiee]

Does anyone have experience of surgery to repair a prolapse?

I have been having physio for over 6 months (ds almost a year), and have been asked to go away and think about what I want to do next. Choices given to me were: live with the prolapse; have a pessary inserted (this was not recommended to me due to my age and lifestyle); or surgery.

My prolapse was severe (front wall of vagina, but thankfully caused no incontinence), and physio has helped a bit.

I asked questions about surgery (what it involved; risks; success rate; how long in hospital; recovery time etc) but physio couldn't really answer them.

I have six weeks before my final trip to physio when I will have to say what I want to do.

Any advice gratefully received!

There is a thread on this forum for cystocele and rectocele repairs, work back a few pages and you will find it.

There are lots of ladies on there who will offer loads of first hand experience.

HTH
I am in the same position as you in terms of deciding about an op.....I have a few months before I need to decide but I will be interested in the response you get!

Muriel xx

Thanks Muriel.
I'll head over and repost there.

I have had my prolapse for 8 years and it is a very serious grade 3 one. It protrudes out of the vagina when not managed. I have 2 ring pessaries in situ. Can I ask why they suggest a pessary is not right for you?

I was 26 and 9 stone when I had it, my job involves a lot of lifting which is the main reason for me not having it repaired.

I have had 2 further children since my prolapse and kept my pessaries in throughout pregnancy and my 2 c sections.

I have a normal sex life with the ring pessary in situ and even use a mooncup.

My prolapse was too severe for physio to make any difference. I am incontinent too and see a urogynacologist (is that the right name?) 6 monthly.

i had the op 19 years ago, after DC2. my prolapse was mild, but I felt uncomfortable.

I think you should have it done- but make sure you get a good surgeon.

If it can be fixed, why wait?

Interesting Suwoo. My physio said that pessaries are for the more mature ladies who don't have sex! It doesn't sound like you fit into that category

Thanks purple.

Not sure that your physio knows her arse from her elbow (or her fanny) then

There are many different types of pessary here are some examples. Mine is a circular hollow one, just like a bangle- middle left. I have 2 different sizes, the smaller being 5mm smaller than the first and wear them simultaneously. I don't have to take them out and they are changed every 6 months.

I willnot 'bother' having the repair, possibly until I am much, much older and then possibly have a hysterectomy, as has been mentioned/suggested by my consultant.

I am lucky enough to be treated by this consultant on the NHS.

I was told that rings/pessaries etc are for older women who have heart problems etc etc and who cannot have a general anaesthetic. I certainly would not want one if there were other options.

Hysterectomy is not always the answer/alternative to a repair as you can get vaginal vault prolapse afterwards if the op has not been done well.

Yeah I knew that purple, that was explained to me.

I hope I have made you both aware that the misconception that pessaries are for older women is indeed that.... a misconception.

The two pessaries control it so well, I don't even know it is there. The surgery is not an option for me at the moment, but may well be so in 4 years time when I begin my career change.

Hi all - I have uterus prolapse of second to third degree, only recently diagnosed. I'm young, slim and my baby was average weight. Still I got uterus prolapse courtesy of the NHS, that will go to great lengths not to do a Cesarean, not matter for how long you are in labour. Anyway, I've been reading your posts, and thought I'd share what I've learnt over the last 6 weeks, as I did quite a bit of Internet searching and consulted a number of especialists both in person and by e-mail.

There are 4 types of prolapse: uterus, vaginal, bladder and rectum. They can happen alone or combined, and there are different degrees.

All I can talk about is uterus prolapse, which is what concerns me.

First, removing the uterus is not a good option at any age - when the uterus is removed the whole geometry changes and you are very likely to get bladder, vaginal or rectal prolapse, or a combination of those.

Second, there are two types of repair operation, one with mesh and one without mesh. The one with mesh tends to be more successful, but it is not widely available.

Now,this is the very important bit: the repair operation is best to have it done AFTER one has finished having children. There are very few cases around the world of women who had the repair with mesh and went on to have children. It CAN happen in theory, but because the operation is relatively new and uterus prolapse usually happens after the menopause (unless you are in the UK and give birth vaginally under the care of our lovely NHS) there are not many women who have had the operation and had babies afterwards.

It is not impossible though, and you can actually have a mesh repair and have a baby afterwards, as long as it is with a cesarean - after the repair the cervix cannot dilate and a baby can only be born with a planned cesarean.

I have been using a pessary for a few weeks now. It's ok, I would prefer to have my uterus in its place rather than down in my vagina being held by a ring though. However, as I want to have more babies I have decided to wait for the repair operation.

Also, recovery time is around 3 months and you can't lift anything heavier than 3 kg. My baby is 17 pounds now and I would not want not to be able to lift her.

You can remove the ring to have sex or have sex with the ring. I don't enjoy sex these days anyway - but I don't know if it's because of my prolapse or my inflamed episiotomy (which has not healed yet) or the thrush I also have :-)

Hope this helps.

hi suwoo, please could you expand on your pregnancies with prolapse?

why did you have c-sections? if it was so damaged there was probably no more damage to be made... (?)

very interested in your story

Hi, reading this thread with interest

I had my third repair op six months ago, anterior repair, rectocele, enterocele, perinium rebuild and tvt tape. My bladder prolapse is a bit better but still incontinent :(

Although I am sooo relieved I have experienced none of the horror stories experienced by some having tvt, I really wish it had worked.

Prior to this I had a uterine resuspension or laparascopic sacrohysteropexy.

Just seen a lovely obstetrician who said it should be fine to have another baby, as long as by c-section. Trying to weigh it all up and decide as last four years and three ops, have been rather traumatic.

Has anyone had a baby after similar repairs?

Many thanks

Clea

I have had a cystocele, rectocele and burch bladder resuspension. And then had another baby, although by elective c-section. After the prolapse surgery, it kind of cleared the way for the uterus to prolapse, hard to explain, and my cervix is extremely elongated and it is this which prolapses. Yuk. I hate it but will not have any more surgery. I prolapsed again after my 2nd child particularly cystocele, but am determined to live with it. And it is stable. I exercise, though avoid running, and going on the trampoline! I wish I had not had the first surgery. I am now in the US and there re many lawsuits regarding surgery with mesh. be very careful. There obviously are good results out there but there are also dreadful stories of erosion and rejection and massive damage. It has taken me a lot of years to get over what happened to me during my first delivery and the damage I ended up with and come to terms with it and part of that recovery has been being able to live with how I am now.

wow, itshotintexas

Thank you for your reply, people who've had a second baby after big repairs seem to be quite thin on the ground.

A lovely lady on here also warned me of the dangers of mesh, I am soo grateful as to be going through that on top of everything else would be awful.

So pleased for you that you had a second baby but sorry that you regret your surgeon.

I know that I have a long journey in coming to terms with the damage that was done during my son's birth. Just don't know if I am brave enough to try for a second even by ELCS, although I would love a second baby...

Good luck with everyrthing.

daisyji, you have had an enormous amount of repairs done and that takes a massive amount of time to recover from, both physically and emotionally - I found that unless I have the physical repair, I was not able to get over what had happened to me, my body, and the damage it caused both physically, and mentally. And the damage to the relationships I had with my son and my husband. The effects were far reaching.

But as time went by, after my repair and I had to come to terms with the fact that essentially I was actually worse off. I had IVF to have another baby, it was too painful to do it enough to get pregnant. And there is a 4 yr gap - thats how long it took to recover enough. And I had a G3 cystocele, rectocele, enterocele and uterine prolapse which i still have.

I had the most fabulous birth, I bonded with him the second I saw him and I couldn't put him down once i had him in my arms. And my section recovery was nothing short of amazing compared to the first time around. That baby is now 9 and the oldest is 13.

It would have been the biggest regret of my life, not having another baby. But having the surgery at the time, was the right thing to do, hindsight now tells me, that I could have lived with the level of prolapse I had before surgery, but I was so fragile and felt so damaged, that surgery felt like the only option. My boys are my absolute joy.

I hope you can fulfill your dreams...

Texas x

That's sooo lovely to hear Texas, that your boys are so precious to you and that the c-section went so well.

I feel like I'm having a constant battle in my head as logically I think it's risky to consider another baby which might undo my repairs. And I'm now 36, so need to decide soonish...

Yet I soooo want another baby, but feel I should just be v. gratefull (which I am) for my beautiful four year old son and not push things by trying again as it was all so horrific first time round birth wise. Which is all a bit paranoid, but hey that's PTSD for you!

How have you recovered from feeling fragile and being left so damaged from first time round?

Bestest wishes

daisyji x

I had an anterior repair in May 11 and I have to say I am very pleased with the results. My bladder was prolapsing so badly it was protuding and I had to keep pushing it back up. Now it's so much better and I am so pleased I had surgery.

I had a cystocele and rectocele repair 8 weeks ago. It is painful surgery, I had surgery on a Tuesday and came home on the Friday. The first 2-3 weeks I was on a constant regime of painkillers and for 6 weeks you need to avoid lifting anything, so it is inconvenient with young children. At 8 weeks I still have a few stitches which haven't dissolved and am still a bit sore but am very happy with the results so far. Please, please do your research with regard mesh. I saw a private gynae who told me he is spending a large proportion of his time reversing mesh repairs carried out by other consultants which have caused huge problems with erosion. It is a relatively new procedure and they simply don't know how they will hold up after 20 years. My surgeon says there are some cases where the risks outweigh the benefits, for example if a woman has had a number of repairs which have failed, but he never uses mesh for a first time repair. In terms of success rates, I was told there was a 20% chance of it recurring.

Hi ladies

Sad to say I've just joined the prolapse party after having my first baby at 38.

V emotionally traumatised by this on top of hard pregnancy and difficult ventouse delivery of a prem baby.

I'm seeing Mr Khullar privately soon. Has anyone here met him or been treated by him? What were your experiences?

I'm hoping he will agree to operate but support me to keep my womb (and possibly have another baby)... And scared he won't.

I want the op because I have allergies and expect my body will reject the pessary and creams. And I can't live my life this way.

Also anyone who has had the surgery, what is the soonest your surgeon was willing to operate after childbirth? x

I had surgery to repair prolapse with transvaginal/pelvic mesh in 2010. It was the worst decision of my life. I was a healthy, fit 40 year old mom of 4 children. And after the mesh surgery, I am now a disabled woman who lives in constant pelvic pain, can't sit, can't have relations with hubby, have to live on pain meds. Please consider a pessary, physiotherapy, or if you need surgery, a repair using your own tissue (they call this Burch procedure). I wish I had known that 10-15% of polypropylene mesh prolapse repairs end in EROSION which is basically the plastic cutting/wearing through your nerves and tissue. It is excruciating. There are several support groups on facebook for women who are considering mesh surgery, or having problems from one. The best one is called Women's POP/SUI TvMesh Complications Support. Also, there are many websites and blogs that explain mesh complications. Here is my favorite article, a must-read for anyone considering this surgery! meshmenot.wordpress.com/top-10-things-to-know-about-mesh-before-surgery-for-pop-sui/

Janet

My friend has this surgery coming up and reading for her

Sheesh I am just so sorry to read this

Must say the general takeaway seems to be avoid mesh and wait a while if you can

Good luck to all

How long is the recovery time ?

Hi All
I had a hysteropexy last July plus rectocele and cystocele. Operation went well they said but it take SO long to recover. 9 months on and better but still constantly changing patterns. I think my prolapse has returned but as I was warned next step is hysterectomy, I'm not rushing back. I want to keep my bits as I've read they help whole pelvic structure and they happen to be functioning ok apart from descent. Re Movicol - I found it way too strong and have resorted to soft dried prunes every night - I can control my 'dose' and they have the same effect and process as Movicol. 5 prunes is normal, 7/8 if I've let things get bunged up! Since starting this regime everything is much more predictable and my insides have tightened up...result!
Thought I'd share as it's a very simple remedy.

I have been diagnosed with Grade 2 uterine prolapse have been told to see physio to improve pelvic floor before anyone will do anything I am extremely worried it will start to protrude the longer it's left did anyone else have physio before repair ? Would be interested to know

Hi, this is my first post & would dearly love some advice plz.
Currently under a Gynaecologist following a MRI which suggested Endometriosis, Adenomyosis, Fibroids - yep Im greedy!
Had a pelvic exam, Gynaecologist suggests I have a Cystocele.
I have requested another scan as the previous one was mainly for my lumbar spine as I have severe back pain. My gynaecologist wants me to have a laparoscopy to determine the Endo/Adenomyosis on the first occasion, she will also perform biopsy. Then suggests a total hysterectomy on another occasion.
Is it necessary to be put through two Ops & two lots of general anaesthetic? Also how will they perform the Op - as I’ve read Cystocele is done vaginally - but she’s also doing a total hysterectomy too?? Sorry for long post. 😕