Prolapse shock

[Briansgirls]

Hello everyone,

I had a bit of a shilock today at the doctor's.
For a few weeks I've been experiencing a heavy feeling around my vagina , trouble urinating where I thing I've finished a wee and then I go to stand up and I then have another big wee.
In the shower last week whilst washing I felt a sizable mass protruding from my vagina , on closer inspection it looked like some kind of prolapse.
As we all do I consulted the internet and believed it to be a womb or bladder prolapse. I've been on HRT for a while now everol sequi plus I used the estriol cream which has helped with itching and dryness. I read that prolapses get graded 1-4 in severity , four being the most severe and in most cases requiring surgery.
Well you guessed it the doctor told me after a full speculum examination that I'm a four , factors like a traumatic forceps birth 8 years agoau have played a factor ,.lifting , exercise etc.
She talked about a pessary ring but it would require changing every six months and would likely be forever , I'm 48 years old so forever maybe quite a while.
We discussed surgery and in her opinion this would be a good option , I didn't think at the time to ask if this could include womb removal ,.my head is swimming with questions.
I wondered if anyone here has a pessary ring or has had the prolapse surgery or any kind of adviceom already medicated for depression and anxiety and I feel a bit shocked at this diagnosis when I just assumed I needed to work more on my pelvic floor with the women's specialist who I had seen before following a birth 8 years ago.

Sorry this is long wanted to spill it all out here.

My friend had a hysterectomy for a prolapse ( womb and bowel in her case ) , she was 41 but didn’t want anymore children , I don’t know what her grade was though

It's a horrible shock I'm sure.

I don't know if this helps but I had surgery 30 years ago in my late 30s for Stage 1 prolapse. It was a mix of bladder, uterus and slight rectocele. Everything was hitched back up.

I think with a stage 4 prolapse you would be looking at a hysterectomy but you need a consultation. if you do go ahead, do your own research. You can choose which hospital you go to, so look at the expertise of gynaecologists- some have more experience than others.

I had private insurance so was able to choose who did it. I had 2 consultations before deciding to go ahead.Recovery was fine but slow- no lifting for at least 6 weeks and I've had to adapt exercise etc since - for life.

Feel free to PM me if you want more info.

At your age I'd suggest you do have surgery as rings etc have some downsides and you're very young to have it forever.

Hi op, you don't say it it's bladder or uterine prolapse?

I have all three. Bowel, uterus and bladder.

My bowel was repaired surgically two years ago, which failed almost immediately. But things are slightly better due to the refashioned perineal support.

Bladder gets worse depending on cycle and if I've been standing all day. Uterus isn't terrible but I can feel my cervix when I put my oestrogen cream in with my finger.

I did try a pessary ring for a year. Mine was silicone and designed to come in and out. I took it out to have bowel movement (or it got stuck and was excruciating) and took it out for sex. Very easy to take in and out. I did like the support it gave me and if I was going out hiking it was additional help.

I'm now at a stage where I have a normal big wee, wipe and stand up then sit down and another trickle comes out and I'm safe for a walk. If I don't, I leak if my stride is too wide.

I stopped doing kegels as I hate them and I hate that squeezy app more than anything. I've lifted weights since my early 30s and pelvic physio took me through correct breathing to avoid pressure on pelvis. Gynae said I should definitely go back to weights after the surgery recovery period.

In the old days women were told not to lift anything, now I spend a lot of time strengthening inner thighs which supports pelvic girdle, ensuring hips are mobile and strong, all of which helps strengthen the area.

It is grim frankly. But I will say that after a few years of being upset about mine and surgery etc. The testosterone part of HRT means my libido is very high and I'm back to normal in that area. 😊

Also, I would caution you against joining the Facebook groups for this. Never has anything caused me more anxiety than those groups.

A lot of the women in them were given instructions on how to behave with prolapse/post repair, by the NHS years ago.

Times have changed and my private gynaes (I actually had two as had to change between surgeries) were experts in their field and their advice is much more up to date.

Do not go down a Google rabbit hole.

Happy to recommend an outstanding private uro-gynae in the south if you want.

It's interesting what you say about exercise @Doodledoggle .
I was one of those told not to lift weights at the time and also by a private physio some years later.
What exactly do you do for inner thigh strengthening?
I do side leg lifts anyway for hip strengthening and inner thighs ditto with ankle weights.

Hi @JinglingSpringbells

There are a lot of prolapse workouts out there now on youtube, which don't put pressure on the abdominal area, but strengthen. Dr Bri is one of the most famous, though I don't do them because slow workouts drive me crackers! But she is good and there's a ton of content.

Off the top of my head, using a yoga block, go into table top, then onto your toes (in bear plank position) and with a yoga block/pilates ball between your knees, lift your knees off the floor. I repeat for 40 secs.

Similarly a bridge with the yoga block or pilates ball, squeeze it between your knees as you lift up into bridge repeat. These work the inner thighs, core and glutes.

I should stress that my repair failed because of my connective tissue disorder, not because I went back to exercise!

But I was damned if at 46 (which is the age I was when I had surgery) I was told never to lift a bag of compost or a kettlebell, or push a full wheelbarrow or do jump squats etc

The instruction leaflet that was on the FB prolapse site said things like 'if you do a job with lifting, you should consider another career'!! And women were constantly urged to 'be careful'.

My leaflet which was from the RCOG was very much - after 6 weeks, do what keeps you healthy and feels good. (paraphrasing!)

I've cracked on and I am very happy now.

Similarly a bridge with the yoga block or pilates ball, squeeze it between your knees as you lift up into bridge repeat. These work the inner thighs, core and glutes.

Ah, that's reassuring as I'm doing these anyway! Try to do 10 x 3 sets.

I only lift weights seated otherwise I can feel my pelvic floor descend, although I am doing PFE daily.

It's grim really. No one told me this could happen if I couldn't squeeze my babies out properly and needed forceps! I'd had my prolapses for 14yrs and it was only meno that made them so much worse, GP diagnosed and then I procrastinated about doing anything for 18 months.

Glad you are already doing those exercises. I'm not as diligent as you but do make a lot more effort than I did before.

@Briansgirls people will recommend kegels. My pelvic physio said that kegels won't make the blindest bit of difference to anything over a grade 2.

@Doodledoggle hey thanks for the advice I just feel a bit shocked today and trying to get a handle on how I feel about surgery ,.I mean I don't want to go and have the ring fitted every 6 months or so and forever !!
She said it's a uterine and bladder prolapse
@JinglingSpringbells I didn't ask many questions as I just couldn't find words but my research this afternoon suggests I could have my womb removed through my vagina and leave the ovaries and tubes as they are , I didn't even know this was possible !!
The doctor did say that I can use my perefit device but it isn't gonna make a huge amount of difference and I could have e a ring fitted whilst I wait for the surgery is another option.
I feel like an old lady to be honest , I spoken with my mum today she's 81 and never had any of these issues z the usual hot sweats but that was about it and she was through it all about 47 so younger than I am now.
I started.my periods when I was 9 so I was kinda hoping this would be over by now.

It's good to hear about lifting weights after the surgery is done , advice has changed so much over the years , I'll have a look into different hospitals and surgeons for definite,.I'm in the east midlands so travelling south probably woukent be an option as theres just my husband and son who is young.

Thank you all for giving me lots to think about , just wondering if this womb removal thing could be possible whilst they're sorting the prolapse anyway

@Briansgirls sorry to chuck another worry at you, but uterine removal risks increasing the bladder and possibly bowel prolapse. They call it vaginal vault prolapse. 😬

You can get a silicone ring that you put in and take out yourself. My GP gave me one. You do NOT need an old lady hard plastic ring. My GP was very much 'you are young, you need silicone'. It's very easy.

@Doodledoggle there's so much to think about and many questions to ask , how often did the ring need to be changed /replaced ? She talked about the surgery changing it every six months and seemed to talk about it being forever whereas with the surgery it was a one off operation that would correct it the best it can be , she never mentioned womb removal it's just something I thought about once I'd got home and did a little more reading

Yes, I was told this too. I asked if I could have a full hysterectomy and was told there was a risk in later life of this so I decided just to have my prolapse operated on.
the rings wouldn't stay in place for me
good luck which ever you choose 😊

I've heard about this but I thought there was now a better technique they used where they 'pinned' something so there wouldn't be vault prolapse.

There is quite a lot online about it and this is from one paper I found - might give you some things to ask about @Briansgirls

The number of pregnancies, vaginal births, obesity, and menopause were the most prevalent characteristics in women undergoing hysterectomy and which influenced vaginal vault prolapse. While abdominal and minimally invasive sacrocolpopexy remain the most durable treatment options, preventive strategies, including McCall’s culdoplasty performed at the time of hysterectomy, can also be effective.

Hi all I thought I'd update , basically there is nothing to update , today marks the day that I could first call up to check what's happening with my referral. Basically my referral hasn't been triaged yet and the admin lady said I'm looking at at least another 4 months of waiting and to maybe try A&E !

I called my GP and asked to see the doctor who referred me she isn't on until next Wednesday so I'll do the phone scramble next Wednesday and try and secure an appointment with her.

I had the most embarrassing moment yesterday at work, was stooping down to load a drawer , got up to a standing position and basically wet myself ! I hadn't needed to go so I thought it all happend to quickly , I told the hospital this and the surgery reception but the wait goes on.

I'm thinking of maybe getting a private appointment, I just don't know what's best

@Briansgirls thats horrific. I can't believe that they are leaving you for so long.

Do you have any option to use private medical insurance?

If you do, then go that route. But see a uro-gynae rather than a standard gynae if you can. I had my oriloase surgery done by a gynae and when I referred myself elsewhere afterwards, the uro-gynae was not impressed with his work.

Really feel for you. 18 years ago my bladder prolapsed, Grade 2.
10 years ago I was diagnosed with cystocele, rectocele and uterine prolapses.

I decided against surgery as my dc were very young. I have literally put it off for 10 yrs!

I would make an appointment with a specialist women's physio. Many fit pessaries and can give good advice regarding long term care.

Thank you @MummyOre my GP thinks that the pessary won't really provide much help , she said pelvic floor exercises wouldn't help either it's too far gone for that.
I've been looking through Nuffield and Spire today and prepared to pay for a private consultation just to see what I'm dealing with, my child is 8 now and I was always aware that having him when I was 40 was going to be a bit of an upheaval with menopause but little did I know I'd be facing this.

Hopefully I'll see the same GP next week and she can advise of other hospitals or maybe she can recommend a private consultation somewhere with a urogynae.

Keeping fingers crossed and legs !! Hope I don't wee in public again absolutely devastated. 😭

I wouldn’t write a pessary off without trying it first. I have a bowel prolapse- had been a minor issue for a while but diligent kegals mainly kept it in place. Then it just suddenly went. Saw a private women’s health consultant. Said I was a candidate for surgery but that women weren’t always happy with the results. Anyway I opted to try a pessary first. The first one came out within a few days but a new sized one has been fine. And really going in once every six months to have it changed it very easy.
At the time I couldn’t manage surgery because I was caring for my mother and could not manage not driving for any length of time. But now I’m happy with my choice. I can always revisit it in the future.

Thank you @FirmGreenHare it was my doctor who can of dismissed the pessary more so than me to be honest , she said I'm young (48) for all of this and that coming in six monthly would be hassle , I agree , and surgery would be more a permanent fix.

I hope I get to see her again next week so she can advise further now that it seems to have progressed from the end of July

I was 34.

GPs rarely have a depth of knowledge about prolapses, pessaries and physio.

I woukd spend £75 seeing a physio instead of jumping to surgery. Its an absolute last resort.

I had a rectocele and perenium repair in mid 30s. It failed almost immediately and they said it was because the tissue was very thin. I have used oestrodel cream and hrt for a while and just live with it. Nothing seems to help.

MIL went straight for the hysterectomy (in her 50's).

She bounced back in no time and never mentioned it again!

Thank you again @FirmGreenHare I spoke with a physio today on the phone , today my prolapse looks like a small baby's head emerging , she didn't think it was something she could help me with !! I have two other private physios to call so I will keep trying.

@Briansgirls If it's that bad the option is likely to be surgery and you should find an expert gynaecologist who specialises in prolapse and repairs- even if it means travelling rather than your local town.

It is really important to choose the right surgeon as their experience counts.

I had surgery thirty years ago. It was done privately so I could choose who did it.

You could try a pessary first but they aren't great to use long term as they can cause rubbing of the tissues and become uncomfortable.

see a gynaecologist if you can and pay for the appt ,as NHS will take ages (and you won't have a choice who you see.)

They do try to avoid hysterectomy now because of the risk of vaginal vault prolapse although there are newer techniques now.