Bladder prolapse and also uterus falling - what to do?

[SandyCadenza]

I am 51. Have been very active playing basketball, tennis, running, etc. Nobody ever told me I was a cystocele 1 (for years) until I became a cystocele 3 - and then it was the first time it was mentioned because it was starting to come out of my vagina and be extremely troublesome. Also my uterus has fallen on top of my bladder and pushed it forward. The apex is all the way down on my bladder. Four docs have said don't do surgery b/c its not a permanent fix and will have to be revised down the road. So, my life has stopped - can't work out with your bladder coming out of your vagina. It doesn't work. Also, I heard a hysterectomy can cause further organ prolapse. Wondering if I should try a permanent pessary. I worked very hard for 2.5 months on Physical Therapy and used Premarin, which gave me migraines almost every day. I am very having a very hard time knowing what to do - but I have lost the life I once had and am having a terrible time with it. Hope to get some good advice.

Sorry to read that - I had severe rectocele and cystocele after third pregnancy - I had a repair done. I wouldn’t rule it out - there’s quite a long recovery (prob about 4 months til properly active again), but there was no way I could have had much quality of life without the repair. My gyn said it was only about 50% effective, in that he says I’ll need a hysteroxopy (I think it’s called!) to lift everything up in 10 years or so - maybe that’s something you could explore. Despite that, I would still recommend the repair for the quality of life it brings.

Are you in the UK ( some things in your post make it sound as if you are not.)

I think you should see another surgeon. If everything has dropped a long way, your options are either a repair- which can work as long as it's done well and you stop all the high impact exercises- or a hysterectomy.

Yes, a hysterectomy can cause further prolapse, but sometimes it's the only option if everything has fallen.

You should stop all the high impact sport. I had a repair 25 years ago and was told no running, lifting, etc ever.

ps
Pessaries are not 'permanent' - they need replacing now and then, and as you get older they can wear away the tissues. They are mainly for very old women who can't have surgery or for younger women who have not completed their families.

HRT alone (Premarin) won't correct a severe prolapse so not sure why anyone said it would!

Thank you all for the advice from everyone. I think at some point, I just won't have a choice....I will have to have surgery.

Sorry to hear you're having a tough time. If you're on Facebook there's a great page for support where you might get further opinions and advice. Good luck
Search for Association for pelvic organ prolapse support

I had surgery for stage 2 rectocele and cyctocele last Monday. I’d had them for 7 years and a previous gynae had told me I was too young for surgery (2 years ago) and to go away and do more pelvic foor exercises, but it hasn’t helped and my leggings would be soaked to the knees after a 5km run and I could feel my bladder poking out by the end of a day on my feet. It was really depressing and life-limiting.

Just one week on and I am feeling ok, no real pain and can pee straight (tmi sorry!) for the first time in years, although I am still resting and not back to work or driving until after Christmas.

I’m 45 and had 3 large babies normal delivery. I was a runner in the past but now I’m going to stick to gym work - pilates, cross-trainer etc and cycling. My PT told me to ask the surgeon for an exercise referral letter when I have my 6 week check and to ask for physio referral too. I’m a huge fan of physio as it has helped me with a herniated disc in my back, which I believe was also caused by weakness following pregnancies. I’m also going to ask the GP about HRT early next year as I have menopausal symptoms.

Prior to surgery I did pilates and other gym exercises 3 x week and did the You Tube physio Michelle Kenway pelvic floor exercises daily. I think the exercise has helped me feel stronger after surgery. The consultant I saw this time recommended surgery straight away rather than pessaries etc and I am really glad I had it. He was brilliant.

In my mind, if a gynae has recommended surgery for you, it’s because it is the best option for you. Hope this helps x

I have just been diagnosed with rectocele prolapse, the pain is awful my bowel is constantly bulging, waiting for a gynaecologist appointment, I am worried about how long and how bad you have to be before they do something, my life has stopped x

I’m younger but still breastfeeding so low estrogen here too. Mine’s grade 2 cystocele with a slight uterine prolapse (cervix sits really low) and I’ve noticed a real improvement from...

• pelvic floor exercises using nhs Squeezy app to stay on track. This sorted my continence out within weeks of childbirth but it took 7 months just clenching away daily until I really noticed a difference in my pelvic floor strength so it is bloody sllllllllow but worth keeping going and going. Then had another plateau then more noticeable improvement around 11 and around 14 months post partum.

*post-natal Pilates from 8 weeks post partum with a qualified physio who knew my issues and specialises in pregnant/post-natal bodies so helped me adapt exercises where needed -

*the free ‘lift’ videos from Femfusion Fitness on YouTube - the lifestyle tips on lifting/breathing/constipation etc are worth watching.

*seeing the specialist nurse at the hospital, and doing electrical stimulation of PF muscles - was given this as nerve damage meant I couldn’t initially recruit all the muscles with my brain but found it helped loads so after the hospital unit had to go back I bought my own.

*estrogen pessaries to plump up vaginal tissue

*ring pessary and EVB compression shorts which I just use for running. I didn’t run until I’d done 12 months getting my pelvic floor as strong as possible but for me permanently stopping the sport I love, and that I use to manage depression and anxiety, isn’t something I’m prepared to do yet. I’ve been running 3x a week and upping my mileage since October and nurse agrees my pelvic floor strength and prolapse have both continued to improve regardless so for now I’ll carry on. The ring pessary is pretty good and I’d definitely explore that as an option - easy to insert and remove yourself with a bit of practise and I don’t think it’s likely to damage vaginal walls if you’re using topical estrogen with it (less nauseating than the oral HRT kind which I’ve some experience of thanks to IVF: it is vile, the pessaries are fine).

I still have a bulgy front wall and low cervix but no longer have the discomfort/pressure/stuck tampon/insides falling out of my fanny feeling, and I never wee myself even running.

Hope you find a solution - it’s awful feeling so let down by your body.