Vaginal prolapse diagnosed today - What next?

[SparklesXYZ]

I went from all being fine down below to having a grade 2/3 vaginal prolapse in about a week. 😢(I'm 45.) My GP has referred me to gynaecology and physiotherapy, but I have no idea how long the waiting lists are (I'm in the West Midlands). I have some questions and would be grateful for any advice and support.

1. My GP thought surgery would be a good idea, given my age and the grade 2/3 prolapse. If you had surgery, how did it go? Did the surgery work? How long were you in hospital for? How soon after the surgery could you drive? (Just thinking about the school run...) How long was the recovery?
2. My GP mentioned getting a pessary fitted. Is this a short term measure? Will it prevent the prolapse getting worse?
3. I'm going to start doing pelvic floor exercises. If you had a grade 2/3 prolapse, how much did doing pelvic floor exercises help?
4. If you went private for either physio or surgery, would you mind letting me know how much it cost?

Sorry, I can't help much with the questions. But what were your symptoms, it's it sudden or happening over a long period of time?

Mine was sudden. I felt it so I was fine one minute, then next I wasn’t.

1. I looked into surgery & discounted it -at least for now. I’m 57 now, probably had the prolapse (mine is a bladder prolapse) about 3 years. Consultant told me surgery maybe last 10 years & every time they redo the surgery it’s a higher chance of failure. I did wait for the referral for some time.
2. decided to try a pessary because I was so uncomfortable I couldn’t sit down for long. I cried on the phone to the receptionist begging them to help. At the time, my surgery wasn’t fitting pessaries locally & I was told I had to wait to see the specialist. As the waiting list was 18 months, there was no way I could have waited. The surgery eventually agreed & it worked amazingly for me. I know it doesn’t for everyone. I go to GP every 6 months & have it changed. Can’t tell I have one. I’ve been told I can wear it long term. The key was getting the right size. I tried three sizes before getting the right one but knew instantly that the 3rd was right. The other two slipped & I had to keep moving it back into place. Since I’ve found the right size, that doesn’t happen anymore.
3. I do pelvic floor exercises after seeing a physio who specialises in gynae issues. Got referred through nhs. She was brilliant. I had to go to hospital to see her for the appointment but she gave great practical advice. I didn’t pay & got that referral quickly Hope that helps. Good luck!

I have a G3 prolapse, I agreed to a partial hysterectomy, and have been on the waiting list for over a year so far and have been told that it will likely be another year before I get the op.

I’ve been assessed by a physio who was very happy with my pelvic floor despite the prolapse.

im 39yo and my prolapse came on a little more gradually, it was a G1-2 prolapse for about 5-6 years, then it dropped very suddenly about a year ago.

@Ooih It happened quite quickly.

@MissMarianHalcombe Thanks for sharing. I'm thinking of exploring the pessary route, so it's good to hear that it's worked for you and to know that it might take a few attempts to get the sizing right. Were you given any advice about lifting heavy things? Is it safe to do that with a pessary in, or is there still a risk that it'll make the prolapse worse? I'm thinking that I shouldn't lift a basket of laundry or shopping bags, which will be a pain, but it's hard to know where the limit is as to what I can safely lift.

@MissMarianHalcombe Thank you for sharing. Can I ask what kind of prolapse means that a partial hysterectomy is required? I have been thinking about pelvic floor strength. Am I right in thinking that even if you have a strong pelvic floor, it might not necessarily help with the prolapse, as the organs above the pelvic floor are still 'loose'?

I was by the gynae physio, especially around exercise. No running, cycling or weights. Swimming & walking essentially. No digging the garden. I think about lifting anything heavy. I think about shopping; take more bags, spread the weight etc. I’ve had a couple of occasions when I’ve felt “heavier “ -for example, tripped up & went flat on my face so the jolt didn’t do my prolapse any favours but I was fine after a couple of days & everything settled back down. It’s annoying to live with but I’m content to do that than put myself through surgery. Everyone is different though but I’d definitely recommend trying a pessary if your GP suggests it as an option

I got “diagnosed” today - although I’ve had it for years. I’ve been putting off doing anything about it as it’s “not that bad” but I needed a coil change and it sort of escalated and the GP referred me to gynaecology. Mine (I think) is uterine and rectum. Afaik I don’t have bladder but tbh I’m so used to being a bit unusual downstairs then who knows. I don’t have “bladder symptoms”.

I can’t give you any advice I’m because I don’t know anything either but hopefully some others will be along.

My GP said that all the pelvic floor exercises in the world will fix it (which I know, because I have done all the pelvic floor exercises in the world) but if I do go in for surgery then I want a pelvic floor of steel first, plus all my other muscles such as abdominals and psoas that support that general area as it’s my instinct that that will help the surgery to work.

I’m wondering if I should have a hysterectomy (as it’s uterine) but I know hysterectomy is itself a cause of prolapse so I really don’t know what can be done. I’ve been told in the past I’ve got “just a small fibroid” which I think is code for “there’s a watermelon attached to your uterus”.

I also don’t know about a pessary. I would like to know if it has any effect (positive or negative) on the muscles and ligaments.

My plan is to wait patiently for my gynaecologist appointment, lose weight (I’m less than 5kg heavier than I should be but I don’t think it helps), be much more diligent with my Squeezy app, find some sort of yoga routine for the surrounding muscle groups - I think strength and flexibility helps.

If anyone has any pessary knowledge/experience I would love to hear it.

I’m also a bit worried how to know you’ve got a good surgeon - if I’m going under the knife I want someone who has done 1000s before.

If possible it is always better to see a urogynaecologist rather than a gynaecologist alone. They have extra specialism in treatment of pelvic floor disorders and surgery compared with a gynae.

It is always better, if possible, to keep the uterus in any pelvic floor repair, as removing it creates a space where other organs can prolapse, for example, an enterocele (prolapse of the small bowel into the space). If possible, pulling the uterus up with a sacrocolpopexy / hysteropexy, or other kind of repair that hitches up the ligaments while retaining the uterus, is preferable to removing it (unless it has to be removed due to disease or fibroid etc).

Pelvic floor exercises are generally good for prevention of prolapse but not so good at actually reversing prolapse once it has occurred.

When you say vaginal prolapse, do you mean that the uterus/cervix is prolapsing downwards through the vagina, or that the back of the vagina is prolapsing and causing a rectocele? These are quite different prolapses with different solutions. It is not uncommon to experience more than one type of prolapse at the same time due to weakness of the pelvic floor.

It is true that surgery may not last forever, but there are numerous factors which cause that, including connective tissue disorders like EDS and lifestyle choices like continuing to lift heavy weights/running/gym after surgery that compromises the repair.

Consider whether your repair will be with or without any kind of mesh, and do some research into that. No doubt you will have heard of the "mesh scandal". Some surgeons no longer use it, some do. Some use biological (usually porcine collagen) mesh instead. Be informed about the risks.

I have never used a pessary so can't comment but my prolapse is in all three compartments and quite complicated.
Surgery privately is costing 14K.

Hope all goes well.