Prolapse / Cystocele
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Prolapse / Cystocele
April 2005
I think I may have prolapse. I am 36 and 3 months post-partum after baby #2. I am
really bummed and feel like I'm "falling" apart. Has anyone else experienced this?
What did you do? thank you.
anonymous please
Hi there. I saw your post about a suspected prolapse and
thought I'd share my experience. After the somewhat traumatic
(induction and then forceps) delivery of my first child I
experienced what I will call a 'protusion'. To be blunt, there
was a fairly large (golf ball) fleshy thing sticking out of my
vagina, about three months post-partum. It was, to put it
midly, unnerving. I saw my OB who diagnosed a 'rectocele',
which is basically a vaginal hernia wherein a rip or tear forms
in the vaginal wall, allowing the rectal passage to poke
through. Charming. After about 7 months post partum it got
better and eventually didn't really stick out all that much. As
the muscle tone improves it tends to draw the hernia back in,
or so they say. Whatever. Anyway, it didn't really bother me
all that much. Then I got pregnant again (whoops) at 8 months
post partum (again I say whoops) and by the end of that
pregnancy it was sticking out again and would ache if I walked
a lot. Mind you, everything ached, so there you go. After the
delivery of my second child the whole thing basically fell
apart and now I have a cystocele (which is where the vagina
wall tears on the OTHER side, allowing the bladder and urethra
to poke through) and a uterine prolapse (basically the
connective tissue at the top of your vagina stops holding the
uterus in place, and it descends). Interestingly, although
possibly only for me, the rectocele mostly went away, possibly
overwhelmed by the competition for room in my poor front-
bottom, as we say in England. Anyhoo, here's the upshot. All of
this can be fixed surgically, and it's important to go to a
specialist in pelvic floor reconstruction, as the negative
outcomes of bad surgery are vaginal strictures (basically they
sew you too tightly and it's painful to have sex etc) or
incontinence of one sort or another (bummer). The good news is
that there is an excellent doctor at UCSF, called Sharon
Knight, who you can go see. There are several other centres for
pelvic floor reconstruction around the country. The bad news is
that it takes many weeks to recover and during that time you
can't pick up anything heavier than a bag of flour. As I have a
two and a half year old and a fifteen month old I have decided
to wait a few years and then get everything fixed at once. In
the meantime I just kind of suck it up. Some days it's worse
than others, and I can't run or do impact exercise any more. Oh
well, like I have either time or inclination... So that's my
experience. In many cases they fix themselves, and certainly
mine seemed to be on the way there before the second baby. IMHO
it's pretty early for you to get super worried about it right
now, and in fact, they won't do an evaluation for prolapse
surgery until ONE YEAR post partum as they consider the vagina
to be in trauma until that time (no shit). I sympathize with
the sensation of everything falling apart -- I find myself
chastened and somewhat embarrassed by my crappy vagina, but
hey, at least it's relatively private. Feel free to email me if
you have any other questions or if you discover some excellent
way to fix it, especially if it involces lying still in a quiet
room eating chocolate!
Abbi
Post partum prolapse can really feel overwhelming, especially in
the midst of taking care of your baby. I am an acupuncturist who
specializes in fertility and pregnancy care and I have treated
this many times and everyone seems to feel overwhelmed in the way
that you described. In chinese medicine, post partum is a period
of two years. I say this because I don't want you to feel like
you are falling apart because your body can repair itself.
Birthing a little one is a big deal and in our country I am not
sure we give it enough credit as we hurry off back to work after
a few months. Anyway, this is definitely something that you
could be treated in a holistic manner with acupuncture and
chinese herbs with good success. I guess the first step is to
know your symptoms to make certain of the diagnosis. I am more
than happy to help you with more specific advice if you need.
Maureen Raytis, L.Ac.
March 2005
So I think I have a 'dropped cervix' also known as a Uterine
Prolapse. I won't know for sure until I see a gyno in a couple
of weeks. I did look up the condition and I have one of the
symptoms: urgent urge to pee at a moments notice. I also looked
at myself and well, things don’t look right.. like the entrance
into my vagina is blocked!! Needless to say when I saw that, I
panicked. And the only reason I even looked was that I felt
some irritation. I’m wondering if things got worse since I got
sick with a nasty cough almost three weeks ago. I’ve had very
violent coughing fits and they do pressure that lower region.
By the way, I did give birth vaginally 15-months ago. The two
gynecologists that saw me afterwards never mentioned anything.
Can your cervix drop afterwards?? I admit I haven’t done keigel
(?) exercises and I’m still nursing my son.
Any way, can any of you out there who may be dealing with this
issue give me some insight, how are you resolving it? Did you
get a pessary, can you describe how it works. Has anyone opted
for surgery?
Thanks!
anon
It sounds like you have a cystocele, which is a prolapsed bladder. The
bladder drops onto the vaginal wall and is visible when looking at your
vagina in a mirror. It often occurs during pregnancy with the pressure
on the bladder from an enlarging uterus, and during delivery from
bearing down. Symptoms include urinary urgency and frequency. Kegel
exercises can help lift a minor cystocele and tighten the muscles, but a
more significant cystocele often requires surgery (done vaginally).
Whether or not you opt for surgery depends on the severity of your
symptoms and whether you want more children (it does not affect your
ability to get pregnant, but you might want to delay surgery until after
you are done having children because it can drop again with subsequent
pregnancies). Good luck!
-Been there!
To the woman who may have the dropped cervix, I too had a baby 15
months ago and since then have had symptoms such as stinging when I
soap my vulva in the shower ( as it feels like the urethra opening has
been stretched), pee still coming out after I pull up my pants & think
I am finished, and right after giving birth a lot of pain. But I spoke
to my midwife and she said do kegals and so I've been doing 5 to 10 a
day on & off and now I feel that most of these problems have just
about dissapeared(over 15 months). It just seems to me that healing is
a long process.
I hope that helps.
A
Oct 2004
My mother (early 60s) was recently diagnosed with a dropped
bladder or cystocele prolapse. Has anyone had experience with
this and tried kegels, a pessary, or surgery? Any words of advice
would be very helpful. Thank you!
anonymous
I had bladder sling surgery for this condition 7 years ago, and it
was 100%
successful. I was in my late 40s, and my condition was so bad that
I needed a thick
pad at all times, and even the thickest pad was not enough when I
exercised. I lived
like that for a decade, had had many embarrassing accidents, and I
became a new
woman after the surgery ; ) The surgery requires an overnight stay
in the hospital
with a catheter, and another day or two at home with the catheter.
I recovered
quickly. You need to find a urologist or a gynecologist who is
trained in the
procedure and has experience with it. I’m afraid I can’t recommend
my surgeon,
because he's no longer practicing in this area. Good luck!
Living a normal life again!
I had uterine prolapse after the birth of my first son, at the
ripe old age of 31. After the birth of my second son, I tried
all kinds of non-surgical options, including kegels which are
useless and have no effect on the tendons and ligaments holding
the uterus in place. It could also be the bladder pressing out
in your mother's case. In any case, kegels can't help. Any
doctor who tells you so you can be sure knows nothing about the
condition. I did go to an osteopath who has demonstrated
success with restimulating the ligaments and tendons to do
their job - alas, didn't work for me. I turned to surgery and
am thrilled with the results. I had the uterus and cervix
removed, kept my ovaries. Also I understand they did some
lifting and tucking of the whole area, including bladder. Its a
major surgery. Prolapse is something that's quite common in
older women and hereditary. My mother had a hysterectomy about
20 years ago at about 40 or so to repair a prolapse she had
lived with for about 10 years, unthinkable. If you're an active
person you simply cannot live with a prolapse. Now, here's the
bad news, my mother thinks she may need another surgery now
that she's older things are sagging again. Good luck.
Sharon
My mother had surgery almost a year ago for a prolapsed
bladder. I don't know the name of the procedure she had (she is
not one to ask many questions of her doctors) but the procedure
put some sort of internal sling under the bladder to lift and
support it. The surgery was done vaginally. She had a very
slow recovery, spent many months still not able to hold her
urine and was in much discomfort. She felt that the doctor
minimized the time for recovery and discomfort. Now almost a
year later, they tell her her bladder is still low. She hasn't
said she completely regrets the surgery (she suffered from years
of yeast infections because of the prolapse) but she swears to
never have another surgery. Everyone's experience is probably
different, but I would suggest your mother asking a lot of
questions (mine didn't) and really thinking long and hard about
having surgery.
anon
She should make an appointment with a uro-gynecologist for an
examination and discussion of all her options. I've seen a few in
Oakland, and I enthusiastically suggest Ed Blumenstock, M.D.
A cystocele patient
I'm a little late in posting this, I think - for the person
looking for advice on cystocele prolapse, here's my two cents.
Get a thorough workup by a uro-gynecologist. I had surgery for
stress incontinence, prolapsed uterus and some other stuff in
July. My recovery was right on target - about 7-8 weeks and I
was operating at pretty close to 100%. If it had been only the
cystocele repair, 5 weeks would have been plenty. (I'm 46.)
My consultation and surgery was with Dr. Eugene Kaplan in Walnut
Creek, 925 979 9969. He is extremely knowledgeable, very
gentle, very aware of related issues, and all-around great. My
surgery included a vaginal hysterectomy, bladder sling, and
rectal muscle repair - about 4.5 hours total. I'm sure it would
have been far shorter if it were only the cystocele.
I'd be happy to talk to you about the experience if you would
like. I'm very relieved that I had the work done, feel a million
percent better with all pelvic functions, and really recommend
my doctor highly.
Hope that helps.
Nancy
November 2003
I am 13 days postpartum with our 3rd baby and just last
night discovered my cervix hanging down into my vagina! I
am 32, this is our 3rd baby in 4 years (all home births), I am
fit and healthy, swam and did yoga (and kegals) throughout
pregnancy, and I am worried and scared! My 3rd baby came
barreling out of me in no time, apparently dragging my
cervix/uterus down with him. My midwive pushed it back up
in place after the birth and checked me again a few days
ago (I was fine), then . . . last night I made my discovery. Of
course, I have spoken with my midwives who aren't yet
officially calling it prolapsed (b/c it's so soon after birth) but
of course it's a strong possibility. Who has gone through
this? I am pretty terrified of using one of those devices to
hold it up, or having surgery - - or, even a hysterectomy. I'm
taking Sepia (homeopathy). We may want another child in 3
or 4 years. I looked in the archives and found nothing . . .
what have others done in this situation? Is there anything I
can do now to increase my chances that it will go back to
normal? Any specialists? Any advice appreciated. Thanks.
scared
Fifteen years ago, I had my first and only pregnancy.
Fibroids that were already present grew enormously, one to
about grapefruit size. After the birth, my uterus descended
into my vagina. The first thing that helped was to put in my
diaphragm (I cut out the middle and just used the ring.)
Later I went to a chiropractor in Santa Cruz who was
recommended for such problems, who may have helped
but I really don't know. One thing I remember doing was
lying down with the legs of the bed raised on blocks, so that
gravity would help the uterus move back in position. I guess
I did that a few times a day for an hour. It's hard to
remember, and of course I had a baby, so I couldn't have
had time to do much of anything.
My fibroids shrunk down post-partum, but I have always had
problems with stress incontinence. My uterus is ''tilted''
according to my nurse practitioner. I wear a pessary, which
is extremely helpful, and I find that abdominal exercises are
as good as Kegels, if not better. I have not needed to have
surgery, but I wear a pad everyday, just in case.
Holding up just fine
May 2003
Has anyone dealt with a prolapsed bladder or uterus? I am
looking for alternatives to surgery for dealing with this
problem. Do exercises really work? Is this a condition
which comes and goes?
km
My doctor recently noticed the same thing happening to me. She
referred me to a physical therapist who specializes in this sort
of thing -- ''pelvic floor rehab''. The plan is that I'll do
that, as well as lots and lots of Kegels for the next three
months and then we'll re-evaluate the situation. Maybe exercise
can be effective enough to make surgery unnecessary. Good luck
to you (and to me!)
Anonymous
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