Everything is Prolapsed/Herniated

Well, I finally had my uro-gyn exam today. She took a good history from me, then some "measurments" and told me that I have the works - cystocele, uterine prolapse, rectocele and most likely an enterocele. My worst numbers were for the cystocele which really surprised me since I thought I only had uterine prolapse and a rectocele.

On a scale of 0-10 with 0 being everything where it should be to 10 being have surgery tomorrow, she says that everything taken together I'm a 5. I was told that it basically boils down to how bad my quality of life gets vs having major surgery. She called every single one of these surgeries major. She said if I had surgery done at this point in my life, (I'm 47) I'd most likely need it repeated (at least once) if I live to a ripe old age. If done vaginally, she said it'd last 5-10 years, if done abdominally 10-15. I have an appointment scheduled for 6 months out to see if my numbers get worse, or stay the same.

Some other advice I was given:

She said, "Don't let anyone talk you into using mesh - there are too many rejection reactions from usine it - synthetic or otherwise. "

She said machine Pilates classes are as good or better than pelvic floor therapy sessions.

She told me to maintain my current weight because every pound I gain puts more stress on all the parts already headed South. She said obesity keeps her a very busy women.

Surgery would give me a lifetime lifting restriction - I believe she said less than 50 pounds.

I'm still trying to take all this in - still quite shocked. Could all these repairs be done in ONE surgery? I for got to ask her that I was just so stunned.

I'd post an Icon with a shocked face, but I don't see one offered.

Thanks to all the Sisters who share their stories and offer support. I have learned so much!

ajmjmm4,
I am so sorry to hear this. That would be a shock. I wish I had some answers for you or some advice to offer but I am here looking for answers as well. May I ask what your symptoms have been and how long it took for them to figure out what was going on with you? Would they be able to tell all of this in a normal pelvic exam with an obgyn? I ask because I have been to two and niether said anything about prolapse but i am beginning to wonder because I have so much pressure in my pelvic area especially my bum. How many doctors did you see before they figured this out?

Thanks and take care.

Let me tell you that I had the works too and I am 36. I had surgery to repair them and feel much better although the uterine re suspension fell down so I am in the middle of looking at surgeons for a hysterectomy to get rid of the uterus and all it's problems plus getting the sacral colpopexy to reinforce that things stay up after the uterus is gone. Repairs in my opinion are worth it. I am better today than a year ago because my cystocele and rectocele repairs are holding. I can tell you that eventhough I need more surgery I still feel better than when I was doing nothing but therapy and exercise. Yes try those things first but remember those lifting restrictions apply to you right now too because ANY lifting will continue to pull down those prolapses. It's a challenge to not lift especially since I have a 14 mos old but you have to be resourceful and do what's best for you. My son was young when I had my 1st repair and he learned to use step stools and how to get around without mommy picking him up and he is a strong independent little boy now. I say get the repairs you need and except that yes you may need more later but maybe not too. On the U.P.R.I.S.E. there are many women who have had repairs young and are still 7-10 yrs later holding up so you never know unless you try. To me it's worth it but research all your options.

oh and yes mesh is too scary for me. I am looking into using bovine, porcine or my own fascia from my leg. The reason I had the burch instead of tvt for my bladder is because I wanted no mesh used. Burch is holding fine and I no longer pee myself when I cough, sneeze etc. Plus the bladder was my biggest prolapse and the surgeons all said oh the burch might not hold but I was glad I took that chance because it did and I'm mesh free

Thank you kimi and krazykatt for your replies. I didn't sleep too well last night and today I'm exhausted. I have spent the last 3 years trying to get an accurate diagnosis - the only symptom that came on suddenly was the very loud bowel sounds my gut makes and the uro-gyn wasn't sure it was related to everything prolapsing. She said it might be worth seeing someone who specializes in IBS. As far as sympotoms, gradually, I started having constipation issues and around the time of my period, it took longer than usual to empty my bladder. The stream seemed "restricted". Other than taking longer in the bathroom, peeing wasn't a problem. My major complaints are the pressure in my bottom when I need to have a BM. I feel like I can't pass gas and that things are moving in the wrong direction. My intestines seemed to be in knots and it is very uncomfortable! I learned from this forum what splinting is and it helps when I really need it. I'm doubling up on the fiber now. Regular fiber in the AM, Miralax in the PM.

My regular gyn never did the type of exam I had yesterday. The urogyn. had me bear down and then cough to see how my rectum, uterus and urethra dropped when I strained. She assigned a number to the distance things dropped. I would have to say that a urogyn - especially one that specializes in pelvic floor issues is the way to go. That was why I choose to see this particular Dr. and she was very knowledgable. All my regular gyn suggested was a hysterectomy. He never checked my bladder or rectum.

Krazykatt, I was told yesterday that my own fascia would be used when I decide to have the surgery. I believe she said she harvested it from somewhere in my abdomen. (Not a pleasant thought). Thank you too for giving me some positive feedback on the surgery. I needed to hear that.

Emotionally, I need to settle down, relax and then take a rational look at where I am symptom-wise to decide how to proceed. I'm still reeling from yesterday's news.

Using your own fascia is good although I have heard that thigh fascia is stronger than abdominal in people that have prolapse. Has anyone suggested trying a pessary to try keeping the "celes" in place. Not only can it help get you through until you make a decision about surgery but it might help you have an easier time with bm's. I don't know if you have visited the U.P.R.I.S.E prolapse site but there are many woman on those message boards who have had surgery and been successful and are a wealth of information on what ?'s to ask and many have been around a while so they know what works, what fails etc. Having a good uro/gyn is a great start but doing your own research is important too. Glad you got a standing exam that is essential in diagnosis with prolapse I would advise anyone to be leery of a surgeon who doesn't do a standing measurement exam too. Good luck! I can't wait to have my uterus gone since now that is the only prolapse that is left. Well that has come back I am using a pessary right now to hold my uterus up so it doesn't damage the other repairs that are holding.

I am 34 and had the works too. I had a hysterectomy, sacral copoplexy, cycstocele and rectocele and some perenial repair. I was about a 7 I think they said. Mine personally was a quality of life thing. I could constantly feel something down there like a tampon not in right. My surgery was very successfull, even though I still wonder if my hormones are right (I kept my ovaries) but compared to before? I am glad I had it done. It wasn't nearly as bad as I thought it would be.
Oh, and he did tell me try not to lift too many things but sometimes that is impossible with a 18 month old. I do feel it when I overdo it still (Jan 2nd surgery) but I try to use common sense and not lift if I don't have to.

krazykatt. Do you have that website address? I googled it but only come up with skateboarding sites LOL.

http://prolapse.hyperboards.com
Hopefully that is ok to post I don't know about the rules around here but I truly believe the women there are helpful and honest. Since you had the sacral colpopexy did you use mesh or another material? When you say you overdo it you feel it what does that mean? Have you had bulges return? My 14 mos old has become fairly self sufficient with a lot of teaching but I understand the need to lift in an emergency.

They used mesh only on that part. Not on any of the other repairs. Before my surgery I had the most awful back pain. It was actually pretty amazing how instantly I felt the back pain gone. I don't think it was the pain pills because I still felt pain (Does that make sense?) from the surgery.

When I over do it..I feel that back pain again and my stomach gets pretty swollen still. I hope it's not just fat but it will go back down the next morning so I am convinced I just over did it. I don't look the same down there so it's hard for me to say what exactly I see. No bulges like before but there is a buldge that he says is normal now. Who knows, I forget what it is supposed to look like anymore. I do have issues with constipation and I stress about not pushing so hard.

My DD is a moose LOL. She's pretty big for her age but I do lift her in/out of the car seat, wlaking to the car, Up the stairs, but I have her walk up those most of the time as she thinks that's cool to do.

Thanks for the website!