I am soooo confused!

Hello,

Two days ago I went to my ob/gyn complaining of what felt like pressure in the vaginal area. It turns out that I have a prolapsed uterus and a cystocele. He asked if I was finished having children and I told him yes (I'm 36 and have 3 kids). He recommended a vaginal hysterectomy, removing the uterus only, not the ovaries. He also recommended anterior repair, which I think is repairing the dropped bladder, and he also recommended a "urethral sling" which I don't quite understand yet. I was so shocked at hearing the word "hysterectomy" that I wasn't thinking straight and didn't ask all the questions I should have. He recommended getting a second opinion. Should I go to another ob/gyn? Should I go to a urologist? I looked into a urogynecologist and there are some in my state, but I don't know anyone who has used any of them. I tried to educate myself on the topic and it seems that the more I learn, the more I become confused and frustrated. Any comforting words would be appreciated right now from anyone who has any insight on this matter. I personally know no one who has had uterine prolapse/cystocele and/or has had a hysterectomy.
Thanks so much!
Kim

Dear Kim,

Welcome to HysterSisters. Congrats on having a doc who is encouraging you to do some research. Because of the involvement of the bladder (cystocele), consulting with a uro-gynecologist is an excellent idea.

This website: http://pages.prodigy.com/prolapse.html/ will give you lots of info on prolapse and how to treat it.

Keep reading & asking questions. Get smart about your symptoms and your options, and make the best choice for YOU.

Sending huge cyberhugs

Hi Kim, I am in a similar situation as you and have gone through a lot of confusion, too! I am older (44), but will be having a hyster. & cystocele repair soon, for the very same reasons you have described. When I was first diagnosed with the prolapsed uterus, my gyn told me that I would have better days and worse days, and that the prolapse may become worse, but that I might only have the "slight" prolapse for many years, and never even need surgery. Well a few months down the road ( I think 3-5 months) things were worse. Not constantly, but went through about 3 weeks of yuckyness before I got up the nerve to go talk with the doc again. Things had indeed shifted and I also had a saggin bladder. I have "put up" with stress incontinence for about 8 years now, after being told by my regular doc that bladder repairs have a low success rate...the whole subject was embarrassing and I didn't find it easy to discuss with either my Gyn or MD. Anyway, after things "shifted" more, the gyn has referred me to a urologist for the cystocele and then there will be a tag-team surgery...I don't have a date yet, and that is the hardest part, so far. I have requested that my ovaries be removed ( family hist. of ovarian cancer) but the doc cant promise he can reach them vaginally...had done so many times, but cannot always reach them. After the initial shock that I was really going to have a hysterectomy, I began to think that I hadn't suffered with fibroids or weeks on end of bleeding, and maybe I was being weak by having surgery just because I'm saggin like crazy..well I was talking with my youngest child and he was very upset that I would be having surgery to remove my baby makin parts ( turns out he doesn't like being the youngest and has been hoping like crazy that there would be another baby...4 is enough for me!)and I told him that I would be able to run after I had recovered from surgery ( you mean you won't wet your pants anymore mom?).I told him I would probably even beat him in a game of basketball, it really hit me ...my youngest child who will be 9, doesnt even have a clear memory of me being able to run without going in the house to change my clothes...The real issue is quality of life. After I realized how the bladder problems and the saggy uterus ( didn't make me feel like the most alluring of all women, DH never once complained or made negative comments) were impacting me, I felt much better about the surgery. I do trust my gyn. and am please to hear that yours is encouraging you to seek a second opinion. What I did read about the options other than surgery for prolapse didn't sound like an alternative for myself...So that did make me feel better about the hyster. I have come to rely on this website quite heavily, cause there is so much info and so many supportive friends here. It makes ya feel like youre not alone with all of this. Anyway, I will meet the uro tomorrow and I am nervous about meeting him and finding out what he will be doing during surgery. I wish you the best and hope that kjnowing someone else is going through the same type of stuff helps alittle. I do think the more information you have, the less hesitant/nervous/confused you'll be. Hang in there, Kim! Amy

Hi Amy, I really appreciated hearing from you. (I was born and lived in Sacramento till I was 8--are you anywhere near there?) Anyway, here's an update on my situation. I went to a second ob/gyn. He said he thinks it's just a uterine prolapse, not involving the bladder. He also wasn't so hasty to recommend a hysterectomy, esp. because I'm not in pain or having incontinence or anything. For now, it's more a psychological matter than anything else. He recommended me to do Kegels like crazy. He also said to go see a urogynecologist. I have an appointment scheduled with one in March. That was the soonest they had an opening. My first doc said Kegels would not help. I asked him about seeing a urogynecologist and he said he would recommend that if I were an older patient having problems. I think he was hell bent on the hysterectomy idea! I feel better now that I saw the second doctor, much more than when I posted the first time. Did you try lots and lots of Kegels? How about a pessary? A pessary doesn't sound very appealing to me, but not totally out of the question. I'm glad you're at peace with the hysterectomy idea. It sounds like your quality of life will improve a great deal. Thanks again for your response. Talk to you again later! Kim

Hi Kim , Yes I live in a suburb of Sacramento, where are you located? I am glad that you've talked to another doc. One of my cousins is a physical thereapist and she works with the elderly. When I first started having stress incontinence, she and I talked about kegels, and one of the most important tips from her was to hold each one for more than 10 seconds...that was very different (and harder to do!) than the way I was taught during my first lamaze class. So, yes, Ive tried them for years with not a lot of help, also, the pessary thing sounds really gross to me. I guess that I have come to terms with the hysterectomy and am just anxious about the urologist. I'm sure that once I get a surgery date, I'll probably freak out again! Thank goodness for this website. :-) Amy

I am now living in southern Louisiana, but I lived in Fair Oaks. Does that city still exist? I went to school at Fair Oaks Elem. and St. Mel's. Do they exist? My dad was in the AF, so we moved around a lot. Wish I could one day go back!
I am discouraged that Kegels didn't work too well for you, but I guess I will keep trying them. And I will be sure to hold for more than 10 sec. each. My mother in law said she had uterine prolapse at 30 and she wore a pessary and did Kegels for a year and was able to get it back up where it belonged. I told her that certainly her prolapse wasn't too severe, but she said it was a 2nd degree prolapse. Hmmm... I don't know what to think. Maybe there's hope for me? Maybe my mil has a failing memory? ! Kim :-) Oh, one more thing--how do you get those static smilies to work? I can't figure it out!!!

Dear Kimberly,

My doc had a drawing (ie, like in a science book) showing the bladder supported by strong ligaments & weak ligaments... the weak ligaments let drips come out, in other words, stress incontinence. Daily kegel exercises make for strong ligaments to support the bladder, and are recommended for all women (hysterectomy or not).

Go to this link, you will see the ligaments image and learn more than you ever wanted to know about kegels. The medical drawing shown here speaks volumes:

http://www.universityobgyn.com/kegal.htm

It's my understanding that kegels can't really *fix* any falling already done, only prevent future falling. Kegels can also enhance your activities under the sheets

Just sign me,
Going for the gold at the Kegel Olympics

I did not have prolapse, but I have a friend who is now
60, and she was diagnosed with prolapse about three
years ago. She elected to use a pessary, and she is having
much success with it. The only negative for her is needing
to go the doctor every three months to have it removed,
cleaned, and reinserted. Good luck with your decison!