Bladder prolapse... gynaecologist said surgery wouldn't last

Women's health
1

I live in Spain.  The gynaecologist said she thought I shouldn't have an operation for a recent bladder prolapse.  As there is no womb she said the bladder would fall down again and it would mean I would need an op. every 2 to 3 years, not good for my body. She has prescribed an oestrogen cream to be used for 2 months (to tighten the vagina so the bladder is not bulging out so much) then another vaginal cream (without oestrogen) to be used for the next 2 months.  This will cost me 40€ every 4 weeks.  I would have to apply the creams for life. What success have others had with surgery (did they have to have it done again?) and what success using the creams?  What about intercourse ?  I can't imagine that being possible with a bladder prolapse?  Thanks for your replies.  

 

2

Maybe get a 2nd opinion. Never heard that before. Lots of women get repairs with no womb

3

Hi tricia,

I'm in the UK, I have had Anterior prolapse repair with hysterectomy done. Not sure why it failed first time but think it was for a few reasons:

Stitching was loosened when catheter and pack was taken out within first 24th hours.

I had little info on after care at home and unfortunately probably overdone things too quickly.

However did return to employment after 7/8 months and managed very well at work for 2 years, had been building up my hours over the 2 years and went from sitting at checkouts to standing at selfscan areas when my prolapse gradually returned.

So have now had 2nd anterior repair along with posterior repair. All went very well this time and I was far more aware this time of the long term recovery and the need to avoid weight bearing and lengthy time on my feet. Returned to work at 3 months post op.

For the most part everything has gone well my employer has done their best to support and accommodate my needs ( here in the UK we have a due care policy which should work for both parties with help of occupational health ), unfortunately I got no help from occupational health and had to do my own negotiating with my employer with help from my GP. So there has been occasions where they have left me on my feet for full shift; unfortunately we all recover at different rates and I have found these occasions to be too much and have had problems with overstretching scar tissue while rushing about between self'scan and hybrid areas.

So not so easy to protect repair at work. At home I have been very careful to take care with recovery process. Using 'Estriol' topical cream to thicken up the internal walls and help take the nip out the scar tissue.

I chose to have it redone as I find that when the prolapse sags it gets very painful and only gets worse with time, I tried the pessay/ring which only worked for a little while but eventually prolapse so bad ring kept coming out.

I recently had my repairs checked by consultant and all is well healed and as it should be so looking forward now, have been told that my repairs will last as long as I avoid any down pressure on pelvic floor. So being very careful and avoiding any heavy weight bearing nothing over a 2 litres and still only pottering about for no more than a couple of hours, can go for short half hour walks and swim 12 lengths. Husband does heavy things at home icluding heavier shopping, gardening.

Trying very hard to find alternative lighter employment but not easy. So still trying to negotiate less time on my feet at work and more on a seat at checkouts.

In the UK these repairs are meant to be done by a 'urogynocologist' specially trained in repair surgery. Hope all this helps, it is not an easy decision to make and I wasted a lot of time avoiding surgery as I did not want my womb out but found that the pain was unbearable after a while.

Take care, you will eventually know what is best for you yourself,

Phyl x💖

4

Hi Phyl. Thanks so much for your detailed reply.  You have a had a lot to go through and it must be hard to be patient and remember not to lift etc which is very hard when you are working.  It sounds like your recent repair has worked very well and you just have to be careful.  In my case, talking to friends here, we wondered if there was such a thing as a "false" uterus that could be inserted above the bladder to stop a bladder prolapsing again!!  In today's world of technology it seems logical as they had lots of "false" parts to put into other parts of the body.  Good luck and thanks again.  Tricia :-) 

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Tahnks Steph but did they keep having more proplapses after 2-3 years?  I will certainly ask for a 2nd opinion though.  T x

6

oops sorry about typos - done in a hurry! 

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Tricia, that sounds like a great solution but alas nothing like that yet as far as I know. This forum is excellent for up to date info, they are also doing lots of research.

There are lots of alternative types of surgery available here in the UK, and the professionals tell us that new techniques are available and showing great success, and who knows what will be available in the near future.

I would love to grow a new womb or scaffolding with new ligaments, but that may not be for my generation. I suppose the finance for such surgery would be best spent on younger women who have had no family yet.

Wish I had know about Estriol beforey first repair; I did find out about it till after the 2nd repair, seemingly it helps the repair by thickening the walls. So sounds like there is some truth in what your gynecologist is saying; thing is you could try the cream and see how it goes and at least you will benefit from stronger tissue's , while you consider your options and maybe get 2nd opinion.

Phyl x☺

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By the way if your prolapse is mild you may be able to prevent it from getting any worse through Pelvic Floor Exercises, have you seen a Physiotherapists specially trained in this area yet they are very good and can offer support and help you to understand how prolapse happens and how different options can help.

X

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Sorry I am a woman of few words lol

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Steph, nothing wrong with few words, few words often gets the point across without rambling like I do most of the time. I probably drive some people nuts who don't want to have to read the whole essay!😅😅😅

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Well thank you. Sometimes I worry that I come across rude or uncaring. A lot of it is just that I use my phone to post. Takes too long lol

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Your right, I go on that long it seizes up!

13

Hi. I'd get a 2 no opinion. In April this year I had a complete hysterectomy,A& P repair and a tvt (bladder sling) I was never told about that it wouldn't last. I was told if I was careful what I done lifting wise it should continue to be a success. My sling was attached to my pubic bone so it wouldn't drop so don't know why she'd say it wouldn't stay in place. Also my repairs were re-attached to a major ligament to keep it all up and in place. There are proper procedure names but I can't remember off top of head but I can find them out for you if you need them to ask about. Just let me know. Hope you get some answers. Good luck. X

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Also i would recommend seeing a urogynecogist instead of a regular gyn. They specialize in pelvic floor conditions

15

Hello Fi - that's all very interesting and helpful.  It's the first time I have heard about a bladder sling so I wonder if anyone else reading this has had one.  So after 6 months do you feel everything is back to normal?  What about lifting things, is that something you can do now?  Thanks, Tricia 

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Thanks Steph, I will make a note of that name. x

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None of this was mentioned at the consultation.  However it is a bit different in Spain as I use a translator for medical appointments and the consultants are in a hurry.  Also if you don't ask a specific question they won't always volunteer information. I have a good pilates teacher and have always worked a lot on pelvic floor exercises in the past....

18

Hi, I would insist on more information, you need to know what's happening and what they intend to do about it long term. It sounds like it's affecting your quality of life and needs a repair. The cream can help but not permanently, it does help strengthen the pelvic walls and tissues I think. I was prescribed it to use before surgery but have now had to stop as it caused a nasty reaction down there!

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Thanks Pollyanna (lovely name), I will use the cream for a while and hope it works as you describe.  I am tempted to get a 2nd opinion.  Nobody has mentioned how a prolapse  impacts on intimate relationships?  Not an easy subject to discuss though.  

 

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Consultants always in a hurry here too, and you are right the only tell you what they think you need to know.

I'm sure plates is good for pelvic floor as long as aware of prolapse and not put any down pressure on pelvic floor. My sister says it's all in the breathing and getting that right; I am pretty sure I always get the breathing all wrong.

X