Update following complications yesterday at 7 weeks

Women's health
1

Hi all...

I posted on a thread yesterday as I was petrified my sacropinious fixation had failed. I had cramps in my stomach and I felt an obstruction. I had a look and it looked different to a week ago. When I push I can see a dome shaped obstruction. I worried all night so went to the doctor this morning.

The doctor had a feel but I said I wanted her to actually look with a speculum. I more or less insisted. I have no further post surgery appointments apart from physio next week...so I felt I was entitled to ask for an opinion. She was very nice and happy to do so and said my womb was still in place. I'm elated that the sacrospinious fixation hasn't reversed! I am not going through that surgery again, not yet anyway! The bits of skin I can see she thinks are inflamed scar tissue. I've asked whether I can be referred to a gynaecologist anyway as I am supposed to be having the urine test but have now been discharged. I'm not sure if this is possible. I'm waiting to hear back.

I think I probably overdid it yesterday which is why I had cramps and soreness and things look differently down below to how they did before. I went shopping and had to split my groceries into manageable bags and make 4 journeys up 38 stairs. Maybe that inflamed the area? I also did a few arm exercises and legs raises and also a plank for 50 seconds. Another doctor had said I could go back to full gym class a 6 weeks - which I haven't - but figured as planks don't involve movement it would be ok. After reading helpful posts yesterday I realise that was way too soon. My doctor today (a different one) confirmed that swimming will be the best exercise.

I have said this before, but there is too much contradictory advice on the internet and also what we have all been told. For example: I was told to do pelvic floor exercises immediately after my surgery- others on here were told to wait 6 weeks. There really needs to be standard detailed expert information of 'dos and dont's' ...Telling women to "take it easy" , have "lots of rest" , "listen to your body", don't lift anything heavy" ... it is all way too subjective and open to interpretation. For example; what is heavy? And if that means only half a kettle of water as some have said, for how long? I've been told various different things - 6 weeks, 10 weeks, 6 months , for ever! The standard NHS guidance is just not informative and detailed enough, firstly on the level of pain to be expected, (absolutely useless there - e.g no mention of sciatica as referred pain, no mention of abscesses developing, like I had, or when buttock pain from SSF was likely to recede, and expecting women to deal with terrible pain by taking paracetamol and ibuprofen : come on! That's just rubbish - stronger pain killers are needed if you get buttock pain).... secondly, there is little guidance on what behaviour you should avoid post surgery and for how long. I've read so many info sheets from various health authorities around the UK , maybe 20... none are detailed enough and done appear to give contradictory advice , e.g time off of work. What would also be helpful is some real photos on the internet of how a 'normal' and prolapsed uterus looks. All I can find are drawings or computer diagrams. They are useless for making comparisons. Another thing that we are given different info on is sex. It's almost like the advice is for the man's benefit ("you might scratch him with the stitches " etc...) but what about from a female perspective? - such as advice on when an orgasm is safe.

So at 7 weeks post rectocele, enterocele and sacropinious fixation (of my cervix as I haven't had a hysterectomy, so it's not vault fixation) these are my recommendations:

1. Get the supermarket to pack your groceries and take to the car and then have someone to lift and unpack at home. Or if you can, do on-line shopping. Don't lift more than a bag with a pint of milk and cation if orange.

2. Still have rest periods and if you have only been signed off for 6 weeks like I was, do not go back to work if your job is not desk work but is manual. Insist on further time.

3. Walking is good exercise and it seems swimming too. Also Pilates and yoga and the instructors should be able to say what exercises to avoid.

4. If you are anxious and waiting for a post op examination, which for some on here seems to be 3 or even 6 months ... go to your doctor in the meantime, as I did today. Say you aren't sure if it's worked and ask your doctor to examine you, like I did today. But with a speculum so he or she can actually see rather than just feel. It's allayed my fears and had also been a wake up call for me to take things more easy.

5. Any lifting - bend legs. With the washing machine I drag towels out one at a time and along the floor and only lift onto the drying rack at the last minute. ( wish I had a tumble dryer!)

6. Sex - abstain from penetration (sorry, this is about us, it's not just about how it affects the man - and 6 weeks is too early in a healing area, even if you feel like you want to have penetrative sex. I think maybe 10-12 weeks. The stitches take about 5 months to dissolve so it might scratch him. But 'man flu' comes to mind here. I'm sure it's not damaging for him, just uncomfortable, but I may be wrong here.

7. Orgasms - I asked my surgeon and he said about 4 weeks is ok. But 6 weeks a better option as obviously the walls of the vagina will contract.

8. Keep taking laxative - I have 2 sachets of movicol a day.

9. Try to accept this is life changing surgery. A lot of adaption is required. I've found this hard and am so thankful to the women on here who are getting me through this. This was initially for the pain period (which receded at 4 weeks for me) and now for the recovery/ behaviour post op period....

I have days where I have no motivation, feel down - I usually 'snap out' after a cry! But the adjustment and psychological side of this is hard at times, and I'm generally a positive and stoic person.

10. Accept help and ask for it. My boys have been pretty useless (22 and 19) ... it's almost like me being ill annoys them ... but my mum has been great (I don't have a partner). If you need help and support ask friends to come on certain days to help shopping etc ( I can't have home delivery where I live). Ask your doctor about home help for cleaning etc. I've just engaged the services of a cleaner as I realise I can't do it. But if you can't afford this, ask your doctor who to contact for help.

I'm not sure how helpful any of this is and you might disagree with it, but it's just a few tips I can think of and ones I think I need to follow myself!

Take care everyone ..

Caz 🦄🌈

2

Hi,

You've nailed it, got it in one, hit the nail on the head, summed up exactly what the main problem is with aftercare advice!

If only the surgeons were all female and had actually gone through at least one of the various numbers of gynae procedures we can have!

We're told everyone is different, as if we didn't know, but surely by now there should be a set of guidelines that lay out, in more specific detail, the strictest advice possible.

So often we're told, " Oh, your body will let you know if you're doing too much!!" Not for me it didn't. After a completely painfree op ( vaginal hysterectomy, anterior and posterior repairs....sorry, can't get my head round all the ' celes&#39 and feeling absolutely great, I must have done something wrong as after 5 months it failed. I had waited 10 weeks for a post op checkup, and advice soooo vague. I think if I hadn't asked questions I would have left with the surgeon's final farewell, "Now remember, this can happen again!"

Fortunately I've since found a urinogynacologist with a good reputation. Contrary to what my own doctor said, my bowel hasn't prolapsed again....I've got the dreaded vaginal vault. I now face an almost 2 year wait for this. Meanwhile I'm left wondering exactly what I did wrong.

You also mentioned the need for help. My husband had to be reminded constantly what I could and couldn't do, but it's maddening to have to ask all the time. If it were the other way round I know I'd be capable of doing what had to be done and checking up he was being careful!!!! And so I'm back to having to depend on help but, as usual, trying to do as much as I can.

I know now that standing, bending and carrying too much ( and for me that's as little as half a kilo!) make me feel worse. I'm not sporty, but loved walking and am lucky now if I can walk for 30mins without having to sit down and try to inconspicuously wiggle my backside till it's at least slightly more comfortable! I'll skip the nightmare of bowel movements!

Perhaps the biggest problem of all is that we only find this forum when it's too late! If only there was an advice leaflet, with details of online help from those who have successfully gone through a gynae op, it would be really useful, and encouraging. My doctor's surgery is full of leaflets on all ailments under the sun, except pelvic surgery!

Sorry for the length of this post....could have been longer if I'd covered everything I'm frustrated about!

Good luck, Caz,.......I think you're out of bed now!!!

 

3

Thank you Caz, this is a very clear and helpful piece of advice. I am a few weeks further on than you (12 on Thursday ) and I'm still being careful. I haven't seen either of my consultants yet - I had joint surgery with a general surgeon and a gynaecologist- and I'm waiting until I know everything is OK /in the right place before I go back to work. I agree that there is a lot of advice out there but not all of it is as comprehensive as it could be. I hope your recovery continues well, Nicky x

4

I am so glad you feel the same. Everything you say is true. Without wanting g to sky d like a feminist lunatic, I'm pretty sure if this wasn't exclusively a female problem things medically would have advanced a lot further. The surgery is barbaric really, but being women we just get on with it. Boys and men just don't get it! My sons' girlfriends were quite helpful when around. Men!🙄

I kept a video diary and I'm thinking of posting them to YouTube, it may well deter women from surgery but it does show how things improve post op. Xx

5

Hi Caz,

Love your post, all very sensible good advise I'm sure this will help lots of ladies who have had similar surgery.

Glad to hear your GP has put your mind at rest and you haven't done any permanent damage overdoing things.

They just don't want us properly about not overdoing things and are not realistic about how long the recovery rakes.

Sometimes think the 5-8 weeks us more for employers benefit than us the patient. They really do need to get thus right.

Take care,

Phyl x

6

Hi Caz, I'm so pleased you saw the doctor & she put your mind at rest.

You have summed it up very well, it's definitely not a quick fix surgery! I wasn't warned at all before having my hysterectomy that it could lead to all this. I would prefer not to have more surgery but the almost constant back pain which is now keeping me awake at night is so depressing. I dread long journeys & holidays at the time in my life when I should be enjoying the freedom of no children etc.

I would add one thing to your list & that's gynaecologists (& urogynaecologists) should work with colorectal consultants as there are bowel problems pre and post op. Dedicated pelvic floor clinics would be wonderful but I can't see that happening.

It totally takes over your life & you can feel quite alone but many, many women suffer as they are embarrassed to even discuss this with their GP.

Good luck x

7

Thank you so much for this messge. It does seem as though there is almost too much information around, but which information is the most useful is very difficult to identify. I live alone and feel that obtaining help is going to be difficult which is one reason why I keep putting off having an operation. The complications after surgery do sound, as you put it, life-changing. I know that not everyone has problems and many women go through it without any real distress. But I do worry. Anyway, thanks for this useful information.

 

8

I agree with your comment about the two specialities I was I think very fortunate that my original referral was to the gynaecologist and after I saw him he said he wanted to send me to see the colorectal specialist to investigate my rectocele before he made any decision about my management. It delayed things quite a bit but I think ensured that I got the correct treatment. X

9

Gosh, so pleased the sacrospinous fixation hasn't failed, I'm amazed you weren't offered a hysterectomy when you said your womb was outside your body. Did you opt not to have one?

I am seeing my surgeon tomorrow, I am now nine weeks post surgery and wasn't due to see her until August 12th, a long wait.

Like you I have so many questions to ask, particularly about exercise. I was one of the women who was advised not to do pelvic floor exercises for six weeks. I'll feed back what my surgeon says, but I must bear in mind we are all different and have had different surgeries.

I hope you now feel reassured, planks and leg raises are both definitely out. I don't think anyone should do leg raises, especially with straight legs, unless they already have fantastic core strength. They are dreadful for your back, without a strong core you end up using your back not abdominals. And however fit we were before surgery, at 7-9 weeks post surgery our body still has months of healing.

I did find a good website detailing safe pelvis floor exercises post pelvic surgery, particularly repairs.

Good luck with your recovery, we need to be patient!

10

Sorry Sheila can I ask do you have a link to the pelvic floor exercises that you mention please? Thank you Nicky x

11

Hi Sheila.

I wanted a hysterectomy as i was told my womb will likely prolapse again but my surgeon said that this would mean there would be nothing supporting the vagina walls and that the rectocele and enterocele would therefore not repair so well. He said that it's not common practice now to remove the womb at the same time. Not sure if I believed him then and still not sure now! This is another example of differing medical advice and opinion!

I too researched safe exercises. One website I could see I had to pay... but I found another with an Australian woman but the exercises were just too easy.

Do let me know how you get on at your appointment.

Very best of luck !

Caz 😀

12

Ha Caz. Well that's certainly contradictory advice, my understanding was that the hysterectomy was needed because my uterus was prolapsed, not nearly as badly as yours. The sacrospinous fixation pulls the vaginal vault up, to support the vaginal walls and to prevent a vault prolapse, something many women in here seem to have experienced. My surgery was not the same as yours though, I had the anterior and posterior repair, so will have to see how it all looks this afternoon.

Regarding the pelvic floor exercises, they are not difficult so when you say the advice on the video is 'too easy' my concern is that you're looking at them as core and abdominal exercises. (Planks, crunches, sit ups etc). All such exercises put huge pressure on your pelvic floor and are not therefore good whilst your body is still trying to heal, the priority for now is just that, healing, the muscle re toning and strengthening can wait. Frustrating as it, especially if you were used to that type of exercise prior to surgery. I was a PE teacher, when at college I spent hours trampolining, competing, doing displays and then teaching it. Possibly a major contributing factor to my prolapses, plus a big second baby! I thought all the exercise was doing me good, but it so depends on what you do, I also did loads of athletics, running, jogging, aerobics pressure, pressure ...

I think all girls should be educated about their pelvic floor, core exercises and maintaining a healthy weight, another huge downward pressure on our pelvic organs. I'm not overweight, just knackered and prolapsed. ☚ī¸

Fingers crossed for success. 😃

13

Hi again!

I did have anterior and posterior .. but surgeon said taking my out womb would encourage repaired vaginal walks to cave back in. The SFF I had fixes the top of the cervix to the ligament. I have permanent sutures in the ligament but the surgeon said it can still collapse and I know it's likely I'll have to have a hysterectomy at some point and then the vault fixation . That makes me anxious!

Yes, you're right about the exercises. I used to do lots of Russian crunches etc at my gym classes. I know those and sits ups are out now for good. I guess I'm just being a bit vain but following my marriage break up I worked hard to lose 2 stone and before the surgery I was 9. 1/2 stone. I've only put about 6 pounds on and I'm not worried about the weight gain. It's just that I had such loose skin from my weight loss and now it's all come back! It's just frustrating to realise I probably won't be able to shift it. I also loved the high impact gym classes!

This is why I'm going to start swimming.

The more I read on here the more I realise something needs to be done to raise awareness of the importance of pelvic floor exercises , but also of safe lifting postures etc for all women. Both my births were natural but straightforward and the surgeon said my 'condition' is almost certainly hereditary - I just have flimsy vaginal walls- and there is a history of it on one side of my family. However, I didn't do my PFE and I'm pretty sure that's contributed!

Can't wait to see the physio next week. I'm going to get a list of exercises that I can do and will reveal all on here!

Caz 😀

14

Completely agree with you Sheila, women need to be better educated on how to look after their pelvic floor. My mother use to always warn me of things I shouldn't do but didn't take it serious. We don't realize that we just can't and shouldn't do certain things.

We especially have to be careful in this day and age when there is so much pressure to be healthy and regularly go to the gym.

My Granmother lived to 107, she never worried about being able to swim, cycle or attend the gym. She spent her time baking for the family, tending her garden (which they say is like a gym session ), her main exercise was tending the house and out and about visiting extended family.

She delivered 5 children yet never had any bladder of bowel problems or prolapse repairs. She was quite spritly right into her 80''s until my aunt became overprotective and didn't want her going out on her own.

Anyway I know I love the healthy high I get from swimming which at least seems to be safe to do, but I miss the gym and although tried returning to cycling may have to give that a miss too.

One the older ladies on this forum has had a few very successfull repairs over many years despite being in high impact employment.

I think at end of day as females we have very different pelvic anatomy from men and as such have to be extra careful especially as we get older and hormone levels start depleting.

Phyl x

15

The main problem is we should not be bipedal, as quadropeds our pelvic floors were supported and weren't faced with the continuous pressure of being upright for so many hours per day!!

Oh to be a horse.  

16

To all the ladies who are interested, I think I might be the 'older lady' you mean Phy! lol  I've spoken to many ladies on here and I agree entirely that most women these days are a bit obsessed with exercise in the gym etc. We are not meant to be muscly as females but do need to keep our pelvic muscles as strong as possible especially after childbirth and heavy impact jobs. My generation did not need this sort of exercise as we worked in the same way at our normal activities, ie housework, gardening, decorating, walking the kids to school, etc. I for one did not and still do not drive! I walked or cycled to work, at least 5 miles per day. Neither I or my kids were overweight in those days and we ate home cooked healthy food, not takeaways and junk stuff. These are what cause obesity and poor muscles. My Mum had weak pelvic muscles among other things and I seem to have inherited them inspite of doing all the right things when I was younger. I also have OA or wear and tear arthritis, probably due to all the above activities and low hormone levels after meno. So I guess we can't win in any situation can we? We are women and have to accept our limitations as we age. I did have two successful repairs, first was hystectomy for uterus prolapse and cystocele at age 40. 2nd was a rectocele repair at age at age 60 and recently a vag vault, (SSF) plus another rectocele repair at 74. My recovery this time is taking much longer, mainly due to being older I suspect. It does pay to listen to what the consultants and their teams advise if we wish to avoid reoccurring prolapse problems. I was not given much useful advice in 1984 or 2002, (previous surgeries). If I had I would not have gone back to work in care homes, supermarkets or anywhere where lifting and standing were and still are the norm! I never went to a gym after I left school but did, swim, walk and cycle. CAN'T ride a bike now lol! (Plus all that Rock n Roll in the 50's!)  So again I advise, be patient patients, don't try to rush things for your own sakes in later life. I wish you all a good recovery but not a speedy one! Poll X

17

Here's the update!

I have been reassured that the surgery has worked, my consultant examined me and said it's all as it should be at this stage. She said the SSF stitches are fine but could take 15-16 weeks to dissolve, she did quite a bit of tugging and prodding which she said would make them more comfortable. Ouch, that did make me feel a bit queasy!

I had a list of questions.

One of my major concerns, and reason for ultimately opting for surgery, was leaking. She said this is quite normal at this very early stage in my healing, nine weeks. She said my bladder prolapse was really bad, as was the rectocele and uterine prolapse, I don't think I appreciated how severe they all were; I was a wreck!

She will reassess me at the end of September and then she will have to see if anything else is needed, medication etc.

I asked about lifting, the standard reply, 'no heavy lifting' was clarified. No more than the weight of a new baby, 7-8lbs, so no lifting garden pots, heavy shopping and definitely not my granddaughter. ☚ī¸

I asked about exercise.

No badminton, zumba, jogging, horse riding, abdominal crunches, high impact classes etc.

Swimming is fine, as is cycling, but not up hills. Static cycling in the gym would work, but I do like cycling outside.

I didn't ask about physio, pelvic floor exercises can now be worked on, I know she wants me to wait a lot longer for all the internal healing.

Despite the discomfort and pain when prodding, she said we could have gentle sex, I'm not sure I feel comfortable yet, slowly does it!

So, a very reassuring appointment but a strong reminder that I've had major surgery and the recovery will take a long time. I must now be patient, continue to take care, exercise sensibly and cross my fingers. (Maybe legs too for a while &#128563.

I'm never sure who can see posts, but if it's anyone other than Caz I hope it might have helped others too. Xx

18

Yes, I was thinking of you Pollyanna â˜ē I was so impressed that you managed to protect your repairs and they have lasted so well despite being in high impact employment, and I also noted that you never mentioned going to the gym or anything like that.

It often looks like many of us ladies doing high impact sport seem to end of with failed repair's or repairs that are not as successful even though not all of us go back to doing these sports.

It makes we wonder if as females we shouldn't be doing such high impact sports at all!

Phyl x

19

Hi Sheila,

I'm sure lots of ladies will be reassured reading your post. You should do a weekly update to record how you felt at different stages. I'm sure it would be well appreciated by others and you yourself could look back and compare how well your recovery us going over the weeks.

Phyl x

20

Thanks for your update Sheila. I found it very reassuring as I'm 9 weeks post op come Monday. I've had a problem with leaking too and didn't have an anterior repair but did have the vault lift, SSF as this had prolapsed. That was most likely due to the hysterectomy in 1984 but it's taken all this time to happen. I phoned the consulants secretary today about the pelvic aches and bladder weakness. She said have a urine test and see if that's ok, if it's not I may have a post op infection. I cannot get a post op appt yet, they're running late so have to wait a bit longer. Anything but an emergency problem I have to see my GP first. I was told that my hospital has still not recovered from the 'winter crisis'! So thanks again, for a bit of reassurance, a timely reminder that it is major surgery and some hope that all will be well soon if I'm a patient patient as I keep advising everyone else! lol  xxx