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diagnosed with stage 1 prolapsed bladder
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diagnosed with stage 1 prolapsed bladder

hi sherri; had a prolapsed uterus removed (partial hysterectomy) 5 years ago; was always getting uti's and urge to pee; saw several urologists who said I had an overactive bladder; put on  meds; then I had pressure/pain in pelvic area went to emergency several times; no help; just given pain meds and sent home; finally saw urologist had a cystoscopy done and was told my bladder was pushing down on my urethra; he sent me to another urologist who did a eurodynamics test and he told me that I had stage 1 prolapsed bladder and that he doesn't do surgery on stage 1; asked him my options; he said \kegels, pessary; now waiting to see another urologist to see if \i qualify for a pessary; I have to take meds otherwise I have constant urge to pee and pressure; I now realize that my overactive bladder was from having a tilted uterus, then prolapsed uterus; because my bladder was fine prior to my 2 pregnancies;  i prefer surgery because I can't bend over; uncomfortable to sit due to tight feeling where my bladder is; if I walk too much get pressure; will I be eligible for a pessary and will it help? can the original Doctor (obgyn) do another A & P repair or should I wait to see if eligible for pessary?
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Hi marisa1959

I too have the same symptoms as you and have a urethrocele and also a grade 3 rectocele and grade 2 intussusception plus rectal prolapse.  You dont seem to have seen a Urogynecologist.  I recommend you see a Urogyne to look at all of your symptoms for another opinion.  At grade 1 cystocele it would be better to find a non surgical route in supporting your bladder and aleviating the pressure from your urethra.  However, there seem to be several relevant points here and one is that with no uterus, you may have little support for your bladder as well as any overactivity of your bladder.  I understand you have a lot of pressure on your bladder and urethra.  I also have this as well, however, for me there is an element of pressure from the bowel that is agrivating the situation.  Do you feel this could be an additional problem for you?  Before you make a decision about an operation, I do recommend you seek a Urogyne opinion.  Normally it is seen to be best to have any pelvic floor problems and subsiquent operations done by a Urogyne, who can look at all of this at the same time for you as well as any pessary questions.

I understand how upsetting and frustrating this problem can be.  Let us know how you get on.
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Hi Marisa,
To answer your question about a pessary, I would definitely try it.  Before my surgery I had tried three different size pessaries.  All three relieved the feeling of pressure and "falling out"feeling.  I had severe vaginal prolapse and every time I emptied my bladder I had very unpleasant muscle contractions.  It is common to have a vaginal discharge with a pessary in so don't be alarmed. Unfortunately all my pessaries fell out on their own due to the prolapse.  Many women can wear a pessary and find relief which I hope you can find.  Be sure your in control of the pessary by learning how to put it in and take it out yourself.  I was too nervous at first and had to rely on medical professional which was not a good thing for me.  I'll never forget the one time I thought it was falling out and ran to the dr. office, only to have the nurse tell me everything was ok and gave me this annoyed look.  That night before I went to bed lo and behold the pessary popped out on its own!  Give it a try and let me know how it works for you.
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thanks for responding; I'm waiting to see a Urogynecologist to see if I can get a pessary; nexy wek will be a month since I've been waiting for an app'y; will call Urologists office to see why it's taking so long; been doing Kegels now for 2 weeks; if I already had a prolapsed uterus (removed with hysterectomy) and now a prolapsed bladder, doesn't that show that my pelvic muscles aren't strong enouph to support everything; will I eventually have future problems (such as vaginal or bowel prolpase) ; is that what happened to you?? I have a friend who had a prolapsed uterus but she chose to have it lifted and not removed; had I known I could have done this (no one told me about it) and maybe not have these bladder problems I am now having; one other thing: did you have the Eurodynamics test (fill bladder up with water in catheter) did you have problems after this test; I was O K  taking medicine (Oxybutynin) but after this test the meds wouldn't work anymore, got spasms again and urge to constantly pee; sometimes presure is so bad have to take a narcotic pain killer; finally got a new medicine but not as good as Oxybutynin...
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thanks for responding; you say you had a vaginal prolapse, what is the history, did you start with a prolpase uterus or how did it start? I'm still waiting just to get an app;t to see a doctor about the pessary; will wait until next week and then call Urologist to see why it's taking so long...even once I get pessary will I eventually have more problems (like a prolapsed vagina or bowel) the doctor seems to think Kegel exercises will help; did you try Kegels??
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Hi Marisa,
I had severe vaginal prolapse but still have my uterus.  My uterus did not have to be removed in surgery.  I believe it all started with the birth of my daughter who was over 9 lbs and delivered with forceps and episiotomy over 25 years ago.  I also had bladder and rectum prolapse.  I had both abdominal robotic and vaginal surgery done together.  The pessary is to make you more comfortable.  Some people can find relief from the pessary alone and don't need surgery.  In my case the pessary gave me relief but did not stay in.  I was told not to do kegels with my prolapse.  I had tight muscles to begin with and kegels just aggravated them.  Instead I had pelvic floor therapy to relax and release the muscle tension.  Have you been to a pelvic floor therapist?  A therapist who is experienced with the pelvic floor was a great help to me and might be for you too.  I also had a urodynamic test done prior to surgery to see if once the prolapsed bladder was fixed that I wouldn't become incontinent.  If I needed extra surgery for that I wanted it to be the same time as my other surgery.  Test wasn't fun but glad I had it done.  Let me know how the pessary works for you.  You might want to see about getting a referral for a pelvic floor therapist from your doctor while you are there aslo.
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Avatar_f_tn
Hi Marisa
I havent had my uterus taken out but have prolapse in other areas as stated.  I do feel that general pelvic prolapse may show a weakness that 'could' indicate other prolapses and very often women have more than one prolapse, however, this isnt always the case.  What is important is that you keep an eye on what is happening to you and you make sure you also keep your Urogyne informed as well if you feel anything needs to be looked at. At the same time you are doing your exercises and hopefully you can get some internal support with a pessary as well as pelvic floor physio.  Make sure you talk to yoru Urogyne about the pressure on your bladder etc.,  I did have a urodynamic test marisa but it didnt make my bladder symptoms worse.  It was a bit sore afterwards but the soreness went away.  I have poor urine flow and retention of urine.  I hope this helps.  
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