Urogynecology Community
Questions for my Wife
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WELCOME TO THE UROGYNECOLOGY COMMUNITY for WOMEN: This Patient-To-Patient Community is for discussions relating to Female Incontinence and Pelvic Floor disorders such as, Cystocele, Drooping Bladder, Intercourse Pain, Pelvic Organ Prolapse, Vaginal Relaxation and Vulvodynia.

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Questions for my Wife

I'm posting a message on behalf of my wife. She had a forceps delivery about 7 weeks ago. She suffered a 3rd degree perineal tear, hemorrhoids, and we just recently found out by way of a visit to a UROGYN that she also has a 2nd degree cystocele (bladder prolapse).

I'm heart broken. From what I've read, this usually does not heal on its own and surgery often fails in recovery. I want to know if there's anyone out there who's had a 2nd degree prolapse and has been able to fully recover. We've scheduled an appointment with a PT who has WCS (which I think means she specializes in pelvic floor recovery). Is there anything else we can or should be doing? Is it too early to start Kegel exercise?

I think right now we just need to hear that there's hope of a full recovery. Thanks for any and all responses.
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1128665_tn?1269277071
There is hope! Forceps deliveries often cause POP complications, the good news is it has been discovered right away so your wife can address it b/4 it gets worse. Personally I had grade 3 rectocele, cystocele, enterocele; surgical repair took care of everything. With grade 2 there is an even better chance of recovery.

The first step is to find a urogynecologist; this is the specialist for pelvic organ prolapse and can guide you with both treatment and surgical options. A PT that specializes in pelvic floor is a great choice for treatment as well, they are well versed in many treatment choices. I would let either the PT of a urogyn advise about whether it is ok to start Kegel exercises yet, it's difficult for me to know what level in her healing she is at. For info on Kegel path, check the article I posted on the Health Pages (upper right corner of this page), Kegels and Kegel Breathing, it gives quite a bit of basic info to do Kegels properly.

A special thank-you to  you as well for taking the steps to access guidance for your wife!

Good luck to both of you!
Sher
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Avatar_m_tn
Hi,

I stumbled onto this site and read your post, my heart goes out to you and your wife.

For you wife dealing with this prolapse emotionally can be very difficult especially with baby to. I run a site called **************.com that offers a lot of emotional help to women going through this. It is forums full of about 100 members of different women with varying degrees of prolapse. I know for fact two of our members were able to treat there 2nd degree prolapse conservatively and have returned to normal. There are many natural therapies she can try before risking surgery, and surgery will always be there if and when she desires it.

I myself had my first baby at 27 and ended up with a severe cystocele, rectocele and uterine prolapse, and this was after a completely natural water birth. I still have a uterine prolapse and the cystocele appears occasionaly (ie once every other month), but most of the time I never even notice the cystocele and I had a water balloon bulge coming out my vagina, now I never even feel a lump. I also had some incontinence with a lot of urgency -- I have not experienced any of that in over two years, I even went on to have another baby!

So to answer your question there is lots of hopes, and her body will do a lot of healing on its own in the next 12-24 months. I still am seeing improvements and I am not 24 months post partum from my second child.

There is a great machine called the kegel8 that address a lot of the nerve damage that can occur from a forcep delivery -- check it out on the web, your PT will also probably have something similar in nature to possibly use.

Remain positive and a lot of good can happen without the surgery. Check out the website mentioned above and you can search cystocele and read a lot of other womens stories.

Best of luck to you. And congrats on the new baby!
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Avatar_m_tn
Thank you for the responses. We have met with a Urogyn; she's the one who referred us to PT. Unfortunately, our Urogyn was so busy, we didn't really have sufficient time to address all our concerns. I'm grateful there is a place like this where I can get some feedback from those in the know.

My wife is seven weeks out from delivery and she feels like she's not healing. It's very depressing for her and she's in a lot of pain. I'm very confident that her 3rd degree perineal tear and her hemorrhoids are going to be ok, and I'm trying to help my wife get that same confidence.

It's the prolapse that has me worried. It just seems like what little info I can find says that it won't heal on its own and surgery will be required, but chances are it won't be successful.

As women who have successfully recovered from cystocele, can you give me a picture of what to expect during this healing process and a general timeline? Thank you so much for the information.

(PS- SSI, feel free to message me your website.)
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1128665_tn?1269277071
I am sorry to hear the direction the appt with urogyn took; when we are in pain it is compounded when we can't get the answers we need quickly. I'm sure the fatigue your wife is experiencing after childbirth is not helping; being a new mom is exhausting even when you have no complications. Has her physician released her to soak in a hot bath? Often soaking speeds healing of those delicate tissues but only should be done after being released. (I'd also recommend checking with a physician prior to utilizing any devices whether Kegel8 or others; as aggessive as her injuries are, you don't want to rush into anything prior to proper healing level-after healing is complete it is beneficial to kick it up a notch.)

Do ask the PT if she is familiar with myofascial release therapy, that is often beneficial in situation where the pain does not go away-often there are fascial restrictions or scar tissue that are causing the pain and an MFR therapist can get these restrictions to release. Some PTs are familiar with this type of treatment.

If your wife is a grade 2 cystocele she should be able to regain balance by utilizing treatments, often women use more than one type of treatment. Pessaries, Kegels, MFR therapy, core support exercise programs like Pilates/Pfilates, support garments, Incostress, tibial nerve stimulation, biofeedback, HRT/ERT, and electrical stimulation are all treatment options; what is utilized varies with individual woman's needs. Sounds like you would be better off approaching the PT than the urogyn in your area; I'm sure she can guide you properly. Know that women have great success with treatments, surgery is an option that some of us choose because it is the path that is best for us. POP surgery should never be a forced scenario, if a physician pushes it, find a new dr.
The heal curve will vary depending on  how many treatment choices your wife uses and how well she uses them. Surgical heal curve is faster, 6-12 weeks depending on what all is done although with cystocele repair alone, it is typically on the shorter end. Treatment options take longer to be effective but there is less of the pain adjustment and cost factor. POP maintenance should be thought of as a lifetime path whether you do or don't have surgery. Think of it like brushing your teeth, you don't get a cavity fixed and then put away the tooth brush.

I think once you have a chance to touch base with the PT and get more questions answered by a PT who can examine your wife, you will both have  more comfort. Know that millions of women have POP and cystocele is the most common type; that is not to say that your wifes situation is not horrific, I can't imagine the pain she has had to endure after this birth and complications. But it is important to know that she is not alone.

Good luck to both of you!
Sher
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Avatar_m_tn
Thank you Sherrie. I really appreciate the information and positive vibes. I'm doing my best to help my wife stay positive, but she's nearing 8 weeks out and still doesn't feel like she's healing. Needless to say she's an emotional wreck.

I think the use of forceps should be outlawed :(.

We're going in to see the Urogyn next week...here's hoping we get some good news!
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1128665_tn?1269277071
I'm with you on that one, forceps cause more harm than good. I'm always shocked when I hear they are still used.

Good luck at the urogyn, I am hoping you get some positive news. Know that even if the urogyn pushes surgical intervention, it will always be your wifes choice whether to utilize the surgical or non-surgical path. There is no right or wrong, it is just a matter a what is best for the individual.

My thoughts are with both of you, I hope your  wife heals soon.
Sher
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