Urogynecology Expert Forum
bladder prolapse after histerectomy
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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bladder prolapse after histerectomy

Dear dr,
I had a histerectomy performed more than a year ago. I was diagnosed with uterus prolapse. I agreed to the surgery because I felt uncomfortable and prequently leaked urine when running.  I am 50, athletic, 177 cm and 77 kg.
My uterus and ovaries were removed. Apart from that my vaginal wall was restored.
I started to run again 6 months after my surgery. I discovered that I leaked urine not only when running but when fast walking even without feeling it!  Intercourse was really painful. I was given special hormonal vaginal cream with estrogene, started hormonal therapy and was given some pills to regulate my bladder. The cream worked, pain was not so severe  but leaking continued.I visited my doctor again after a few months and she informed me that this time I had a bladder prolapse. She wants to operate again and put a stress related vaginal tape inside me. I read about it on internet and  I am concerned with some surveys' results. My doctor is convinced that my running is greatly related to my second prolapse.  Please tell me if it is possible to decrease my problems at least in 50-75 % as my dr insists on and if there are other alternatives to this procedure?
Should I stop running as she suggested?  

Regards,
Eve
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Sorry to read of your problem.  Your condition is not uncommon.  Stress Urinary Incontinence, leaking of urine with cough, jumping etc, is very common and can be treated effectively with a simple surgery to place a small amount of mesh under the urethra to support it.  This is called a mid urethral sling and cure rates are around 90%.   I have a number of patients that have had the sling and are runners.  They have done well.  

Regarding vaginal wall prolapse, cystocele, this too is common.  It can also be repaired.  The decision to use mesh to repair the cystocele  is one that is somewhat controversial with some doctors using mesh and other not.  Should you decide to use mesh, it is important that your surgery be done by a doctor that uses mesh a lot.  

I would advise my patients to undergo pelvic floor muscle strengthening and  repair the cystocele either with a permanent mesh or an absorbable mesh material.  I would not restrict her running after 6 months of post op recovery.  

Good luck.  
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