Pelvic Organ Prolapse (POP) Community
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Avatar universal

Bladder Prolapse Surgery question

I have been diagnosed with cystocele.  My doctor gave me urogyn gave me three options: do nothing, pessary, or surgery.  She did not really stress any one particular.  She told me to think about what I wanted to do. I feel the prolapse significantly.  It is poking out like a little balloon. I am 48 at a decent weight and healthy.  I feel a lot of pressure, lower back pain, and of course, it is present physically in the vagina.  I am seriously thinking surgery is the best option for me to fix this problem.  Any experience, strength or hope out there. I hate the idea of surgery. Has anyone had this and how long were you out of commission?  Much appreciated.
18 Responses
Avatar universal
Hi ~ I would start with the pessary and physical therapy...as we should always start with the least invasive routes first..see if this helps...I am your age and have now had 2 pelvic organ surgeries and I do not regret them, but many think it will be a quick fix...we still have to do the work to keep our pf strong and healthy.
so here is the short version of my pop story...
I had cystocele, rectocele, entrocele, vaginal vault prolapse, my levator ani muscles had torn and collapsed to the bottom of my pelvic bowl as well rectal intussusception ( and other stuff was done in the same surgery for endometriosis, but that is not what you want to know about...so trying to stay on focus here)
I had a 6.5 hour Davinci surgery to correct everything...the pop repairs were corrected with a sacrocolpopexy with mesh...I am almost 2 years out and doing much better ~ my mesh repairs are holding strong and I have no regrets...but I had hoped this would be the end of the pop journey, but because I have pelvic floor dysfunction (nervous system will not allow the pf muscles and nerves to work together properly) about 11 months out I began having a hard time having a bm and emptying my bladder...I had a pretty good feeling I had a new pop...so at 1 year out I saw a new uro/gyn (the first surgery I flew out of state in order to have a specialist in both pop and endometriosis) but because of the pfd I knew I needed someone close in order to give me the vaginal valium for the pfd...so I saw a local uro/gyn and sure enough all my mesh repairs were holding perfectly but because those repairs were so strong and the pfd make the anus unable to open the waste took the path of least resistance and pushed through the 2 inch area between my anus and the mesh to create a new rectocele as well as bubble out my perineum which is call perineal descent...so I had that repaired 4 months ago with a vaginal suture only repair and am pop free and doing much better then with the pops but I still have the pfd to figure out which as long as this is going on my repairs are always going to be at risk of failing...so although I have absolutely NO REGRETS and if all the repairs fell today I would go in asap and have surgery again...I had tried everything (except pessary because it was not offered to me) to fix things naturally....but I had gotten to a point the only way I could remove waste from my body was with enemas and colon hydrotherapy...lived this way for over 6 years so I was beyond ready to go where ever I needed even if it meant a colostomy bag...so if I were in your shoes..I would try the less invasive approach first...as the surgery will be waiting if and when you have had enough and you will know you are ready!
The recovery for the abdominal repairs were much harder as it was a longer surgery with alot more done (6.5 hours 4 days in the hospital (bowel resection and mesh rectopexy and endo excision along with all the pop repairs and sewing my levator ani muscles back together) but I was ok'd to go back to activities at 6 wks with the dr. saying "Use common sense" and I was not really back to me until 9 months...but I was able to do most things by 3 months just gingerly....
The vaginal repairs (2 hour surgery and 1 night in the hospital) were the same restrictions on lifting (nothing over a gallon of milk for 6 weeks) and then slowly build back up...with the vaginal repairs I struggled to stick with restrictions because the recovery was easier ...but I did anyway as I don't really want more surgery (have now had 6 abdominal surgeries)
Now at almost 2 yrs out from abdominal mesh repairs and 4 months out from vaginal suture repairs I am back to walking 3+ miles a day and lifting 40 pounds (with care) and practicing my very intense yoga...I still am struggling with the pelvic floor dysfunction which seems to flare the IC and round and round I go...but I did go from not having a natural spontaneous bm for over 6 yrs to going every day now....I can eat again...my pain is less not completely gone...but less...and I am still hoping it gets better...but my journey of pain in my pelvic floor is a 25 year old journey...so realistically I know this may be the best I can be and I am good with where I am...would like a bit better...but over all...would have those surgeries all over again if I need to without a doubt...only with a uro/gyn though...good luck and let me know how you are doing and if you have any other questions...You will get there just do your home work as there is no going back from surgery!;)  
Avatar universal
Thanks so much for your generous response.  I am concerned about the pessary because it does not fix anything. It just holds stuff up from what I understand. It has to be taken out for sex, to be cleaned, etc.  The dr. told me the only way to fix the problem is with surgery.  Exercise might strengthen the muscles, but that bladder is going to stay where it fell.  So, that is what concerns me.  I am going to try the pessary, but I might schedule the surgery and then see how the pessary works in the mean time.  If I like it and it seems to work well, I might hold off on the surgery. I can't conceive having sex with this bladder in the way. How does that work?  Lol,  Not to mention the other necessary functions.  I worked all day today and I felt horrible pressure and cramps.  I know there is certainly worse that can happen, but this condition is quite unpleasant.
Avatar universal
Exercise will only strengthen the muscles so they can better support the prolapses...this is correct that no amount of exercise will "fix" prolapse only give better support.

Some women do leave their pessary in even with sex..depends on the pessary being used...but many gals actually take theirs out at bed time...clean it and leave it out til the next morning...every day...so once you learn it...should be fairly easy to manage...I know women who are still using their pessary 20 yrs out and many who are putting off surgery with pessary.

As for sex...you can have sex with the organs there...lots of lubrication will help and also if you put a pillow under your butt or "doggie style" will both help things move out of the way, but if not the males penis will be able to move things out of the way....and they do not notice...lol...

If you are done having children and really just "want things fixed" a VERY loaded comment because I don't think things are ever 100% back to before...no way they could be ...then research your uro/gyn and make sure they know what they are doing...ask tough questions like how many of these surgeries have they done, what were the outcomes, will they use mesh or not, if not, what will they use, what will the restrictions be after surgery and for life...how many surgeries have gone wrong and what did the dr. do to resolve the issues...if they say all their surgeries went perfectly...no problems I would be a bit concerned...as there is the "learning curve" not saying couldn't be...but do your home work on your uro/gyn and make your best choice and then move forward from there...;)

I think putting the surgery in the schedule while trying the pessary is a good way to go about it..as we can always cancel our surgery if we want/need to do so...

Good luck and do let us know how you are and what you are doing in regards to your pop...
Avatar universal
I use a silicone pessary to hold up my cysto/ursthrocele, rectocele and uterus and it is very helpful.  I also use vaginal oestrogen as well which plumps up the vaginal walls and keeps them healthy as I am post menopausal.  I think it is a good idea to consider a pessary while you look at surgical options to give you time to make the best decision for you.  
Avatar universal
I have been referred to a urogyn. She is going to fit me with a pessary on Oct 30th.  She said she would like to see how the bladder responds to being put back in place. I don't have incontinence now, but it could happen when the the bladder is pushed back in place. I hope not!   Also she knows that I am nervous about surgery. She said she has been doing this for 20 years, and she does at least one a month.  She said she is very comfortable with this surgery.  She said the success rate is 85%.  She does not use mesh.  Just an incision in the vaginal wall, push the bladder in place, and then sew it up.  So only stitches.  Which sounds good to me.  Is it normal to be in so much discomfort?  My pain and fullness feels  worse like I mentioned earlier. My lower back and pelvic area are aching non-stop. But I am just taking it a day at a time.  I am doing most of my normal routine, but I get off my feet more because of the pressure and the feeling that it keeps dropping or pushing through. After a long day at work it is definitely pushing through because I can see and feel it.  I am a newbie at this so I guess I am feeling down about it.  Plus I know I am going through menopause, hot flashes, depressed, etc.  Not terrible but feeling so crappy physically does not help.  I am used to being on the go and feeling youthful.  This has taken the wind out my sails big time.  lol. I appreciate the support!  mj
Avatar universal
sounds like you are in good hands with this urogynecologist!
It is true that we can leak once the bladder is lifted because what happens is the bladder is sitting on the urethra causing a kink...when it gets lifted up off the urethra it "unkinks" it sort of like a hose when it's kinked up the flow is low to none and then when you go unkink it the water once again flows freely..so this does not always happen....when I had my bladder lifted we decided to hold off and see how it went as the uro/gyn said that it would be a simple procedure if I did leak...I have been ok...(some leaking in the healing,but was from swelling) I did have mesh repairs and am very happy with them as I live a very active life and wanted the strongest possible repairs...not for everyone, but I am thrilled with the results of my abdominal placed mesh repairs...
Yes pop can cause extensive pain issues because the organs are not sitting where they belong with makes the muscles have to work inappropriately to support them as well as stretched or pinches the nerves. The pelvis if filled with so many nerves I am amazed that so many doctors say pop doesn't cause pain...how could it not when things are not sitting in their proper places so they can't be supported properly making us have to work the muscles inappropriately which makes the nerves have to work differently...I always think of it like a still pond...when you throw a stone into it you get the "ripple effect" and I feel this is what happens in our pelvic floors as well...one organ is out of place (or more) which ripples to every other organ, muscle and nerve in the area and surrounding areas...It can also be many other things causing the pain, as mine started with endometriosis and interstitial cystitis (Horrible pain)... then there was the pop issues and I have pelvic floor dysfunction and feel I have had this all along ~ who knows which came first...but it  has really been extremely problematic...so at least for me...I start with what seems most problematic and keep going until I feel the best I can be, know what the worst out come might be, but keep positive and plan for the best, then if things get a little complicated I keep seeking answers (have been at this for well over 20 years now so I have gotten unfortunately pretty good at it ~ lol ~ I do hope the pessary works for you as it will kind of show you what it will be like to have the bladder lifted at least some what...I am much better with my organs in place...maybe not perfect, but will we ever be perfect again? I am way past that expectation...lol ~  Let us know how the fitting goes! Good luck!
Avatar universal
There is a great book called Bad bladders: Taking control  on Amazon that a lady I met after my surgery wrote. Great book with her first hand acct. Of the entire ordeal from diagnosis to surgery. Funny as well.
Avatar universal
That sounds good. I will check that out. Thanks.
Avatar universal
My surgery is December 16th. I am really nervous about it.  I changed doctors because I was feeling apprehensive and a bit irritated with the first doctor.  I love the new doctor.  I feel a lot better with him and he is doing the surgery.  I tried the pessary. I can't get it back in once it comes out.  When the doctor puts it in, it feels good for a few hours.  Then, it doesn't and it comes out. I don't think that is the solution for me.  I have stage 3 bladder prolapse and stage 1 uterus.  The plan for the surgery is to take out my uterus, (I have 3 kids, and I'm 48) and do the bovine graft.  That seemed like the best option for me for a long-term solution.  But like I said, I am nervous and scared.  I can't avoid surgery. I feel like everything is falling out.  I feel a lot of pressure and daily aching.  I am just feeling awful much of time. It just seems like this condition is taking a lot out of me. But I am glad I found a doctor I like and trust to do the surgery. He is a urogyn and does these surgeries weekly.  
Avatar universal
I understand this is a very important decision for you to make.  It is really encouraging you have found a Urogyne you are happy with that has so much experience with this prolapse operation.  Do you know their success rates?

In terms of pessaries, there is a huge amount of choice and Urogynes often only have a limited knowledge of the full range.  However, if you feel you really want to have the prolapse operation rather than go for another pessary then I wish you luck with your operation.
Please make sure you are your aftercare sorted in terms of no lifting and heal well for the best result.  Also, ask for a womens Physio Therapy appt through your Urogyne or Dr to be set up to help you to strengthen when you are able to do this as after care is important.  
Good luck and let us know how yo get on.
I would like to mention also that 'bladdersister's' suggested book as we know nothing about it or any of its content.  Thank you
Avatar universal
I had the surgery Tuesday. It seems as though the surgery was very successful. I had a hysterectomy, rectocele repair, cystocele repair, and one other repair.  It was an extensive surgery but the surgeon that I have is board certified in urogyn. He did the cystocele repair with bovine material to secure the repair.  So far, I am quite sore but trying to stay ahead of the pain as ipurr2 has suggested.  I am drinking a lot of fluids, eating healthy, takings meds, stool softener, etc.  I am only 2 days post op and feel that I am doing extremely well. But I am determined to take it slow!  I am fortunate to have my husband who has been a wonderful caretaker.  I look forward to the future results of this surgery.  It is most definitely a rough surgery.  Whew.  
Avatar universal
Good to hear you are on the healing side of your surgery and that you have such a helpful husband.  Continue to look after yourself well and keep taking the stool softeners.  
As you are only 2 to 3 days post op now you will feel very sore and also very tired.  Rest lots and do some little walks in the house when you feel able.  
Heal well.
Avatar universal
So glad to hear you found a great surgeon as this is critical in a good outcome! The next important thing is you making sure you heal well as you will only get this one chance to do it correctly. So this means resting and walking (little gentle walks), my walks started as a small walk around the nurses station one circle each hour and by the time I left the hospital (4 days) I was walking several nursing stations and several laps, so keep up the walking as this gets things moving (gas and bm's), staying ahead of the pain, as long as you are taking pain med you need to take the stool softener and I would strongly suggest magnesium and miralax for life...I am planning to take it forever...allow your husband to take good care of you for the next 2 months, then as you begin to up your activities do it slowly and if it hurts, stop and try again in a week...count on thinking your pop's failed over and over through out the healing phase as each activity will cause swelling and as the sutures dissolve and your body has to pick up that workload you will have swelling....if you struggle to poop do not bare down at any cost...it will happen..in time...in the mean time just have baby wipes and clean your self up and let the rest come out next time...your energy will be low for a while then you will have a day of feeling good and of course do more then you should and then most likely have days of fatigue after so be patient...I finally felt pretty much myself at 6 months and very well at 9 months...happy healing!
Avatar universal
I re-read your post last night.  I am two weeks in and that is how I feel. I feel like my repair has failed.  I am still showing light bleeding, pinkish..and now feel that full, bloated feeling and feel like something is coming out again.  I am not in any pain really, just that bloated achy feeling.  How long was it until you started going out, driving, etc? I went out a couple of times and only drove briefly one time.  I went out Monday and was out for a few hours...but then yesterday I felt awful and scared that I overdid it.  So then I chilled for the whole day and night.  My post op is appt not until January 26th.  How long were taking the ibuprophen.  I don't feel a lot of pain, just soreness in my bottom. And I feel that raw and itchy feeling and that hanging feeling again.  ugh. I hope that is  normal. What are your thoughts?
Avatar universal
2 weeks is very soon to be driving and going out as well for a few hours.  What healing aftercare did your Urogyne give you?  In order to get the best from your operation you need to rest up and do short walks to begin with round the house then lengthen your walks.  I am not sure you will be insured to drive your car at all so soon after your operation.  Call your Urogyne for advise about how soon you are allowed to drive.  If you take care while you heal you will get the best results.  
Take it easy and take your time to get back to normal activity.  12 weeks is usually seen to be a good healing time with steps along the way as you get more active.  
Good luck and let us know how you get on
Avatar universal
Hi, They told me I could drive in two weeks, which really surprised me. I am even more surprised now considering how not well I feel.  I got the impression that they were rather nonchalant about activity since they said I could drive in two weeks.  So I have been up doing some household things, taken some short walks in the neighborhood, etc. Not as much as normal but the couple of days I felt really good I did some more. I thought the walking would be good.  Now I'm concerned and I have slowed down a lot.  I appreciate the advice. I sincerely hope I have not impeded my healing.  I was thinking that if I am still feeling bad I might call the dr and see if he will see me on Monday.  t
Avatar universal
Good idea to consider calling the Dr if you continue to feel unwell.  And also great to hear you are reducing your activity.  Short walks are OK as long as you feel up to it, but lots of resting too and no lifting.
Good luck with your healing
Hi Ladies ...I am having a hysterectomy and a grade 2/3 cyctocle  repair on the 17 th ..feeling nervous. !!! Can you tell me how much pain is involved after surgery..I am allergic to codiene and  morphine .Thank you
Avatar universal
Yes I had prolapse surgery, before surgery I did not have any urine leakage at all. After surgery, I started leaking, I was 8 weeks trying to heal. It's been 4month, still leaking. Went back to my physician and she said I need another surgery. Not what I wanted to hear. Even with the bladder prolapse, I had no pain or leakage. Wish I did not have the surgery
Did you have your operation done by a Urogynecologist?    
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