Prolapsed Bladder after Hysterectomy for Prolapse

[Joan288]

I am a 65-year old teacher with a bladder prolapse that gets worse as the day goes on.   I will go into the washroom at work to urinate and can't and by the time evening comes, I have to lie down doing Kegel exercises so I can empty my bladder at bedtime.  I gather it's Stage 3 because it feels like it's falling out and protrudes so that I can fell it when I'm walking.

The surgeon just said that nothing could be done about it when it happened after I'd had hysterectomy with anterior and posterior repair.  He said that he will not do surgery with the methods they have now so I'm left with this problem that is driving me crazy.  I ordered a "truss" that is ridiculous and just cost a lot of wasted money.  I ordered a book on exercises that say it takes six months of doing them four times a day when I'm teaching all day, marking and prepping at night.  I don't have the time and retiring right now is not an option.

I am getting osteoporosis and am supposed to be doing lots of exercise.  I had been doing it, but have had to stop altogether with this problem.  I have told some of my friends at work but nobody talks about it or knows anything about it.  

Any help you could suggest would be appreciated.  

Joan (Canada)

[Sharilee16]

I had hysterectomy in May 2012 and have been experiencing some off and on pain in my vagina since 2014.  Just this summer it has become an everyday issue with much discomfort at times.  I realize at this point that I should have addressed the whole issue sooner but am now taking steps to hopefully get some treatment or relief.
Is this forum still going as there doesn't seem to be any new posts?

[Teapotme]

I am 56. I had hysterectomy at 34. Have not been sexually actives in a few years. I have a protruding bladder. I tried using a tampon, I hurt when trying to take it out. I used ky  when inserting, that did not hurt, however when it was in i felt i was having menstrual cramps, while it was in. I am going to try the Poise Bladder Support sizing kit.

[UKlady1001]

There are a large number of pessaries on the market that Urogynes often havent seen... and the Urogynes are the prolapse experts who measure us for pessaries so look at all the pessaries on the market..like the silicone ones as well as and look at what POP/s they hold up as you may wish to try a different pessary even if only until you decide on having a POP op if this is what you want to do.  

Sounds like your Urogyne has looked at supporting the top of your uterus as well after removing uterus which is good.  
If you feel the need, have another opinion.  It is pretty normal for ladies to get more than one opinion unless they feel settled about what they want to do.
Ask your Urogyne about how many of these operations they do a month and what success rates they have plus how long you can reasonably expect the repair that they do to last.  
If you operation is successful you should have a minimum of a 12 week recovery with help also from a womens physio therapist and hope to gain back your sex life as well as get rid of the pelvic pressure and cervix hanging out.  
Glad you are cancer free.  Take your time to make your decision to make sure you are happy with what you decide to do.k

Let us know how you get on and let us know what you decide
Good luck gizzie

[Fallinggizzie]

I am 67 year old woman whose vagina has protruded so much that my cervix is exposed.  My bladder has also dropped but so far only urinary urgency when the liquid comes down.  I went to one gynecological practice but was not happy.  They recommended a pessary whose ring was hard that I began to have vaginal spotting for the first since menopause and caused me to pee right after I left the office.  I am now with a urogynecologist who did all the tests for cancer - all fine - and is recommending a urodynamic test before a recommended vaginal hysterectomy to remove uterus & cervix and tie up the vagina to the pelvic ligaments.  Medical advice on line is general at best.  I am healthy, recommended weight, and never smoked, but my first delivery was a dozie with foreceps to remove my daughter who stuck in my birth canal after 30 hours of labor.  I am scared.  Will I have intercourse pain after I recover?  Will I have urinary incontinence?  Shall I just put up with pelvic pressure and my cervix hanging out?  I appreciate this blog since pamphlets don't do it and I need more questions to ask my uro-gyno?  From a fallen gizzie

[UKlady1001]

Anything that increases intra abdominal pressure is not good for prolapse.  However, with ladies who experience constipation, abdominal bowel massage can be helpful following from the beginning of the large bowel gently round towards the end of the colon.  Also, deep diaphragm breathing in the morning while laying in bed can massage the bowel into producing peristalsis which is also helpful.
Kegels done properly maintaining that they produce a lift and tighten are also helpful.  It is best that ladies get help from a womens physio to help them to do pelvic floor exercises correctly.  
Yoga can be very helpful for ladies with prolapse as long as they avoid any of the poses that increase abdominal pressure like planking and stomach crunch type poses.  
Pflates is also another type of exercise similar to pilates but for ladies with prolapse.  Hab-it is another good pelvic exercise regime for prolapsed sufferers.
Thank you for your input Dalubaba.  

[Dalubaba]

I came across a massage which may help in POP. It involves abdominal breathing and simulteneously (sp) sqeezing perineum in and up and relax. In this way abdominal diaphragm massages downward and perineum massages upward.( this is not properly presented as I am writing it from what I remembered.)
The question is whether this type of massage is helpful for any organs between diaphargm and pelvic floor.
Kegel exercise is also suggested for pelvic floor. So I thought this massage can also be used. I am not an expert. I do yoga and read it just as a hobby..
(Sorry no spell check is done)

[UKlady1001]

Did you have a Gyne do your hysterectomy?  Also, did they support the top of your vagina?  
Consider seeing a Urogynecologist as they are prolapse specialists.  I wonder if the Gyne that did your hysterectomy was out of her depth when you mentioned bladder prolapse.  
Any straining to have a bowel movement is contraindicated for prolapse and can cause prolapse anyway.  I take Miralax/Laxido and also use good evacuation technique to make BMs easier.  Have a look at the sqatty potty to raise your legs while on the toilet for the correct position for evacuation.  You can use a childrens step stool etc to get your feet higher as well.  
I suspect you have pelvic floor issues which could be making your muscles tight inside so relaxing them may take help from a womens physio therapist and/or bowel biofeedback.  Ask your Dr to refer you to a Urogynecologist and womens physio.  You could ask a Urogyne to refer you to a womens physio as well.  
A pessary could indeed help to support your bladder as well so look up pessaries and take some information about them to your appt so you can be measured for one as it is a Urogyne who will measure you but they often havent seen the full range of pessaries available.  
I am so sorry you have had such an upsetting experience with your operation and subsequent prolapsed bladder and BM problems.
It is really important not to strain to have a BM so consider the options mentioned and also see your Dr for help with appropriate laxatives etc as well as a referal to a Urogyne.
I wish you luck and will be thinking of you as I know how upsetting this can be.  
Let us know how you get on

[carolecernuto]

Hello Joan, I, too, am frustrated and dismayed by bladder prolapse.  Had a hysterectomy with accompanying surgery for hemmorhoids.  After surgery, couldn't have a regular bowel movement, because, I believe, the surgeon seemed to have overcorrected and made the anus too tight.  Forcing and bearing down, to the extent that I would almost lose consciousness when having a bowel movement,  is what I believed has caused my bladder to protrude and "bubble" out of my vagina. Have gotten urinary tract infections for the first time in my life.  I had the hysterctomy because my uterus was protruding, and now am experiencing this bladder prolapse.  Tried to discuss this with surgeon...she made a hasty retreat from the consulting room.  Have made an appointment to find another gynecologist.  Will ask about a pessary....wish I would have gone with that in the first place....Carole C.

[UKlady1001]

Hi there and welcome to the prolapse forum.  It is good to hear you are going to a Urogynecologist for a second opinion as they are prolapse specialists.  Find out first what they say before you make any decisions.  Also, ask them about a pessary and look pessaries up as you could use one of these to support your prolapses while you make a decision.  There are lots of types of pessaries.  I have a silicone T pessary Type R and there are lots of other ones.  Urogynes measure you for a pessary but they rarely know the wide range of pessaries available to make sure you take your own information with you as well and discuss the different types that hold up different types of prolapse.  
Since you are post menopausal oestrogen cream can be really very helpful as it keeps they vaginal tissues in good condition.  I use this and put it on my pessary as well for both lubrication as well as to help my vaginal skin as well.  
It is a good idea not to make any hasty decisions regarding prolapsed op as you need to be happy with your decision and have time to consider your options.
I hope you get a Urogyne appt soon.  Make sure you have all your questions written down for your appt and take someone with you if possible as well for support.
Good luck and let us know how you get on.

[Frustrated_K]

Hi! I'm new to this site but have found all this information very valuable. I am 55 yrs. old and just stopped menstrual cycles in  Sept. I recently had a bladder infection treated by my gp, but when meds didn't initially stop the urgency to urinate, I called my gyne and went to have my annual exam to make sure all was ok. He informed me that I was Grade 2 bladder prolapse and slight rectal prolapse. I too, had never heard of this and felt no symptoms other than a lumpiness inside the vaginal area. He recommended anterior and posterior repair with stitching of the tissues. He also wants to do a hysterectomy!.( I have never had any issues with my uterus). Do you know if it's possible to do the anterior and posterior repairs without a hysterectomy. I am going to go to a urogyne for a 2nd opinion, but would like to gather as much info as possible beforehand. I am currently feeling better, the bladder infection cleared up and I am not sure I want to have the surgery quite yet, due to relapse issues that I heard were a big problem. Any info would be appreciated. Thanks. Frustrated_ K

[UKlady1001]

Do you not use estrogen cream either?  It is a good idea to use the cream vaginally in order to keep the vaginal skin as healthy as possible as long as your Dr is happy to prescribe it for you.  
Some ladies take bio identical hormones as well which are a bit different to HRT and may be tolerated for a longer period.

Do you want to use a tampon to keep a vaginal prolapse supported from coming down?  A pessary is a better option especially if your vaginal skin is dry etc as the tampon will dry out your vagina and could create drag when you pull it out.  A pessary is best measure for by a Urogyne and there are many different types that are for different or multiple prolapses.  Do some homework before you go to your Urogyne and take leaflets with you.  I have a silicone pessary which is very helpful.  

I understand your worry with the possibility of a new partner, but men rarely notice our prolapse bulges unless they are hanging externally.  
Getting a proper diagnosis from a Urogyne will help you to know exactly what is going on and what treatment choices you have.  Take a pessary catalogue with you and discuss this as well.

Good luck and let us know how you are getting on

[Joypar]

You gave all such good info, I also have the bladder falling and leakage,  I am not on hormones, took myself off 12 years ago.  So can I use a tampon or not and what is the other plug you suggested. I am 65 and in good shape and excercise all the time.  Tired of this new body part just hanging around.  Afraid to get involved with a new guy because of this.  

[UKlady1001]

Yes it is often a shock for us to find we have bulges vaginally and great to hear you are going to see a Urogynecologist to get a proper diagnosis.  

Good luck with your appt
Let us know how you get on

[jmlynn]

Thank you for all the info on this page....Just now having what i think is somewhat of a bladder prolapse.  I am going to get a consult with a
Uro/GYN too to see what they say. Had exam post UTI and yeast infections lately and family doc never said anything....but i too can see with a mirror the bladder....not huge but there for sure...Good grief.....who knew....so glad to have found you all.  Blessings to you from Michigan  ...

Joy

[jmlynn]

Thank you for all the info on this page....Just now having what i think is somewhat of a bladder prolapse.  I am going to get a consult with a
Uro/GYN too to see what they say. Had exam post UTI and yeast infections lately and family doc never said anything....but i too can see with a mirror the bladder....not huge but there for sure...Good grief.....who knew....so glad to have found you all.  Blessings to you from Michigan  ...

Joy

[UKlady1001]

Did you have your vaginal vault suspended when your had your hysterectomy?  
I am sorry to hear you are so unwell.  I do feel you need to see a Urogynecologist as they specialize in prolapse and I wonder if you have more than one prolapse.  You will need an examination to be sure and they will also do tests.  Have you considered if you could have yeast overgrowth in your bladder?  
UTIs and bladder pain are more common with bladder prolapse than we are lead to believe at times and then we meet a brick wall with some Drs.  This has happened to me as well.  
I too get tired and have similar pain to you.  Some of this is follicular cystitis and possible IC for me as well as prolapses and PF Dysfunction.  
A pessary may help you at least in the interim with having to stand up all day working while you find a longer term solution.

Your GP wont understand most of your symptoms but they can refer you to a Urogynecologist.  Keep going and ask the questions.  If you hit a brick wall with a Dr, they may not know what is wrong so try another door to knock on and gain information along the way.  

Good luck and let us know how you get on.  

[Rowie15]

I had a total abdominal hysterectomy at 36 due to stage 7 endometriosis. The endo was so severe it could no longer be managed with hormone treatment or regular laparoscopies. I also had a prolapsed uterus. Now, six years after my hysterectomy I have a prolapsed bladder. I can feel it and see it and it is affecting my ability to empty my bladder. I am on my feet all day as a teacher and often don't get a chance to go to the bathroom during the day - nature of the job. At night my sleep is disturbed as I am up and down to the bathroom. I am booked in to see a gynaecologist, but will enquire about a Uro/Gyn. In the interim, I seem to be suffering from one UTI after another. I am lethargic, have aches and pains in the lower back and abdominal cramping. I am very conscious of hygiene and am worried. I am so tired all the time. Is this normal for someone with a prolapsed bladder? My GP had no answers.

[UKlady1001]

Thank you very much for coming back to the forum to answer member questions.  
I am sorry to hear you are experiencing further bladder prolapse but am very glad you feel you are better than you were before you latest operation.

I dont remember if you have considered using a pessary but you could ask your Urogynecologist if they feel you could use one and they could fit you at the same time.  

I wish you a good retirement.  Good luck also for the future.  We are always here for you if you would like to update us or ask further questions.  

[Joan288]

I'm sorry I haven't been back to this forum for well over a year.  I've been so busy but have decided to retire this June.  The second repair I had lasted a while, but I have a partial bladder prolapse again.  I am keeping it under control and get regular checks with the surgeon.  He said that it could stay like this for a long time but unless it gets worse or a new, safer method comes out for repairing it more permanently, I guess I have to put up with it.

To answer someone's question, no I didn't have the mesh repair.

Good luck to all, especially those facing surgery.  I would do it all again and have no regrets.  I'm just waiting now for something that will hold my bladder up permanently.  It's still better than it was before the last repair.

Take care.

Joan

[UKlady1001]

I understand how fearful you may be about an operation on your prolapse.  Do you know if you had the top of your vagina suspended when you had your hysterectomy?  Without suspension, you would have been and may still be more prone to further prolapses so if you have no suspension is this to be rectified at the same time as your bladder prolapse operation?

It is important to feel comfortable with any procedure you have done so write down any of the questions you feel you need answering and find out how many operations of this type your Urogynecolgist has done and what success rates they have.  If you have mesh questions for your Urogyne, ask them about this.  

I hope all goes well for you.  Let us know how you get on

[UKlady1001]

Spend time researching any recommended procedure and ask your Urogynecologist about their success rates in that procedure and how many of these operations they do a week.  

You dont say how your prolapse is affecting you or what grade it is.  Hopefully you have time to consider your options and get more comfortable about the choice you have made.  Look at all your options.

Good luck.

[Necee53]

I have been reading the comments and I am getting more frightened. I had a complete hysterectomy 10 years ago. Last week I was told that my bladder had dropped. I can feel it and have been experiencing lower pain in my back and lower abdomen. I am schedule to have surgery in February. I have started reading all the information I can and I am glad I found this sight. I appreciate any and all comments and advise on this matter. I had complications with my hysterectomy because of endometriosis and fear having this surgery.

[joan1111]

Did you have the mesh or what was the procedure to lift the bladder?  I am facing this now as well & certainly am becoming aware of scary issues with the mesh.

[UKlady1001]

Did you have mesh and is your surgeon a Urogynecologist?  I am sorry to hear about your cystocele repair failing so soon after your operation.  It is very important to have prolapse procedures done by a very experienced Urogynecologist.  Ask how many POP repairs they do a week and what success rate they have.  In the USA some Drs recommend that the Urogyne you see be fellowship trained.  
I hope this helps.  Let us know how you get on.