Cystocele after childbirth

[ckm5513]

I am 7 weeks after childbirth (second child).  My baby was 10.5 and head was 14 3/4 and was born face up.  So over all a hard birth - big baby.  I pushed on my back for about a hour, and was cut twice with muscle damage done.  I am healed far as the the cut, but two weeks after birth I found that my bladder had prolapsed.  I am nursing, and was told my bladder is a stage 2 cystocele.  My question is, once I stop nursing and my estrogen returns, what type of healing should I expect? My Doctor said not much will change since I am nursing, but at my 6 week it had gotten better from 4 weeks ago.  What is average healing for a grade 2 cystocele?  My ideal would for it to return to at least a grade one, so I do not notice the bulge nor see it.  Is that possible? Is complete healing possible? I know worse case would be no change - but what should I expect far as healing in this area?  Or should I just assume surgery will have to take place?  I am 28 years old and a physical education teacher so this is really bothersome.  Plus the idea of that area not being "normal" really bothers me.  I am pretty sure we are done having children, but don't like the idea of the cystocele making that call for me.  If I did carry another pregnancy what would be the chances of this coming back assuming it healed to a grade 1 and a c-section was preformed?

Thank you in advance - I'm really having a hard time with this! And just want to enjoy my new son, instead of thinking about my badder 24/7!

[ckm5513]

I saw a urogynecolgist  at the U of M hospital.  I was told there is no prolpase and that it is normal to see the walls of your vigina after having a baby, especially one as large as my son. I can see mine when on the toliet right at the opening, and while standing it is higher.  She put me on a kegel workout and said things should keep improving even while nursing.  After I'm done nursing things should greatly improve.  She also said this happens more than they would like, when other doctors diagnosis wrong and that prolapse is a easy thing to say when there is a little sagging or looseness has occurred in  that area.  She said I was at a negative 1 1/2, I forgot to ask her what that meant, since I was overcome with tears of joy!!!  Can you shed some light on what she meant?  All my other organs were completely fine also.  Does this happen often?  Or should I seek a 3rd opinion since I got two very different verdicts?  Overall very happy, but still a little nervous and confused!  She also said I was a 3 out of 5 after doing a couple kegels, and then a 2 out of 5 after I had done a couple more.  Can you shed some light please.  Thank you!

[Lennox Hoyte, M.D.]

Please be sure to get your prolapse evaluated by a urogynecologist. There are some good ones at Ann Arbor campus of the U of Michigan ( I am thinking of Dr. Dee Fenner, and Dr. John Delancey) . A trained urogynecologist will be able to give you a thorough evaluation, perhaps allay any fears you may have about your bladder.

Dr. Hoyte

[ddeiman]

I am not nursing and do have some leakage when i laugh, cough, or lift anything heavy like my son so I need to do something. I have been doing kegels 4 times a day for months now and it helps some what but "the bulge" gets worse around 3pm after being up all day and then by night it's way too uncomfortable. I started physical therapy to help with the incontinence issue but she said the bulging would just be about the same unless fixed surgically. I saw the surgeon once and now my pre-op is Feb 27th. I'm hoping for a move up :)  He is at the Washington Hospital Ctr in DC and he is a urogyn surgeon. I agree having this happen at such young ages is horrible. I'm 35. I miss being active and my sex life isn't so great anymore either which puts strain on me & my hubby. Although he has been SO understanding and sympathetic. Like I said we had hoped for another but I can't wait to have this fixed. I wish I knew someone who has had the surgery and gone on to have a successful pregnancy. My son was avgerage at 7.4 lbs but he was stuck behind my pelvic bone for 2 hrs I pushed and finally got him out but I had a bad tear and he had major bruising on his head. I almost had a c-section and now I wish I had but hindsight is 20/20 ya know.  I'll keep you updated. Best of luck!

[ckm5513]

Thank you!  Have you had any improvement?  Are you nursing?  Mine did improve from when I found it at 2 weeks PP.  Mine was at bulging a bit through my vigina, but now is just visable.  I can tolerate it more - but still do not like it.  I am active and just the thought of it makes me cringe.  My doctor told me once I stop nursing there is a 50% chance of it getting "better" - it will never be healed, but a little more improvement would be nice.  I know it has to get better where I can not feel or see it, or surgery will be my only option.  I can not live with this, being a active 28 year old!  My doctor really messed up with this one - I measured 3 weeks early from about 36 weeks on.  I should of had a c-section to deliver such a big baby since there is no family history of this condition in my family.  Please keep me updated on your surgery.  I would like to know the outcome and how sucessful it was, and if you would recommend it to me.  Are you having any leaking of urine?  I am not.  Are you going to a specialist for this surgery?  I just made a appt. with a specialist at the University of Michigan hospital.  I'm hoping to get more answers.  God knows I'm not trusting the doctor that delivered my baby to do it.  Your email did not come through so we will have to find another way to connect with eachother for support.  
By the way congrats on your son, they are a true blessing no matter what they do to our bodies!   Also, I attribute a lot of my improvement on the fact I am using the Kegalmaster.  It really helps you do them correctly and I have notice it getting a little better.

[ddeiman]

I'm so sorry to hear what your going through and I just wanted to tell you I understand wanting to enjoy your new baby and not think about all the other stuff. I just had my 1st in July and since have been diagnosed with a Grade 2 cystocele, mild uterine prolapse and mild rectocele. I have been using a pessary since Oct but it doesn't help much. The bulge pushes past the pessary by the end of the day. I am now in phisiotherapy but have pre-op appt on 2/27 for repair because all these things don't give me back the quality of life I want. My poor 5 1/2 month old needs a mom who can take him out in the stroller or at least just pick him up to play without feeling the pressure there. Being this was only my 1st I wanted a 2nd but don't think I can go through it and make things worse than they are if they're intolerable now. If you need just to vent sometime to some who understands my email is dawn.***@****  I know it's hard to find others for support. I can also keep you updated on my surgery to let you know how it goes so maybe that can give you insight about your own choice for treatments. Best of luck!