Uterine Prolapse

Archived Q&A and reviews ▼

Archived Q&A and Reviews

Questions

Uterine prolapse following forceps delivery

April 2012

I'm seeking advice for a friend. In short, due to numerous and puzzling reasons her gynecologist performed a rushed lateral episiotomy and forceps delivery. (They delayed performing a c-section to the point that the baby was in distress). The effects of which have been a wound that is not healing well and a prolapsed bladder and uterus. She's been unable to leave the house for more than 20 minutes at a time lest gravity takes its toll and is at her wit's end. In addition, her doctor didn't recognize just how dire her situation was until a good 8 weeks after delivery. She's consulted with two specialists; each recommended a full hysterectomy. She's in her early 40's and she's hoping that there is another solution. Has anyone had this experience? Any recommendations for doctors or other professionals that may be able to help would be much appreciated. Also stories of hope please. Hopeful

Run, don't walk, to Dr Sharon Knight, urogynecologist at UCSF Women's Continence Center http://coe.ucsf.edu/wcc/AboutBladderProbs_home.html Dr. Knight specializes in prolapse. Do not waste time/money on a regular gynecologist--there's no comparison. Here's Dr. Knight's bio: http://www.ucsfhealth.org/sharon.knight Much can be accomplished non- surgically for example with the right pessary--which the regular GYNs are wrongly quick to dismiss. They just don't have sufficient experience and expertise (and either don't know it or won't admit it). Call Dr. Knight, she finally saved me after 2 others said surgery! What a relief! Twin Mom

Hi-I had 3 kids in four years and due to both genetics and my middle daughters' birth weight, I also had bladder and uterus prolapse. I recently had the total vaginal hysterectomy and bladder sling, and pelvic floor repair surgery.

My ovaries were left, so I did not go into menopause (I am 42). I have to say that now, 9 weeks post op, I am really glad I did it and also glad that it is behind me. Before, I had to plan my life according to my bladder-sit on aisles for movies, always check where the bathroom was, etc. but now I can even laugh and sneeze and not pee!

It is a big surgery and she will need help with household and kids after it for a few weeks, but overall, I feel like it was a success. There is a website called www.hystersisters.com with tons of info, resources, chat rooms, etc.

You are welcome to email me directly for more info if that would help. Kim

Has she considered using a pessary? She should call those specialists back and ask them if any of them can fit her for one. It sounds like her prolapse is fairly severe, but occasionally, using a super tampon will help hold things up temporarily.

Also, there is an operation called a ''Manchester Procedure'' that suspends the uterus without doing a hysterectomy. It is not commonly done in the US, more common in the UK. She might also ask them whether they would consider doing that - although I am not sure what her reasoning is for keeping her uterus when it is prolapsed? If it is to have more kids, then the Manchester procedure would not be an option, but the pessary would be a good one.

Also, postpartum prolapse does improve a bit over the first 3 mos or so, so perhaps the degree of prolapse will change a bit for her (although it never goes back to prepregnancy ''normal'' ) over the next few weeks. Feel free to get my email from the moderator if you have more questions. I am a health care professional that does this work within Kaiser. A BPN Ob/Gyn

There is a device called a pessary that will give significant relief for uterine and bladder prolapses. It isn't that different from a diaphram. For some reason, doctors just don't tell women about this device. You seem to have to ask for it. It is not necessarily a permanent solution, but it assists to hold up the bladder and uterus. I used one for 18 years,a fter the birth of my second child. At about age 55 I did have surgery done....I would say it was about 60% successful. The pessary is a great short term option. Prolapsed mom

Pelvic organ prolapse surgery? Mesh?

Feb 2012

Has anyone in the BPN Community had Pelvic Organ prolapse surgery in the last year, if so did your doctor use mesh or sling of any type? I am looking to have the surgery and would love any reviews of either Doctor Kaplan or the use of mesh. I have read the FDA warnings and I am very concerned to say the least. under the knife

I saw Dr. Kaplan a couple of times when I was consulting about having my (extensive) POP repaired. I felt like personally he was knowledgeable in his field (I went to him because he'd been recommended as being a specialist with pelvic floor repair), but a little overenthusiastic with his approach to the repair. I appreciated his thorough exam, but wasn't crazy about his bedside manner at times. He did recommend a LOT of mesh, slings, and a hyserectomy to help prevent recurrence.

I've been waiting to go through with the surgery until my husband and I are sure we're done having children - but in the meanwhile I saw Dr. Ed Blumenstock in Oakland, and was much more comfortable with his ''just enough to fix the problem and keep you comfortable'' approach (no mesh required, but he did recommend the hysterectomy). From what I've heard from the various doctors I've consulted with, it seems like vaginal mesh has had great improvements over time, and have to wonder if those scary commercials are referring to a specific brand, mesh from long ago, etc.?

Anyway - if you want to chat more privately about POP and all the fun decisions and lifestyle changes that accompany it, please feel free to contact me. I know how crummy this is, and you have my empathy. C

Hi. I had rather substantial pelvic floor repair surgery in June 2011. I ended up getting 3 opinions (including Dr. Kaplan), and each surgeon was very different in their opinions and proposed approaches. I too was very concerned about the FDA mesh reports, but wanted to make sure that I had a surgery that would not fail me in my very physical job.

After lots of asking around, looking at list serves etc. (check out hystersisters.com - the amount of info. there is astounding, but can be overwhelming - take with a grain of salt) I ended up going with Dr. Eric Sokol at Stanford Hospital. He is a gem of a surgeon and a good communicator. I'm thrilled with the results and have no regrets about the surgery. It did require me to really, really, really take it easy and lie around a lot for 2 months, but then I was good to go! I did not go with the mesh procedure, except for a tiny strip of mesh to support the neck of the bladder.

Best of luck with this - I was scared, but had to do it, and I am so happy that I did! Sara

Hi- I also suffered a pretty involved pelvic prolapse after the birth of my son 21 months ago and have investigated repair surgeries (which will involve a hysterectomy). If you're interested in chatting, please contact the forum moderator for my email. Not a fun spot to be in.

Uterine and bladder prolapse and my vagina is inverting

Oct 2009

I am 4 mos. after my 2nd pregnancy/vaginal birth. I had severe tearing w/ my first, leaving me with mild fecal incontinence. Now, after my 2nd, I have uterus and bladder prolapse and my vagina is inverting! The surgeon who is very well-regarded that I have been referred to - he is referring me to PT until I'm one year post childbirth to see how much of my body has healed on its own. I'm a bit overwhelmed at how many surgical procedures (bladder in a sling, vaginal restructuring/possible uterus hysterectomy and rectal area/spincter repair) I may be in for - am I in a minority? Do many women have to go thru this? Did I do something wrong - or was there a way I could have prevented this? Are these surgeries worth it? Other alternatives? The surgeon is pretty convinced that if I don't fix these issues surgically, I will be incontinent in my older years...

pelvic area falling apart

Hey there -- I know, the crappy vagina issue sucks, but don't worry. It's really common, and you have several options, as you've already discovered. I have an older post about this in the archives, but I actually had the repair/hysterectomy a little over a year ago since posting that. Firstly, I have three kids and was done having kids, so clearly that's your first consideration. If you think you might have more then many surgeons won't do an interim repair because the pregnancy and delivery will ruin their pretty work. If you're done, then I think they'll still make you wait a year, because they're bastards like that and it's not their vagina. Having said that, I went to San Diego to a pelvic floor center where my doctor ONLY does pelvic floor reconstruction, and who did it with a robot, through my tummy, leaving five tiny scars. I was home the next day and was sore for a few days, and that was it. It was easy and I wish I'd done it sooner. I still have the occasional problem with constipation (who doesn't) because I also had a rectocele (honestly, it was a collapsed house of cards down there) but it's so much better than it was. In the interim you can buy some spectacularly ugly undergarments that basically hold your bits in, and also work as a highly effective contraceptive. Good luck, you are far from alone! Abbi

Sorry, just a quick follow on... the ugly but enormously helpful undergarment in question is the fembrace (yes, you read that right) and can be found at http://www.fembrace.com/ Honestly, it saved my butt (so to speak) until I could have the surgery. The clinic at UC San DIego was http://health.ucsd.edu/women/incontinence/ However, I live in LA, so that was close for me, I know there are great surgeons in SF too. Abbi

Please go and get a second opinion, and a third before proceeding with surgery! My mother had this surgery (bladder sling) several months ago (was told it was very common and easy - no big deal) and has had nothing but trouble since - having to self-catheterize (the sling is too tight, apparently), having multiple UTIs, etc. She went for the surgery b/c the prolapse bothered her, but this is much worse. Since the surgery she has seen many specialists and is still waiting it out. I think she has had the best luck with Dr. Deng at UCSF in case you are looking for another opinion. Do not take this lightly. concerned My advice would be to not look to blame yourself or anyone else for your body's condition, and to begin an exercise program that will help with the issues.

It sounds like you feel guilty and/or might be looking to blame your doctor or midwife or yourself for why you are having so many issues. Try to avoid this if possible, because it takes away any feeling of control you may have over your body.

I also recommend a workout video that is fantastic--it is called ''The Pelvic Core.'' It was made by a woman named Dr. Suzanne Martin, who is a physical therapist in Alameda (so you could always consult her too). Her website is www.pilatestherapeutics.com. The exercises are difficult at first and will take some getting used to, but it could greatly aid you in your recovery. If you have any doubt about your form, or your ability to do the workouts, you could always consult Dr. Martin or your own doctor.

Best wishes! Elizabeth

Do Kegels help uterine prolapse?

Nov 2007

The archives make it pretty clear that Kegel exercises help incontinence. But can they help minor uterine prolapse?

Two years after the non-traumatic vaginal delivery of my first child, I'm preparing to try to conceive my second. While charting my ovulation I've been checking my cervical position, and I've discovered it's hanging a LOT lower than it used to! Sometimes it's within an inch of my vaginal opening. Yikes.

I knew things were drooping down there -- I think I also have a mild bladder prolapse -- but my healthcare providers always said things were within the range of normal, although once one of them described my vaginal walls as ''flabby.'' I always accepted their dismissals of my concerns, but now that I've actually begun to examine myself, so to speak, I've diagnosed myself with a ''first degree'' uterine prolapse, meaning the cervix is in the lower third of the vagina.

Besides having trouble using tampons successfully and an occasional annoying ache after intercourse, I don't have any troublesome symptoms, so it isn't (yet) a medical problem requiring surgery or pessary. But it's psychologically challenging to feel like my insides are falling out. Plus I'd like to prevent further problems, especially as I'm hoping to get pregnant again soon!

I know I should have been doing my Kegels all along, but it's just hard to stay motivated. I was hoping some success stories, especially any involving improvement of a mild prolapse, would help inspire me! Any advice is welcome. Flabby

Have you been diagnosed with uterine prolapse? Placement of the cervix varies throughout your cycle and can certainly change after giving birth. Kegels tone the vaginal muscle walls, so they're not going to do much for you if you have an honest-to-god prolapse situation, which it does not sound like you have. meg

I'll be curious to see your responses because I've been dealing with this since the birth of my twins about a year ago. I too don't have any incontinence, but my walls actually fall outside me regularly. I know, gross, and frustrating when you're trying to keep up with toddlers. But because of no medical issues I've been kind of brushed off by docs. I've been told to do Kegels by my OB and got a little more advice from my internist... she recommended a book by Peggy Brill that focuses on increasing core strength. From what I can tell increasing these core muscles is a lot more helpful to my situation than the Kegels. By core muscles I mean the upper inner abdominals (my lay term for them). It's observation only, but when I'm sagging and still have a long walk home it's by sucking my tummy into my ribs that gets things right. I believe some yoga works these muscles. Maybe you can ask about improving core strength and your MD will have something to say. Unfortunately when I asked for a referral to a physical therapist I was told I had to wait until 15 months after my kids' births to address the issue. But maybe you could see a physical therapist if you're able on your insurance. sagging too

Surgeon for repair of prolapse cystocele

March 2007

It's looking like I'll need surgery to fix a combination of uterine prolapse/rectocele/cystocele. Kegels aren't going to fix it,sadly. I don't want more kids, so I'm fine with a hysterectomy. Does anyone have recommendations for a good surgeon to do this? Preferably in Berkeley, but could go to SF if needed. I'm also interested in hearing from people who have had this kind of repair--what was the recovery like? Were you able to resume full lifting (e.g., 35 pound kids) after you recovered? Could you go jogging? (I miss jogging...) How long before you could drive or work? Just wondering what I'm getting myself into. anon

Unfortunately my surgeon no longer practices in this area, but I can comment on recovery which you also asked about. I had some vaginal prolapse, but the most severe symptoms (incontinence) were correctable with bladder sling surgery, and it was such a blessing. I suffered years too long -- I couldn't even walk a few blocks without peeing, much less jog. The recovery was easy, just a few days of discomfort and then some time for complete healing. I also have rectocele, but I've managed so far without surgery. Biofeedback techniques have improved a lot since my surgery, but I'm convinced that some of us need surgical repair and shouldn't suffer because kegels and biofeedback aren't effective. Good luck. happy hiker

Dear anon, I could write a book, but I have one already - the binder of material that I still have from my completely successful surgery in July 2004. I worked with Dr. Eugene Kaplan from Walnut Creek, who performed the surgery at John Muir. (I was fine with doing it there, as his offices are across the street; I wanted him to be able to check on me more conveniently, frankly, vs. being closer to my family in Oakland. Them I didn't want to see till I got home!) I had a the whole enchilada: bladder work, hysterectomy for prolapse, and repair of rectocele. Had a bladder sling, repair of tear from episiotomy (if he's going in, might as well get it all cleaned up at once, was my attitude.)

I had surgery July 5 and followed post-op instructions like my life depended on it. I was not working at the time, so I didn't have to deal with when I would want to return to work, and I'm glad I didn't. For several weeks I had 2x day hot baths, naps, etc. - it was 5+ hours of surgery, so it's pretty major stuff. Hardest part was feeling constantly ''not quite right'' while I had the suprapubic cathether for 4 weeks. I had to wear it until I was peeing enough the usual way that it was not a risk to remove it. I think the micromotions of a tube hanging out of your body just makes you feel crummy. You may not need it. Like I said, follow the instructions to the letter and you'll do great - as long as you have Dr. Kaplan doing the procedure. 7 weeks post-op I was riding a bike and bodysurfing on a family vacation, feeling fantastic. No problems since, even though I'm lax about the kegels...

Dr. Kaplan is a urogynecologist, meaning he specializes in the whole set of stuff in your pelvic floor, and passionate about his work. He drew pictures and made sure I understood thoroughly what he was planning to do. When I had trouble with one of the post-op medications, I called him on a Saturday evening, and he answered his phone immediately. He was helping to repair a poor result someone else had done on another patient, as she told me while sitting in the waiting room. He's the best. T (925) 979-9969 F (925) 979-9979 W http://www.agscenter.com/ 120 La Casa Via, Suite 209 Walnut Creek, CA 94598

He was not in my PPO network at the time, so I had to pay a portion of the cost out of pocket; I would do it again in a heartbeat. It's too important not to take it to the best surgeon you can find.

Last word of advice: go read up in HysterSisters, an online support forum. I didn't find it till afterwards, but it's chock full of a ton of great information. Take a week to read as much as you can there, then get your questions together for any surgeons you want to interview. There is a specific forum called ''Hysterectomy Special Needs Pelvic Floor and Bladder Issues'' that is related to the associated surgeries - which in my opinion were more involved, from a recovery standpoint, than the hysterectomy. I had to USE the bladder and rectum again right away; the uterus I didn't miss at all!

good luck! . - Nancy

Class Improving the Tone of Your Pelvic Floor

Oct 2006

wondering if anyone has taken this class and found it to be helpful in recovering from post partum issues:
What does the tone of the pelvic floor have to do with our sense of well-being, back pain, bladder control, trauma, and our feeling of support from the ground? Find out through a few short presentations and a series of quiet, easy movement lessons coupled with awareness. You will take home ways to sense and improve function in your pelvic floor and leave with an easier, more complete experience of your whole self. Carol LaDue is a Guild Certified Feldenkrais Practitioner

I took this class a few years ago. It was very helpful. You do exercises in class (very easy and mild) that strengthen the pelvic floor muscles. You also get a binder of these exercises and more, and info on pelvic floor care to take with you. Unfortunately I couldn't make it to the 2nd class due to getting sick but the 1st class was great...time and money well spent. It's still useful to me 2 years later. Good luck leaky no more

Cystocele/vaginal prolapse/Kegels

Dec 2006

7 months after the VBAC birth of healthy 9.5-pounder, I (late 30s) am still dealing with vaginal prolapse - a moderate-to- severe cystocele. Essentially my vaginal wall is so thin that depending on time of day and activity (evenings, standing/lifting/coughing are bad, shoulder stands good for obvious gravity reasons) my bladder bulges into the vaginal area from inside. That bulge often reaches the opening, getting squeezed and rubbed there.

Thankfully I have had no tears or incontinence issues, but that golfball-size bulge feels heavy, very uncomfortable, in the way, and keeps me from moving the way I would like to (and have to, with 2 kids, a PT job, groceries etc.)...

My midwives had advised Kegels, but that didn't lead to further improvements after month 3 postpartum. (I still keep doing them and think I'm doing them right.) My new OB said Kegels won't help much in my case, and prescribed estrogen cream to strengthen the dry, thin tissues (I'm still breastfeeding and plan to keep doing that for a while, but it keeps those tissues weak). She also suggested occasionally wearing one (or two) tampons to press things back. Tried it once, felt uncomfortable in a different way, and had bleeding afterwards. Hm. The cream seems ok, a bit messy, but will only have longer-term effects. The OB advised against surgery at this point, since it can be unsuccessful LT and/or can damage the bladder.

My questions: 1) Anyone else out there who had a similar degree of cystocele, without incontinence, in their late 30s? What helped you? Did you fully recover, and how long did it take? 2) Is there any softer, reusable device I could use instead of rigid dry tampons? Or things to make plain (or even ''super'') Kegels more effective - anyone have experience with the various ''original'' Kegelmasters etc.?

Hanging low

What you need is a device called a pessary. If your doctor can't fit you for one, ask for a referral to someone who can. Also, if the cream is too messy, ask your doctor for a prescription for an Estring - small silicone ring that you wear in your vagina all the time that secretes a small amount of estrogen. I used it while nursing my last two kids, and it was much less messy than the creams. Once you have finished having kids, I would consider having the surgery. It can make a world of difference. more common than you think

I think I may have prolapse

April 2005

I think I may have prolapse. I am 36 and 3 months post-partum after baby #2. I am really bummed and feel like I'm falling apart. Has anyone else experienced this? What did you do? thank you. anonymous please

Hi there. I saw your post about a suspected prolapse and thought I'd share my experience. After the somewhat traumatic (induction and then forceps) delivery of my first child I experienced what I will call a 'protusion'. To be blunt, there was a fairly large (golf ball) fleshy thing sticking out of my vagina, about three months post-partum. It was, to put it midly, unnerving. I saw my OB who diagnosed a 'rectocele', which is basically a vaginal hernia wherein a rip or tear forms in the vaginal wall, allowing the rectal passage to poke through. Charming. After about 7 months post partum it got better and eventually didn't really stick out all that much. As the muscle tone improves it tends to draw the hernia back in, or so they say. Whatever. Anyway, it didn't really bother me all that much. Then I got pregnant again (whoops) at 8 months post partum (again I say whoops) and by the end of that pregnancy it was sticking out again and would ache if I walked a lot. Mind you, everything ached, so there you go. After the delivery of my second child the whole thing basically fell apart and now I have a cystocele (which is where the vagina wall tears on the OTHER side, allowing the bladder and urethra to poke through) and a uterine prolapse (basically the connective tissue at the top of your vagina stops holding the uterus in place, and it descends). Interestingly, although possibly only for me, the rectocele mostly went away, possibly overwhelmed by the competition for room in my poor front- bottom, as we say in England. Anyhoo, here's the upshot. All of this can be fixed surgically, and it's important to go to a specialist in pelvic floor reconstruction, as the negative outcomes of bad surgery are vaginal strictures (basically they sew you too tightly and it's painful to have sex etc) or incontinence of one sort or another (bummer). The good news is that there is an excellent doctor at UCSF, called Sharon Knight, who you can go see. There are several other centres for pelvic floor reconstruction around the country. The bad news is that it takes many weeks to recover and during that time you can't pick up anything heavier than a bag of flour. As I have a two and a half year old and a fifteen month old I have decided to wait a few years and then get everything fixed at once. In the meantime I just kind of suck it up. Some days it's worse than others, and I can't run or do impact exercise any more. Oh well, like I have either time or inclination... So that's my experience. In many cases they fix themselves, and certainly mine seemed to be on the way there before the second baby. IMHO it's pretty early for you to get super worried about it right now, and in fact, they won't do an evaluation for prolapse surgery until ONE YEAR post partum as they consider the vagina to be in trauma until that time (no shit). I sympathize with the sensation of everything falling apart -- I find myself chastened and somewhat embarrassed by my crappy vagina, but hey, at least it's relatively private. Feel free to email me if you have any other questions or if you discover some excellent way to fix it, especially if it involces lying still in a quiet room eating chocolate! Abbi

Post partum prolapse can really feel overwhelming, especially in the midst of taking care of your baby. I am an acupuncturist who specializes in fertility and pregnancy care and I have treated this many times and everyone seems to feel overwhelmed in the way that you described. In chinese medicine, post partum is a period of two years. I say this because I don't want you to feel like you are falling apart because your body can repair itself. Birthing a little one is a big deal and in our country I am not sure we give it enough credit as we hurry off back to work after a few months. Anyway, this is definitely something that you could be treated in a holistic manner with acupuncture and chinese herbs with good success. I guess the first step is to know your symptoms to make certain of the diagnosis. I am more than happy to help you with more specific advice if you need. Maureen Raytis, L.Ac.

I think I have a 'dropped cervix'

March 2005

So I think I have a 'dropped cervix' also known as a Uterine Prolapse. I won't know for sure until I see a gyno in a couple of weeks. I did look up the condition and I have one of the symptoms: urgent urge to pee at a moments notice. I also looked at myself and well, things don\x92t look right.. like the entrance into my vagina is blocked!! Needless to say when I saw that, I panicked. And the only reason I even looked was that I felt some irritation. I\x92m wondering if things got worse since I got sick with a nasty cough almost three weeks ago. I\x92ve had very violent coughing fits and they do pressure that lower region. By the way, I did give birth vaginally 15-months ago. The two gynecologists that saw me afterwards never mentioned anything. Can your cervix drop afterwards?? I admit I haven\x92t done keigel (?) exercises and I\x92m still nursing my son. Any way, can any of you out there who may be dealing with this issue give me some insight, how are you resolving it? Did you get a pessary, can you describe how it works. Has anyone opted for surgery? Thanks! anon

It sounds like you have a cystocele, which is a prolapsed bladder. The bladder drops onto the vaginal wall and is visible when looking at your vagina in a mirror. It often occurs during pregnancy with the pressure on the bladder from an enlarging uterus, and during delivery from bearing down. Symptoms include urinary urgency and frequency. Kegel exercises can help lift a minor cystocele and tighten the muscles, but a more significant cystocele often requires surgery (done vaginally). Whether or not you opt for surgery depends on the severity of your symptoms and whether you want more children (it does not affect your ability to get pregnant, but you might want to delay surgery until after you are done having children because it can drop again with subsequent pregnancies). Good luck! -Been there!

To the woman who may have the dropped cervix, I too had a baby 15 months ago and since then have had symptoms such as stinging when I soap my vulva in the shower ( as it feels like the urethra opening has been stretched), pee still coming out after I pull up my pants & think I am finished, and right after giving birth a lot of pain. But I spoke to my midwife and she said do kegals and so I've been doing 5 to 10 a day on & off and now I feel that most of these problems have just about dissapeared(over 15 months). It just seems to me that healing is a long process. I hope that helps. A

My mom diagnosed with a dropped bladder or cystocele prolapse

Oct 2004

My mother (early 60s) was recently diagnosed with a dropped bladder or cystocele prolapse. Has anyone had experience with this and tried kegels, a pessary, or surgery? Any words of advice would be very helpful. Thank you! anonymous

I had bladder sling surgery for this condition 7 years ago, and it was 100% successful. I was in my late 40s, and my condition was so bad that I needed a thick pad at all times, and even the thickest pad was not enough when I exercised. I lived like that for a decade, had had many embarrassing accidents, and I became a new woman after the surgery ; ) The surgery requires an overnight stay in the hospital with a catheter, and another day or two at home with the catheter. I recovered quickly. You need to find a urologist or a gynecologist who is trained in the procedure and has experience with it. I\x92m afraid I can\x92t recommend my surgeon, because he's no longer practicing in this area. Good luck!
Living a normal life again!

I had uterine prolapse after the birth of my first son, at the ripe old age of 31. After the birth of my second son, I tried all kinds of non-surgical options, including kegels which are useless and have no effect on the tendons and ligaments holding the uterus in place. It could also be the bladder pressing out in your mother's case. In any case, kegels can't help. Any doctor who tells you so you can be sure knows nothing about the condition. I did go to an osteopath who has demonstrated success with restimulating the ligaments and tendons to do their job - alas, didn't work for me. I turned to surgery and am thrilled with the results. I had the uterus and cervix removed, kept my ovaries. Also I understand they did some lifting and tucking of the whole area, including bladder. Its a major surgery. Prolapse is something that's quite common in older women and hereditary. My mother had a hysterectomy about 20 years ago at about 40 or so to repair a prolapse she had lived with for about 10 years, unthinkable. If you're an active person you simply cannot live with a prolapse. Now, here's the bad news, my mother thinks she may need another surgery now that she's older things are sagging again. Good luck. Sharon

My mother had surgery almost a year ago for a prolapsed bladder. I don't know the name of the procedure she had (she is not one to ask many questions of her doctors) but the procedure put some sort of internal sling under the bladder to lift and support it. The surgery was done vaginally. She had a very slow recovery, spent many months still not able to hold her urine and was in much discomfort. She felt that the doctor minimized the time for recovery and discomfort. Now almost a year later, they tell her her bladder is still low. She hasn't said she completely regrets the surgery (she suffered from years of yeast infections because of the prolapse) but she swears to never have another surgery. Everyone's experience is probably different, but I would suggest your mother asking a lot of questions (mine didn't) and really thinking long and hard about having surgery. anon

She should make an appointment with a uro-gynecologist for an examination and discussion of all her options. I've seen a few in Oakland, and I enthusiastically suggest Ed Blumenstock, M.D.
A cystocele patient

I'm a little late in posting this, I think - for the person looking for advice on cystocele prolapse, here's my two cents. Get a thorough workup by a uro-gynecologist. I had surgery for stress incontinence, prolapsed uterus and some other stuff in July. My recovery was right on target - about 7-8 weeks and I was operating at pretty close to 100%. If it had been only the cystocele repair, 5 weeks would have been plenty. (I'm 46.) My consultation and surgery was with Dr. Eugene Kaplan in Walnut Creek, 925 979 9969. He is extremely knowledgeable, very gentle, very aware of related issues, and all-around great. My surgery included a vaginal hysterectomy, bladder sling, and rectal muscle repair - about 4.5 hours total. I'm sure it would have been far shorter if it were only the cystocele. I'd be happy to talk to you about the experience if you would like. I'm very relieved that I had the work done, feel a million percent better with all pelvic functions, and really recommend my doctor highly. Hope that helps. Nancy

Prolapsed Uterus Postpartum

November 2003

I am 13 days postpartum with our 3rd baby and just last night discovered my cervix hanging down into my vagina! I am 32, this is our 3rd baby in 4 years (all home births), I am fit and healthy, swam and did yoga (and kegals) throughout pregnancy, and I am worried and scared! My 3rd baby came barreling out of me in no time, apparently dragging my cervix/uterus down with him. My midwive pushed it back up in place after the birth and checked me again a few days ago (I was fine), then . . . last night I made my discovery. Of course, I have spoken with my midwives who aren't yet officially calling it prolapsed (b/c it's so soon after birth) but of course it's a strong possibility. Who has gone through this? I am pretty terrified of using one of those devices to hold it up, or having surgery - - or, even a hysterectomy. I'm taking Sepia (homeopathy). We may want another child in 3 or 4 years. I looked in the archives and found nothing . . . what have others done in this situation? Is there anything I can do now to increase my chances that it will go back to normal? Any specialists? Any advice appreciated. Thanks.
scared

Fifteen years ago, I had my first and only pregnancy. Fibroids that were already present grew enormously, one to about grapefruit size. After the birth, my uterus descended into my vagina. The first thing that helped was to put in my diaphragm (I cut out the middle and just used the ring.) Later I went to a chiropractor in Santa Cruz who was recommended for such problems, who may have helped but I really don't know. One thing I remember doing was lying down with the legs of the bed raised on blocks, so that gravity would help the uterus move back in position. I guess I did that a few times a day for an hour. It's hard to remember, and of course I had a baby, so I couldn't have had time to do much of anything. My fibroids shrunk down post-partum, but I have always had problems with stress incontinence. My uterus is ''tilted'' according to my nurse practitioner. I wear a pessary, which is extremely helpful, and I find that abdominal exercises are as good as Kegels, if not better. I have not needed to have surgery, but I wear a pad everyday, just in case.
Holding up just fine

Has anyone dealt with a prolapsed bladder or uterus?

May 2003

Has anyone dealt with a prolapsed bladder or uterus? I am looking for alternatives to surgery for dealing with this problem. Do exercises really work? Is this a condition which comes and goes? km

My doctor recently noticed the same thing happening to me. She referred me to a physical therapist who specializes in this sort of thing -- ''pelvic floor rehab''. The plan is that I'll do that, as well as lots and lots of Kegels for the next three months and then we'll re-evaluate the situation. Maybe exercise can be effective enough to make surgery unnecessary. Good luck to you (and to me!)
Anonymous