My experience of Pelvic Prolapse and the journey to fix it.
My surgery was Tuesday, exactly a week ago, and I’m day 8 post op, and ready to reflect. Pelvic Organ Prolapses are a common thing, more common than most people think. According to the Royal College of Obstetricians and Gynaecologists 50% of those of us with a uterus suffer with some kind of pelvic prolapse, so it’s good to talk about it. Ranging from mild urinary incontinence, which we often joke about as we reach certain ages and realise going on a trampoline is now fully out of the question, to multiple pelvic organ prolapse.
I first noticed my prolapse in 2019 when my GP surgery nurse confirmed something was starting during my routine cervical smear test. She referred me to NHS pelvic floor Physiotherapy. My pelvic floor was strong, but after physio she referred me to Gynaecology. Back then it was only six months to see a gynaecologist and I was diagnosed with a mild prolapse and small rectocele. That would be my uterus/womb dropping into my vagina, and the rectocele was my uterus pushing into the back wall of my vagina causing a mild lump in the rectal passage. She didn’t think much needed doing, but set an appointment to check again in four months.
Then the Covid Pandemic hit in 2020 and we were in lockdown. All non-urgent appointments were cancelled. My biggest problem was an aggressive reflux cough, as every coughing fit pulled on my body and worsened my prolapse. In the middle of 2020 I noticed I felt heavier down below, the rectocele was bigger, and when I coughed my cervix pushed down into my vaginal vault. It caused difficulty with a blockage in my rectum meaning I needed to digitally help each bowel movement to pass, and I’d need to push my cervix back up and into place inside my vagina. By the end of the year I’d developed a cystocele, where my bladder had also dropped pushing into the front wall of the vagina, meaning constant trips to the bathroom to pee, and getting up twice a night to empty my bladder. You know you have a bladder prolapse when you can feel, and see, a bulge (like a ball) at the entrance to your vagina. All of this happened during a time where no doctor appointments were available except via telephone.
I posted on Facebook about it, I’m an open book, and asked for people’s experiences, so I’d know what to expect. I got some lovely feedback, including a friend in the US who’d recently gone through the whole process of surgery for a three compartment prolapse, and was able to talk me through it. It’s so important to know you’re not the only one and that other people know what you’re going through. I then joined a message board for advice, and later found a Facebook group which was amazing. FPOPS UK(Female Pelvic Organ Prolapse Support for UK is a private group for those going through prolapse in the UK, and is incredibly supportive with personal stories, questions, and a hive of information and health advice. It has a fantastic document on the site with a walk through of what to expect after prolapse surgery and how to deal with it, absolutely invaluable!
I finally saw another Gynaecologist consultant in June 2021 who diagnosed a three compartment prolapse, uterine, rectocele, and cystocele. I was offered a pessary or surgery. I chose surgery, a vaginal hysterectomy leaving ovaries intact, and pelvic floor repair. I was told the waiting list was about six months. So I began to prepare myself, expecting surgery by the end of the year.
Everything about a prolapse is undignified, humiliating, and frustrating. Incontinence, pain, constant heaviness in your pelvis, abdomen, and legs, digitally manipulating bowel movements, pushing uterus back up inside vagina, needing to be close to bathroom facilities at all times, needing to wear pads or pessaries, some people can have pain and difficulty with intercourse, fatigue, and much more. The younger you are the more help you get, the older you get it appears the less important you are. I was lucky, being only 50 when they offered me surgery meant they took me seriously, and my consultant said “You shouldn’t have to be dealing with this at your age.”, but I’ve talked to people in their seventies for whom the only thing offered is a pessary. Uterine, reproductive, and pelvic degeneration of health can be overlooked as par for the course for those who’ve borne children and/or aged, and it shouldn’t be that way.
September 2022, a year later saw a letter from NHS saying no date available for surgery, so I got an appointment to have a ring pessary fitted, as the prolapse was doing nothing but get worse every day.
If you’ve never seen a Ring Pessary before, the first one is a shock. It looks like a big silicone curtain ring… I started with a size 74. That’s 74mm, which popped straight out again. I tried size 77, then 80, yes, 80mm, eight centimetres, almost the size of a baby’s head. It fitted okay, I could put it in and take it out no problem, and I felt more comfortable with it in, but bowel movements were impossible with it inserted.
My date for surgery was finally offered for 23rd May 2023 and I was flooded with relief. Pre-assessment was good, and I went in on the Tuesday morning for a vaginal hysterectomy and pelvic floor repair. I saw my anaesthetist, shared my concerns as I don’t come round well from general anaesthetics, and talked about the operation with my surgeon. I went up to surgery at 2.10pm. I was put at ease as they gave me the spinal anaesthetic, then we joked about how it felt like a gin and tonic as I started getting warm feet and feeling fizzy, and I told them I loved Hendricks as they put the gas mask over my face for the general anaesthetic, and then I was under.
They kept everything calm and quiet as I came round, which I’d asked them to do as I’m autistic, and I came round slowly from what I thought was a dream. I was fine and happy. Then the next thing I knew it was 4.10pm and I was back on the ward.
I was immediately very sick, nauseous, and faint, due to the anaesthetic, and couldn’t eat anything when they offered me dinner. When the painkillers started wearing off I took paracetamol and started noticing how I felt. I had a catheter inserted and vaginal packing which was incredibly uncomfortable. I felt a strong urge to pee, which confused me with the catheter, but I was probably just feeling swollen. I had a couple of pieces of toast later in the evening from a lovely student nurse, who also French plaited my hair when I couldn’t reach to do it myself properly.
I was asleep by 9pm, and I slept well on the ward with two other patients, but was definitely glad I’d brought my silicone ear plugs. Obs (blood pressure, temperature, checking the surgical site, and offering pain killers) were every four hours, and by 5.30am, I was awake. The two nurses who looked after me on night shift were amazing, discreet, calm, and friendly, and happy to provide Oromorph when the pain got too intense.
I couldn’t eat much all day, couldn’t face food at all, and couldn’t wait to have my catheter and packing removed. Once removed, I had the obligatory pee and was ready to go home. The NHS is wonderful and I was very grateful to everyone who had been part of my care.
The worst thing straight after surgery apart from the nausea, was feeling so uncomfortably full of gas. They pump your body with gas to be able to get to organs and perform surgery, but it doesn’t dissipate for a while. I found peppermint tea (as advised by a commenter on the Facebook Prolapse Group) really helped to release some of that gas! I still had barely any appetite and could only eat fruit and stay well hydrated. I lost half a stone in the first week from eating so little.
I felt very weak, very faint at times, sleepy, and uncoordinated. It was enough to walk to the bathroom and back. I bled for three or four days, then very sporadically. I needed to inject myself in my tummy each day for a week, with pre-loaded syringes of blood thinners to prevent blood clots from a lack of movement after surgery. The best way is to sit on the edge of your bed, pinch a large amount of skin in the appropriate area, for me it was just below my tummy button in my abdomen, and inject slowly but firmly. I made the mistake of once trying to inject while standing up. That was a definite error as you don’t hold as much flab in your fingers when standing and not only did the needle hurt, but it bruised too. If you do it the way the nurse explains the needles are so teeny, you can’t even feel them when you inject.
The scariest thing was waiting for a bowel movement. There’s a terrifying thought of wrecking the whole repair job with one strain! Didn’t happen. I’ve been taking Laxido, a stool softener, for years to prevent strain, and I added a senna tablet or two. Now, they tell you that that first poo is like a cow pat. Best description ever, lol! It happened on day three, I got cramps and knew it was time. There’s no straining because you’re still so swollen the muscles to strain don’t even know they’re still there! I had no ability to push at all, so just sit and let it happen. If you’ve taken stool softener or laxatives you’ll be fine. I also don’t appear to have the rectal prolapse that had begun anymore either, which I’m over the moon about!
On day five post op, I took a look at myself for the first time. To be fair, there wasn’t much to see down below. Very mottled in colour, bruised, and battered, and I could see black stitches on the back wall of my vagina. Everything is going to be swollen for a few months, and I’ve been told it can take up to three or four months for the swelling to go down and up to four months for the stitches to dissolve. My belly was still distended, but the gas was reducing, I didn’t feel like there was a hedgehog stuffed up my vagina anymore either, which was so good! My appetite returned, but I still couldn’t face chocolate or sweet things for a while, which was strange!
All in all, a week after surgery, I know I need to keep taking it easy, and I will, but I feel much more myself already. Bearing in mind I’m still taking paracetamol so the residual pain is kept at bay. My husband and daughter have been looking after me, Lexi, our German Shepherd teenager is being relatively careful, and I’m enjoying reading and watching TV until I can’t keep my eyes open, which is often right now! I still feel weak and very tired, but will build up exercise cautiously. I’m doing foot stretches to help prevent blood clots too. No lifting of almost anything for six weeks, and even then I have to be careful not to lift heavy things in the future to avoid a further prolapse, but that’s common sense. There’s a 30% risk of anyone who’s had pelvic prolapse repair surgery of having a further prolapse in the future. I won’t restart doing pelvic floor exercises until after the go-ahead after my 6 week post op check-up, but then I’ll be working at them hard! Like I said, it’ll take a few months to get back to normal and see how my body feels without a prolapse… but I can’t wait!
The Last Krystallos 