New Here, 3 1/2 months post-partum

Two failed vaginal prolapse surgeries (2001 & 2006)..mesh disconnected and eroded into the bowels, necessitating a temp loop ileostomy 2008. Now dealing with vaginal prolaplse once more..is there hope??

I am so very sorry for everything you have been through. It is stories like yours though that make me thank God I found this site and Christine so early on. I pray someone can help you.

Hi Samnabby

So sad that you have ended up in the situation you are in. This is what happens sometimes. Don't blame yourself. You have enough to deal with.

Samnabby, I suggest that you have a look at some of the Forums on sites that have more of a surgical focus. There you will find ample evidence of the failure of these surgical repairs. You are definitely not alone with this problem. Doctors freely admit the the first surgery works better than subsequent surgeries, so it is unlikely that more surgery will leave you better off than you are now, in the longer term. There is further damage and scarring every time you are opened up. There will also be a risk of further prolapse, cos when they tighten or remove tissue or resuspend it always creates new stresses on the fascia, kind of like darning nylon pantihose by drawing the fabric together.

Only you can prevent further surgical damage by not having more surgery. I hope you can utilise the techniques on this site to help you to manage your body as well as you can. Call back with questions and comments.

Cheers

Louise

thanks for sharing bgp...i too have seen some major improvements with my cystocele and rectocele....alhough the last few week my cystocele has dropped alittle....it is deffinately an up and down road i have considered for in the future looking into a pessary mainly for when i am standing a lot....i am 4 months PP so it is still very early...i hope things will improve for me in the next year. As far as rectocele for me there is no eating whatever i want ....if i dont get atleast 30g of fiber and plenty of water then my days are HORRIBLE but i have made a lifestyle change as far as my food goes......i havent done a lot of the workouts yet so that should help too....i have done the ballet work out and it has helped my arches soooo much...they usually hurt really bad after a day of standing but when i do the workout i can really feel the difference(thanks Christine!!)
this all kind of runs together im in a hurry!
~Amanda

Hi bgp

It is indeed a long haul recovering from a pregnancy. I am sure you will still be experiencing improvements 12 months from now. Yes, progress is up and down. Only when your body stabilises and you start to trust your body again will you be able to feel comfortable about the setbacks. I still have setbacks nearly five years after starting this work, particularly after over-exertion, but I dismiss the worries and just get on with using my body properly, and my organs all rise again after a few days.

When you think about how much natural internal stretching there has been during a pregnancy I think it is a bit silly of an ob to even mention prolapse at a six week checkup. It is just an unnecessary worry for the woman. Many pp prolapses are just slack internal tissues which will shrink back over the following 12 months or more. Real prolapse is caused by fascial damage, not unresolved stretching of fascial tissues. Telling a 6 week postpartum woman she has POP is about as stupid as telling a boxer after a fight that his eyes are all swollen! Of course they are swollen! That's what happens when you get hit in the face repeatedly! The swelling will all be gone in a couple of weeks, all by itself!

I personally think the 6 week checkup is simply a sign off for the ob re infection, cessation of lochia and establishment of feeding, and to ensure that the woman has some sort of contraception strategy organised, particularly if she is not breastfeeding. The real recovery from pregnancy, labour and birthing happens over the following year.

Cheers

Louise

so how can you tell if you have a "real" prolapse or if it is just the fascia tissues being stretched to their limit?
or is it just one of those time will tell kind of things? When i do a self exam i cannot feel my cervix or uterus it seems pretty far up....all i can feel is a bulge in the front(comes to opening usually) and a slight one in the back. So maybe this is a good sign that once the skins shrinks back everything else will too....
~Amanda

Hi Amanda

I am just thinking about this logically. I am in no way qualified to state it as fact. Hopefully Christine will read this and make some more informed comments.

Fascia is a fibrous 3D structural system in the body that is designed to keep all the body's parts (bags of 'jello') in their correct positions in relation to each other, no matter what we do, and what position we are in. It is a bit like a big knitted bag with zipped compartments for each organ. Each of the the pelvic organs sits inside its own 'bag' of fascia. When the uterus grows during pregnancy, the fascia in the whole abdominal cavity must have to grow and mould differently to re-orient all the abdominal and pelvic organs so the belly pokes out the front and everything else can still function. After birthing all this fascia suddenly has nothing much in it, so it all flops around, and takes months and months to regain its original pre-pregnancy dimensions, which is why we feel all floppy in the belly after birth. The same thing happens to your skin if you lose a lot of weight too quickly. The skin cannot shrink back to a smaller size very quickly, so you look a bit like the Saggy Baggy Elephant for a while until the skin shrinks itself back. I think this is how some women literally push the whole uterus during labour, but it can miraculously all go back in again and shrink back eventually to produce no evidence of prolapse later on.

POP happens when the pelvic fascia is compromised or weakened by something, and splits, or is cut (eg surgical procedures like caesarean section or episiotomy or appendectomy. It can also be damaged by excessive chronic straining to empty the bowel, or excessive intraabdominal forces putting undue pressure on it, eg coughing; a birth where the baby is pushed out before the cervix is fully dilated, resulting in the vaginal walls shearing off the underlying fascia; probably even inherent low strength of the tissue itself. When the fascia is cut surgically it is very hard to join it up exactly, like a slashed pullover, and it may be left with holes or bits that are pulled unevenly by scar tissue, and will subsequently rip under pressure. When this happens to the fascia around the bladder, vagina, uterus and bowel these organs can move around a lot more, make bulges in the vagina, and feel like they are literally going to come out of the vagina. Suturing an Episiotomy seems to be a particularly tricky procedure because the tissue is all swollen and distended from the birth, and it must be very hard to match the two surfaces up again accurately.

This is why I say not to worry about these bulges persisting. Your body is still regaining its pre-pregnant size. They may decrease a lot, but you might still be left with some prolapse. On the other hand they may be undetectable in 12 months. Just use your body's natural structure to give your abdominal organs plenty of belly room and keep doing what you are doing to 'reset' them back into their correct spots.

Does this make some sense?

Anyone else got thoughts on this?

Cheers

Louise

I think that louise gives a very good description of whats going on.
in my mind, I imagine that the fascia thins out as it stretches to accommodate a growing uterus. maybe it grows too, I dont' know. I remember when I took Human Gross Anatomy, the fascia reminded me a bit of pizza dough. stretchy but in layers. some areas were thicker, less elastic and more supportive than other areas. I wonder, if during pg, labor and delivery, the fascia doesn't thin out and lose its supportive abilities.
I'm hoping that over time, with proper posture and nutrition, the fascia begins to return to its former prepg state. like if you over stretch your pizza dough and wind up with holes in your pie, you can let it rest for a few minutes and the dough bulks up a bit and you can then easily repair your hole.

obviously, there are many flaws in my hypothesis, comparing live breathing bodies to lifeless ones, and dynamic growing tissue to dough, but that's how I think of it.

but one thing is for certain. many, many postpartum women have found their symptoms to improve over time. some even without doing anything about it.

these are great discriptions....i think i have a better understanding of what is taking place. Sounds to me like the year after you deliver is the most crucial time for healing from something like this.
~Amanda
thanks for commenting

I have to say I LOVE your description, Louise!

Thank you to the ladies on this thread with your encouraging words regarding the healing that can come during the postpartum year. It's going to go a long way toward helping me to be patient with my body. This is truly the best stuff I've heard regarding the subject -- I may even post it on my bathroom mirror (the one I need to avoid checking with) as positive healing affirmation.

I just confirmed this morning what I've been suspecting for weeks. I've got myself a little ol' postpartum cystocele. I go through the range of emotions from "who cares? only I know about it" to "why me? I did all the birth stuff gently and 'right.'" (Don't get me wrong, I know in the grand scheme of things, a cystocele is MINOR, and I have sooooo many blessings in my life. I'm just a dramatically emotional person by nature). But my body was made to birth, wasn't it? Surely it is made to heal as well. I'm 13 weeks postpartum -- that's barely 1/4 of a year! If I go according to Chinese medicine, two whole years is postpartum healing time.

It has helped me to write out a "game plan" (with my posture at the top) to aid me feeling in control of this healing journey. I'll now add 'visualize pizza dough fascia closing up!" ;-)

If anyone else can lend a positive story of their postpartum prolapse going into "remission," I'd sure appreciate that, too.

Hugs.

I found my prolapse when my third child was 18 months old. took about a year for me to feel confident that it had stabilized and even begun to recede and I got pg with baby number four. so after the birth I knew I'd still have a prolapse. to my surprise it was no worse than before I got pg. I continued to see small changes (my cystocele, in my opinion, is probably worse than many of those described here). most surprisingly, I noticed recently that its even smaller than I ever expected it would get. and my baby is 21 months old. 21 months and I'm still seeing changes! unbelievable.
now, when I say mine is pretty bad, I mean that its larger than the ones others describe. but know that I am 99% symptom free. no incontinence. no discomfort. no limitations to my lifestyle.

and I just noticed you're 13 weeks pp. I was at my absolute WORST at 12 weeks pp. it will get better.