nature abhors a vacuum

Body: 

so my cystocele has gotten even smaller. that's the good news.

and now my cervix has moved. not sure if this is bad news or good news, hoping someone will have a clue. used to be not especially low enough to worry about, but seemed to be pointing anteriorly toward the right. I was looking for it the other day and couldn't find it. and that's strange, where's a cervix going to go? well, it was moved back, not sure if its lower, but now its pointing straight back towards the posterior wall. it feels a bit lower maybe, but again, not sure if its just the change in orientation.

so I'm worried that the space made by the shrinking cystocele made room for the uterus to fall. although I'm also hoping that this is maybe a good sign, if the uterus is properly positioned shouldn't the cervix point posteriorly? or do I have that wrong.
that's what I get for skimming the parts of the book that I felt didn't apply to me.

Yes...the cervix is generally directed toward the back in full anteversion. I think you’re right about the vacuum and it occurs to me that some percentage of women might have a choice of which organ they want to be at the leading edge of prolapse!

xChristine

Hi Christine and Granolamom

It has been my experience that there isn't a great deal of conscious choice involved.

Here we go again with another analogy. If you have a vehicle packed for a holiday with some things just sitting in the vehicle, not packed away, any trip over rough roads will shift things around. At the end of the day some of the things that started at the top of the pile where you could reach around from the front seat and grab if you needed them, always end up down the crack between the front seats, jammed firmly in behind three days of unread newspapers, or the water bottle. So you re-pack the vehicle the following day and the following thing happens. Sometimes you get smart and pack those slippery things on the floor in the back so they stay where you put them, even if you can't get at them readily while driving/passengering along.

The other thing that happens is that small things packed loosely in a large container will move arouond more than they would if confined in a smaller container.

During a day of active living our bodies do the equivalent of riding over rough roads. How we pack them in the morning has some effect on how much they will move around, but what we do during the day will have a much greater effect.

I never really know what is plugging the plughole at any time unless I am doing a self-exam. Sometimes any one or all of my celes may be virtually undetectable. All I know is that after a lot of strenous bending and lifting, I am likely to find my cervix peeking and my cystocele low in the vulva. The rectocele must be quite high cos I rarely have much trouble with it except occasionally with bowel movements. So I bend deep at the hips and slightly at the knees, do some suck ups and lots of jiggles with my weight central, then on the left foot, then the right foot, then bear down slightly (to remove residual air and create that useful vacuum) and stand up again. This is usually in or after my shower following the hard work. Then its off to the Bliss Balm jar to get my vulva and vagina well lubricated so the external surfaces can slide around properly. That usually does the job so I can get on with my day again.

It really doesn't matter to me what is plugging the hole as long as I don't feel the discomfort. I think it is working through the displacement (felt as vulval discomfort) that is likely to cause more damage. I don't think further damage is likely to happen as long as my organs are tucked away when I start, and I check on them periodically.

Unfortunately the other day I found myself lifting clods of turf (rather bigger than I had ordered) out of the ground onto a trailer. My friend I was working with (male, no less) works very fast and very hard, and I found myself trying to keep up with him. Silly me. But the POPs were fine again that night.

Gmom, I think we have to remember that we do have damaged endopelvic fascia inside us, and we really don't know which bits are damaged. EPF is hard enough to visualise in its undamaged form, let alone when it is damaged. If you are worried about the lop-sidedness of your cervix you could try gettin' down and doin' some serious jiggling to see if you can get your organs back into their tailored but ripped jackets again. Sure, they will slip out again, but their proper position is still there. You just gotta find it.

Christine, does this make any sense to you?

Cheers

L

I think you're right. I've been having crazy trouble with the defecating, rectocele or whatever is above it causing me problems; but, the cystocele and uterus are doing quite well. I would much rather not to have to deal with the rectocele if I had my choice. I think it's the worst one. Sounds like it's a good thing that the uterus is pointing at your back! I also find, that if the rectocele is good, then it doesn't irritate anything else up in there and your body starts to heal faster.

I was wondering along the same lines. I'm new to all this, but it seems that as I eat right I have less trouble with the rectocele. As soon as the rectocele starts to behave, my bladder falls more and I start to have mild urinary issues. I've been working on the fire-breathing and the nauli, and really feel like my muscles are starting to work for the nauli exercise. Then today my uterus is lower than it has ever been!!! Which really upset me at first, but maybe it just seems worse because my cystocele is getting better. Is that similar to what your saying, does it make sense, and is it a good thing? I'm planning to order the video, but now I'm worried if I keep doing the exercizes my uterus will just prolapse more and I'll be more uncomfortable.

Yes, many women find that rectocele is the hardest one to work with, particularly if they have ongoing constipation that they have difficulty dealing with. Carrying your organs further forward makes sense when we are talking about uterus and bladder, but moving them forwards does make room for a rectocele (perhaps masked by backwards pressure from the cervix and bladder) to come forwards too. I think that jiggling and nauli and firebreathing help to reposition organs, and of course there are other parts of the large intestine that will come in from the sides and top to fill the gap as well, so there isn't room for the rectocele to expand forwards.

I figure that the large intestine which includes the rectum has pretty equal internal pressure from end to end until the rectum fills, and the pressure in it increases to distend the rectum into the vagina. If there is no increase in pressure in the rectum because the rectum can continue expanding into the vagina (rectocele) I don't think the pressure sensors in the rectum give the brain the 'time to go' message, so the stool continues to lose moisture, hardening instead of being voided. Further stool backs up and constipation is the result. That is not to say that rectocele is the only cause of constipation, or that constipation is the only cause of rectocele, but there is no doubt a vicious circle between the two, which has to be broken one way or another so that rectocele can be held back and managed.

It is keeping that internal pressure down by emptying the bowel as often as it gives you the message, that will prevent the distension of the rectum into the vagina, and keeping the stool soft so that the large intestine can wrap itself into the space on either side of the vagina, providing further packing around the plughole.

I think how well we manage rectocele and associated constipation really determines how well we manage POP overall. If you don't have rectocele it may be there but held back by bladder and uterus. If you really don't have it at all, then attention to diet and bowel health is imperative so that it doesn't get the chance to develop.

Christine, does this make sense?

Louise

Great sense, Louise, and I can’t improve on your explanation. You know what I feel certain has happened to me (I feel it happened 24 hours after my surgery as I was desperately trying to move my bowels while pushing hard against the toilet seat - there was no wholewoman to help me! - lol) is that my small intestine slipped into the place the front of my uterus used to occupy. This is very common after dissection of the “Space of Retsius” so that severe UP is almost a given.

It’s so amazing though, that my round ligaments (thankfully untouched) still pull my shrinking uterus as far forward as it will go - I have always known that if I can do this, all you uncut women can do it too!

I had just been wondering the same thing lately, gmom - Wondering whether the heavenly-sounding lift-n-tuck Nauli might do for my cystocele/rectocele, could disrupt whatever "natural pessary" that might presently be occurring within, possibly allowing my uterus to fill the void should I ever meet with "success" with the vacuum breathing....The thought made me pause in my recent attempts, that's for sure (well, that and the start-up of my period). My fear is that if my uterus did end up 'trading spaces' with my present POP, causing my cervix to descend as low as my 'cele(s) now set, beyond the entroitus, that I'd end up being in more dire straights than I am now...And do I want to chance that happening?... but again, gosh, what if there is that chance that perhaps I am not too far gone to experience the heavenly heights that alemama has been lifted to....

If I could only see what's in store down the road. Ah well, hey.

♥~Blue

The only thing I'd add is that I do believe the shape of the lower bowel can be improved through firebreathing/nauli/posture. It takes longer because the rest of the "hose" has to be lifted as well, but it is definitely doable. Shift all the guts forward and the lowest portion will eventually follow. Also - in natural posture the vagina should be flattened enough so that the bowel cannot squeeze into that space. In other words, I don't think we should assume the rectum will always move in when the bladder/uterus are moved forward.

Hi Blue!

It's so great to hear you sounding hopeful!!

The uterus is the top, or ceiling, of the whole ball of wax. And it's anchored well into the front of the body by the round ligaments. It seems virtually impossible that the pelvic interior would allow the uterus to significantly prolapse in a woman who is consciously maintaining the natural shape of her spine. Even if the front/back bulges increase, the uterus should stay above (in front of) them.

You've probably noticed that UP is the less common of the three in this population. It's a symptom of greater pelvic anatomy derangement and my point is that if you don't have UP now, you certainly shouldn't develop it.

Christine

Geez...I just had to jump out of bed to add....

Because the rectum is suspended from the spine, when we move the pelvic interior forward, the back vaginal/front rectal walls are lifted up, the rectovaginal fascia tighened, and eventually the rectocele improved. Goodnight! :)

Before I had my first baby at OBgyn apts they always had a very hard time finding my cervix- it was because it was not easily seen and very deep in and oriented to aim at the posterior wall.
Sounds like you have seriously repositioned your uterus- Congratulations.
of course it will depend on when you check it- during ovulation the cervix will tip down (ever looked at mybeautifulcervix.com?).
I don't think a posteriorly facing cervix is an indication of uterine prolapse- in fact I would think the opposite. If anything is going to come in and fill the space my guess is that it would be the rectocele-
but honestly if your uterus is moving forward it should be pulling your rectocele up more and your bladder- perhaps that is why your bladder is smaller- the uterus is lifting it.
Wouldn't it be great if you are actually reversing your prolapses??? WHee!

it *would* be great if that were actually the case. its what I'm hoping is going on, but I'm almost afraid to say it out loud.

Sounds like that is what you are doing. When I was having my daughter in the hospital and the nurse doctor were checking my cervix, they kept saying it was far back. I asked if that was due to the prolapse, and they both said yes. Hopefully with yours moving down a bit, you have got it where it is supposed to be...............I hope to some day be in your shoes!

Just wondering what position you were in when they assessed what was happening? I am guessing that if you had been on hands and knees with them examining you from the back end, your cervix would have been well forward. But doctors and nurses don't seem to like examining women unless the woman is on her back. That is what they know, and can compare you to 'normal'. Go figure.

L

Yes, I was on my back when they checked me. I'd labour on my hands and knees and they would periodically get me to flip over to check my progress!