I just need some help!

Hi Kgirl

Welcome to Wholewoman. You have a positive attitude and I am sure you have a lot to learn. We have all 'been there'. It really is wonderful that you have found a physician that you can relate to. It can be a very lonely place to be if you cannot find one you like.

Has your cystocele been there for a while, or has it just happened suddenly?

You will find that getting to know how your body works will give you more confidence in dealing with POP yourself. I would recommend that you have a good look at the FAQs on the main site, do some Searching of past posts (via the Search box at left) and get Christine's book, Saving the Whole Woman, edition 2.

The new DVD is a good starter too, great for strategies. For the first time we can see Christine doing a studio workout with a couple of women, and a demo of firebreathing.

The book is better for the anatomical explanations and the explanations of surgery. This is not a paid ad. They really are very good products.

Once you have found out all you can from past posts, post your own questions and observations.

Cheers

Louise

I could have written you post kgirl. I have been living with my cystocele since before Christmas and not seeing much change, yet. I really think it had been there for awhile, but I never felt anything so I never gave it much thought. In Dec. I squatted down in a weird postion and when I stood up I felt something "full" in my vaginal area. I must have caused something to let go or move down. I hate that feeling all day. I don't have much discomfort in my back, just now and then when I have worked hard during the day trying to stay in posture. I am trying the fire breathing and some of the exercises but I have been fighting a cold and a period after not having one for 9 months. I am 54. I am hoping things will start to improve some in the near future but I know it takes time. I would be happy just to know things won't get worse. I have been having alot of my own pity parties too, I can really relate. Let me know what suggestions PT has for you. I know my muscles are very weak too. I never did kegels in my younger years, now it is probably too late. Take care, Connie

welcome to the site
I found my cystocele when I was 32 or 33, don't remember (I'm 36 now). I also thought this only happened to 'little old ladies in nursing homes'. the secret truth is that it happens to young women too. some women who've come through here have been in their early 20's and had not even had children. so go figure.

PT, as far as I can tell, traditionally does very little for prolapse. kegels will not stabilize or reverse a prolapse though some find them helpful for regaining tone/sensation and for managing symptoms of stress incontinence.
those muscles are TINY and not designed to hold up our pelvic organs. I started doing kegels the day dh and I began ttc our first. my muscles were STRONG and yet, I still developed a prolapse. so if strong muscles won't prevent it, how will they reverse it? so don't go worrying over your weak muscles. the key in stabilizing or reversing a prolapse is postural. read the faq's on the home page and use the search function to learn the posture. the posture will help position your bladder over the pubic arch (bone) instead of over the vagina (a hole). the posture gives your pelvic organs room in your belly rather than push them downwards.

so you asked for some advice.

1- learn the posture
2- watch your diet, constipation makes this all worse
3- never ever strain on the toilet
4- never ever do crunches or situps or any other exercise which flattens your stomach that way and pushes everything down & out (there are other abdominal exercises you can safely do)
5- read as much as you can on this site
6- if you can afford it, buy the dvd and/or the book (the second edition). definitely worth every dime.
7- know that most of us here are living well with prolapse. it is not a life threatening condition and for the most part, it doesn't even threaten quality of life. you are at the beginning of this road, but it does get easier as you learn to manage it. I do everything I ever wanted to do before I found my cystocele. I've gone on to have another baby, I run around with my kids, I lift whatever I need to, I garden, I take long walks. life's good.

so stick around, we won't get tired of listening to your complaints or questions. we know what you're going through.

Hi Kgirl

Ah, so you have had a hysterectomy. I now need to tell you that hysterectomy does alter the support mechanisms of all your pelvic organs, as a considerable amount of tissue has to be cut to remove the uterus. Then the vaginal vault is reslung on other structures in the pelvic area. This means that *all* the organs are not able to move freely within their fascia compartments, and the uterus is no longer available to help keep the bladder and rectum in their places.

Unfortunately the fact that the pelvic area is no longer structured as it was originally designed to be also changes the way intraabdominal forces are directed within the pelvis. It probably also means that you will not be able to get maximum benefit from WW posture principles.

Sorry I am the bearer of this news, but having been so positive in my first post I feel it is necessary to let you know this. Wholewoman techniques are designed primarily for women with a uterus. I hope Christine will also post re hysterectomy, as she has many times in the past.

I hope you can gain some benefit.

Louise

Hi Kgirl,

Welcome to wholewoman and I’m sorry to hear you are having these difficulties.

Intraabdominal pressure as it manifests in the human body is really an astonishing process and the foundation of our ability to sit and stand. From six months of age onward, babies and children puff out their chest and upper abdomen to balance themselves perfectly so they can use their hands and move their head and voicebox freely. This puffed out look becomes sleeker as we age (goatgirl) but clearly, it is a basic design of the human body that is compromised when we try to “corset” the abdomen with exercises, postures and clothing, which is so popular to do in our culture.

In women, that puffed out chest and upper abdomen (by this time it is really best described as “pulled up and relaxed”) supports natural breathing, encourages an extended lumbar curve, and is the basis for moving the uterus into position and then maintaining its role as anchor for the entire pelvic interior. A large “anchor” thrown over the front of a boat is a very good analogy for the uterus. Just its weight and position alone keep the vaginal vault pulled up and if that isn’t enough there are two ligaments on either side of the front of the uterus that act as guy wires embedding into the labia and pulling the uterus into its horizontal, anterior position. Of course, the uterus and vagina are one continuum and the vagina is also pulled into its natural axis. It is very important for all women to realize just what is removed during all forms of hysterectomy (uterus). This is never a minor procedure, but truly a removal of the hub of the wheel of a highly evolved pelvic organ support system. All women should work in any way we can to begin to abolish hysterectomy in our time. Outside of gross malignancy, there is never justification for it.

How to anchor what is left of the vagina and ligament stumps has always been the bane of reconstructive pelvic surgeons. The puffed-up “barrel” look of a young child’s torso gives us a clue as to how much pressure is moving through the abdomen and pelvis with every breath we take. The pelvic interior is perfectly designed to protect itself from this pressure - but that protection is completely removed along with the uterus. Your experience in the shower is extremely common as internal pressure finally breaks loose the stitches or mesh extensions used in trying to stabilize the vagina. Some women get years out of a hysterectomy - but when things come down they usually do so dramatically.

Okay...that is the bad news. Actually, I have turned my focus to the post-hysterectomy woman and am more hopeful than ever that they can stabilize their conditions too - albeit not to the degree of a woman who has a uterus. Here is the theory and all of you post-surgery women will have to be the practice:

The vagina has lost its primary stabilizing force and structure, but it is still connected at the back wall to the rectum. The rectum in turn is continuous with the sigmoid colon, which is also carried at the front of the body. This is really the only connection left, because the relatively free-floating bladder does not carry a lot of pulling force toward the front, although it should be encouraged toward its anterior position as much as possible. Our entire anatomy and physiology is set up for pulling the pelvic organs toward the front of the body and we must work with what is left of that design.

What this means is that the post-hysterectomy woman needs this postural work at least as much as the rest of us. However, she needs different exercises and she will not experience the same level of results. That is okay! A ring-with-support pessary often works very well without a uterus pushing it out and all post-hyst women should at least be fitted for one. What is important to realize is that the second, third, fourth, etc. surgeries often cause more damage.

I must also mention the possibility exists that intraabdominal pressure will keep trying to turn your vagina inside-out. This process will hopefully be mitigated by the postural work and the pessary, but you should also develop an established relationship with a trusted reconstructive pelvic surgeon who will help keep an eye on things. If vaginal vault prolapse becomes profound, it will have to be responded to with surgery - most likely a sacrocolpopexy where the top of the vagina is anchored to the spine with a mesh bridge. But truly, Kgirl, I have great hope that the post-hysterectomy pelvis can be stabilized with an exaggerated form of this work. We just don’t have the data yet.

So...I would suggest you begin with the seated and standing postures and also diaphragmatic breathing - all of which is taught in the dvd. I believe there is much more to gain from additional breathing exercises, which I will soon put into a dvd for the post-hysterectomy woman.

I hope this has been both informative and inspiring.

Wishing you well,

Christine