Structural question regarding bladder/intestine location

Hi Josee

You seem to have a pretty good understanding of pelvic anatomy and you have explained clearly what you think is happening. I think you are right. The whole abdominal and pelvic cavity is like a whole bunch of bags of jello that are interconnected. When there is pelvic organ prolapse some of the connections in the pelvic part have been stretched and maybe damaged. When you see abdominal surgery, eg CS, being done on TV you see the intestines literally being lifted out of the abdominal cavity. The intestines seem to be arranged like a convoluted wheel where the spokes are way too short, so the intestines go in and out, in and out around the edge. I guess they have to be very mobile to accommodate the stool moving through them, while only having wide curves to go around, rather than tight corners, on the way down. This mobility would, I imagine, allow them to move down in front of the uterus and bladder, and push them back towards the vagina if the fascia around the uterus and vagina are not strong enough to send them packing.

You could try inversion-type exercises to reposition the intestines, then use physical manoeuvres like turning over, and how you get up, to reposition the pelvic organs forwards, and underneath the intestines. We did talk about prolapse of the intestines a few months ago with another member who seems to have disappeared.

Nauli may also help, as may my jiggling exercise (bending forwards deeply from the hips and creating inversion of the torso and getting air into the vagina, then jiggling the knees to kind of shake everything up towards the chest and into place, then uncurling into Wholewoman posture).

I sometimes get my bladder stuck back, as you describe, usually after awkward exercise. The other day I was shifting furniture and boxes around, and taping up flattened boxes to pack stuff into, in a hurry, and discovered afterwards that my bladder was quite low. I wondered what could be pushing it back from the front, and figured it was probably intestines. I do these upside down jiggles to get everything back where it belongs. Sometimes it works. Sometimes it doesn't, but it was OK the following day.

Does that make any sense?

Louise

Hi Josee

Louise's advice is always spot on. I have also heard that Mayan massage can be good for repositioning your insides.

I wonder also (pure conjecture here, Louise will probably know) whether it's worth experimenting with having a very full bladder, empty intestines (eg fasting, semi-fasting). As it's all a bag of jello and not fixed, it may be you can help move things around a bit. I think that my rectocele may feel better with a very full bladder (unfortunately not a viable long-term solution) but it's hard to tell for sure. Judith xxx

An interesting theory Judith, but I doubt that it would be sensible or practical. It is important to empty the bladder properly when it is full, and not hold on for ever. Also, the bowel is not full or empty all along its length. There are bits that are full, then bits that are empty, all along it, all the time. I would think that eating less, and keeping the intestines 'not distended' would be a sensible way to do it, and keeping the body well-hydrated which would mean several big pees during the day.

I think the regular emptying and filling that happens probably contributes to the overall movement of organs within the abdominal and pelvic cavities, and allows the organs to rearrange themselves, along with regular whole body exercise. WW posture prevents the stomach pressing down on the belly too, and allows intraabdominal forces to be reflected off the front abdominal wall and bounced around evenly inside the body.

Yeah, my rectocele is better with a full bladder for sure, but my cystocele is better when my bowel is not full.

Cheers

Louise

Hi Josee

Just checking. Where is your cervix, front or back vaginal wall, or right at the top? So, I am asking you whether the bulge is on the rectum side or the abdominal side, and is it there all the time?

L

Hi Josee

My guess is that there are some intestines falling down the front of the uterus and maybe the bladder. The solid thing is probably the round ligaments that are "bands of connective tissue that arise on the sides of the uterus and pass down through the groin and attach to the labia majora of the vulva" Glossary STWW, ed 2). These round ligaments are not tight connections, but they could conceivably become taut if the uterus is being pushed upwards,ie backwards. When you bear down with the uterus pointing upwards, the uterus may descend slightly and the round ligaments could become slack again, so you might not feel them. However, as far as I can see, the round ligaments kind of go out sideways. I cannot visualise them in 3 dimensions. Have a look on Wikipedia at the article on The Round Ligaments Of the Uterus. There is a drawn image from Gray's anatomy, the righthand image in Additional Images that might help you to visualise it a bit better.

The other possibililty is that it is the body of your uterus, and that it kind of flips upwards and out of reach when you bear down.

Gray also talks about the differing positions of the uterus. He observes that the fullness of the bladder will determine the position of the body of the uterus. That makes a lot of sense to me. Gray is pretty good, if you remember that most of his anatomy drawings were done from horizontal cadavres, not standing, living humans. So gravity sometimes puts the bags of jello in different orientations to how they would be with the subject standing.

Christine, where are you?

Cheers

Louise

ps Gray's Anatomy is a classical anatomy text. The hardcover version of it is about A4 size and about 3 inches thick. It is available online via www.bartleby.com .

Hi Louise, yes, totally agree, I certainly didn't mean it as a therapeutic measure for long-term, just as a temporary one-off to (a) get a sense of what organ is where and (b) if you can get them where you want them, you might be able to keep them there with posture/exercises.

Many people empty their bladder way before it's actually full, I'm just wondering whether letting it get full (then emptying it, not holding on to it) might give more sensory perception of what is where and also move things, albeit temporarily. Ditto fasting or semi-fasting, just meant for a short period. I think that for me using the sea sponge pessary achieved a similar outcome, it pushed things back into place and then I could keep them there, using visualisation, exercises, posture etc.

Just a theory, as I say. Of course you're right about the rectum not being full or empty along its length. I do find that when the rectocele is bulging more, I can't feel the cystocele, I suppose that the relationship between the celes depends on exactly where they are.

Anyway, just wanted to make clear that I'm not advocating drastic measures as a long-term treatment, I just like experimenting on myself, as long as its harmless. Judith xx

Hi Judith

I didn't 'really' think you meant long term fasting. I do get your point, and I think your comments about the full bladder being a pessary in itself is very true. If we empty the bladder as soon as it is 1/4 full (perhaps what happens when Members say they are feeling like having little pees all day) we are preventing it from blowing right up and acting as a pessary.

So waiting until you get the full bladder sensation (as opposed to the 'need a pee', sensitive urethra sensation) then going and emptying properly, then having a drink after every pee, it keeps the bladder filling all the time to

* keep it round and substantial, rather than flat and floppy
* maximise its pessary effect by taking up more space - for benefit of uterus and rectocele,
* as well as training it to only need emptying a few times every day instead of our planning our day according to the location of the nearest toilet.
* Then when you go it really does flush everything out of your bladder like a tap, rather than like a dropper bottle, and
* it keeps the kidneys working at full capacity, detoxing the body, which kidneys like.

Sounds like Win-Win all round.

Louise

Hi Josee

If the last CT didn't show anything I doubt that another scan of any sort is likely to. I think you would do better to go to a physician or good body worker who can identify what is happening by palpation. With all the modern scans availaable, diagnosing by palpation is a dying art, but it is not invasive and the practitioner can 'read' what is happening while you are standing, sitting or lying. *And* you can get direct and interactive feedback, as opposed to a scan which is done by a radiographer, read by a specialist and the report sent to the doctor to tells you the result. Another shortcoming of the scans is that they all have to be done lying down. What is the point of that, when the information you are looking for relates to standing or sitting? IMO, all the providers will get their cut of the pie but you may end up spending half the day and a lot of money getting little extra information.

But you are the one who decides how worried you are about it. If you are really worried, and have faith in the ability of the scans to give you the information you want, then go for it. You are the one who lives in your body, and you may learn something from another scan. Ask your doctor before committing to another scan what information would be revealed.

Just had another thought. The solid thing isn't your pubic bone, is it? It is quite hard to examine your vagina without tilting your pelvis back, and when you have POP, tilting your bladder and uterus backwards. You might be able to feel your pubic bone through the bladder, then when you bear down the pubic arch might move up further, and out of the way?

Cheers

L