Cystourethrocele & lots of questions

Submitted by australianjanelle on October 1, 2010 - 11:08pm
Body: 

Hi everyone. I have some questions, but first, a bit of my background....

I am 39 years old, and currently I have a cystourethrocele, which apparently is both a urethrocele and cystocele. Last time I was looked at it was a stage 2, with my cervix about 1cm from the vaginal opening, although recently it can feel more of the front vaginal wall rather than my cervix.

I had a uterine prolapse at 11 weeks pregnant, resulting in severe retention issues and needing to be cathetered for about 4 weeks (it was complete hell) before the baby grew large enough to lift my uterus out of my pelvis. The rest of the pregnancy I had no more problems with emptying my bladder, although I did notice the first appearance of a cystocele coming down, which my obstetrician dismissed as nothing.

I went on to have the most beautiful, natural, drug-free labour delivering my second daugther in just under 3.5hrs. (I should also note that my first birth was also complication free and lovely - I have been very blessed in that regard, so I am rather bummed that I have a prolapse now).

About a week after my fabulous birth my euphoria ended with a bang one night when I went to the bathroom and everything "fell out". My cervix was about 1-2cm outside of my vaginal opening and I felt terrible. Could not empty my bladder properly although thankfully I had found the WW website in my pregnancy and emailed Christine, and so knew about getting on all fours to urinate, which I am sure spared me a trip to the hospital to be cathetered that night.

I now have a 13 week old baby, am breastfeeding, and am about 30lbs overweight/need to lose to get me down to a healthy BMI and my pre-baby weight.

Now, my questions that I am hoping someone can help me with are:

1. I have been referred to a pelvic floor physiotherapist who showed me a picture of the pelvic floor muscles being a hammock like structure. From what I gather from Christine's book and DVD, that is wrong.

2. She also wanted me to do my pelvic floor exercises lying on my back? Is lying on my back OK or does that put my organs in the wrong position?

The physio sessions are very expensive and also invasive so I don't want to waste my time if she is coming from the traditional view of pelvic floor health which is wrong.

3. I am feeling a constant urge to urinate and feel like I am never emptying my bladder, even in the all fours/leaning forward at right angles position. It is not cystitis (yet) just an uncomfortable feeling. Any tips from anyone as to what I can do?

I did my first WW workout today and felt like an ungainly hippo but liked the workout and will do regularly from now on, and have just started to maintain the posture (have been breastfeeding lying back in bed - would this have made things worse?) Any tips of how to breastfeed in posture.

OK, have to go to attend to crying infant, excuse my rambling and hope someone can help me. Am feeling fat, uncomfortable and miserable about my failing body at the moment.

tillymama

October 2, 2010 - 7:29am

Hi
I don't have any answers to your questions but wanted to say hello as I've just joined and it seems that our situations, symptoms and questions are pretty similar. (I've posted a newbie post today if you want to read details). I'm so sorry you find yourself on this board too but hopefully we can keep each other company on our road to recovery.

louiseds

October 2, 2010 - 10:47am

Hi AustralianJanelle

I will leave the ladies who are more at baby stage to give their comments on what it has been like for them.

Look, s*%t happens, and sometimes it happens very suddenly. You think you have had really good births, then wham, POP comes along to spoil your picnic. I am sure we can help you to get your organs behave better than they are right now.

I wouldn't say your PF physio is wrong. I would say that modern, western, fitness culture would have us standing in a way that causes the pelvic floor to act like a hammock. If you change your posture so that you are standing as tall as you can, with your beautiful milky boobs held proudly, with your neck tall and your chin not jutting out, your butt not tucked under at all, and your your lower abdomen relaxed, rather than holding it in to try and not look 'still pregnant', your pelvis will tilt over more forwards and your pelvic floor will tilt from horizontal to diagonal, and will become a stabilising, springy wall at the back of your body, rather than a floppy hammock underneath. When you pull up tall, the back opening in your pelvis widens and grows longer. That sounds like bad news until you realise that it means that your pelvic floor muscles will be stretched tighter, so they will be more springy and resilient. Uterus and bladder will literally slide forwards onto the front of your pubic bones and come to rest against your lower abdominal wall.

Having just had a baby your pelvic floor may still be pretty floppy and not very responsive. This happens sometimes. Yeah, me too, about 25 years ago with my second birth. This may be why your physio is suggesting PF exercises lying down, because there is less resistance from gravity (because her view of the world has your uterus and bladder directly over your vagina making the hammock bulge), so you will get a greater range of movement so you can get them moving again. So don't lose faith in the physio just yet. She will probably have you changing to more upright once the pelvic floor has woken up again.

You are right. Being upright will put your organs into better relationship with each other and to your vagina. There is an article by Christine in the Library, called Doing Kegels the Right Way, or something like that. Read it now, and compare it with the instructions the physio has given you. Take it along and ask her what she thinks. You are entitled to know why you are being told to do different things in different ways. The knowledge helps us to be able to get the most out of any therapy because we can start to interpret and understand what is happening.

You may be urinating frequently because the sphincter surrounding your urethra is just not very strong ... yet. The urethra itself may also be stretched and quite wide, and is not being helped to shrink back a bit because the muscles surrounding it are not very strong themselves. So you have a kink in your urethra that is helping your continence, but it is a pretty crude and accidental fix that is far from perfect. Ultimately we will be able to teach you how to suck your own organs up with exercises based on creating a vacuum in your torso. That will help to take the downward pressure off your vulva and pull everything up and forward, and squeeze your urethra tighter.

Three months postpartum is the pits. Many Mums report that POP is worst at three months, maybe for the next few months. Then it starts to get better, and we really don't know why. Baby is getting bigger and heavier, and the babymoon is over, and life is becoming more normal, and the workload gets heavier. Then we get the guilts and think it is our fault that we feel fat and uncomfortable, and that life will never be the same again.

It will take two years before your body has fully reverted from the pregnancy. The six week check is the doctor signing off on the birth, checking that your feeding is going OK and that your have your contraception organised. The next 22 1/2 months it is over to you, your family and the child health nurse. By 12 months postpartum you will probably be much better.

So, improve your posture (think princess, or porn star if you are up to it. ;-) Get the picture? Treat your own diet and exercise as a priority, as an investment in your baby's wellbeing. No need to rush off to Yummy Mummy classes. A walk, in Wholewoman posture, every day, with the baby if you need to (push the pram handles at hip height so you don't have to brace your abdomen) will get you moving again. Walking is wonderful exercise for the pelvic floor too. Leave the heavy lifting for someone to help you, and break big loads down and do more trips. It works. Walking up hill is great for your thigh muscles, which are very, very important muscles because they allow us to push our bodies upwards, which engages a whole heap of muscles, not just the pelvic floor. always stick your butt out if you are lifting. You will understand all these things if you buy Christine's book and/or DVD, and trawl these Forums for personal experiences of others. Use the search box to look for posts on similar topics. You will be amazed at how many women have the same story as yours.

Oh yeah, can the tight shorts and jeans too. Those pre-pregnant ones need to go in the back of the wardrobe for now. They are a real health risk if they compress your abdomen and try and squish your bladder out. I suggest that you go for knits, lacky waists, low cut waists that can be higher at the back, long tops that will allow you to relax your belly without embarrassment. Mini-skirts need to be stashed away too. You need to be able to bend deeply from the hips with your legs and knees apart without the world seeing your knickers.

I think I have said enough for now. More questions and comments, please.

Louise :-)

tillymama

October 2, 2010 - 11:47am

Hi Louise
I've tried to find Chrisitine's Doing the Kegels the Right Way but can't find it. Do you have a link?
Ta!

Aussie Mum

October 2, 2010 - 7:35pm

Hi AustralianJanelle

Louise has given you some great information, she is always so caring and helpful, we are so lucky to have her here.

I just wanted to add my personal experience as it has been recent for me with my pop - now at 9 months pp. I had great improvement once I saw a good physio. I found her assessment and advice fantastic and got quite some improvement from it. Also I do find kegels helpful, to an extent. I felt very uncomfortable doing them lying down and folllowed the advice on this site - always do them sitting in WW posture. I found they helped with some urine leakage in the early stages, and I do feel stronger down there now! I have rectocele by the way - but physio mentioned some very slight weakness of the front wall. I discussed WW with my physio, who didn't seem particularly interested, but was happy for me to only do kegels sitting up.

I have found WW posture when I go walking does make a difference - I have experimented - walking in a more neutral position, then in WW and it feels much more comfortable and less 'weighty' in the pelvis.

I am still improving, although have my up and down days/weeks, but see a big improvement overall - and aiming for more! I have really stayed on top of any other issues that come up and tried to keep my health in check as it all seemed to impact on the pop (eg with back pain I had great results from a chiro).

I hope you start to feel better with the workout and posture, and whatever else your journey of healing brings you.

louiseds

October 2, 2010 - 9:10pm

Go to the Village Post. Going back to the Village Green might be the easiest way to get there. There is a search box where you can 'search past issues'. Type in "kegels the right way" and it will come up in the hits. sorry. I got it wrong the first time.

australianjanelle

October 3, 2010 - 11:26pm

Dear Louise

Thank you SO MUCH for your wonderfully detailed answer to my post. I really must say how overwhelming the support at WW is, its just wonderful.

I am onto my third day of doing the WW workout daily. I am finding that the WW posture is easy - when I remember to do it - I am sure that in time it will come more naturally and I won't be stopping and pulling myself up into it 100 times a day. The DVD is WONDERFUL - not just the work out but Christine's comments and information. I just wanted to get on a plane and fly over for a visit and hug everybody.

I've read Christine's article on Kegels, which make alot of sense to me and I will do from now on in the WW sitting posture.

Will keep you posted as to how I am doing, already after 3 days I have noticed an improvement in all areas so will see how I am after a couple of weeks.

Warmest regards,
Janelle.

clavicula

October 5, 2010 - 1:24am

Hey, Janelle,

Welcome to the boards, it is the right place for you.
First, congrats on the baby and the great birth! I know how empowering a great birth experience could be!
About the constant urge: been there, done that. I remember, for me it was horrible and literally constant. It drove me crazy! It made me depressed. Slowly but it went away and around a year PP it was gone. Simply WW posture and proper bladder emptying helped.

Kegels on my back made my urge to pee worse. Maybe it won't affect your cystocele, but beware!

Now 2 years PP I am considering pregnancy and feel awesome! I have a pulling scar (bad tear, lame stitches), some ache here and there and some pressure around my period, that is it. I feel fine now, but I remember, 13 weeks post partum I just simply wanted to die, I was so scared and devastated.

So there is hope, it will not come immediately, as Louise said, at around 3-4 months PP it is the worst! But healing is around the corner, do not lose hope!

These wise ladies here saved my life, so do not worry, WW will help you too!

Liv

new_mamma

October 9, 2010 - 11:51am

I am curious how we are to pee on all fours? Wouldn't that make a big mess? Just trying to understand?:)

granolamom

October 9, 2010 - 8:32pm

well, you can get a basin on the floor under you. or if youre inventive and have a good sense of balance you could actually figure it out on the toilet (no way I can describe that in words and I'm not about to post a video) or you could be efficient about it and go in the shower.

louiseds

October 10, 2010 - 3:44am

I don't think you need to do it on all fours. I find that bending over from my hips, putting my hands on my knees, and sticking my butt out , kind of like firebreathing stance, is quite good too. We don't have neighbours so our lemon tree gets treats from me, as well as the boys in our family. Wonderful lemons too! A laundry bucket works well too. You can steer the stream quite effectively by bending your knees more or less. Straighter knees and bending forward a long way will have it shooting out the back!;-) Take the bucket into the shower recess if you are worried about spilling it and your modesty prevents you from fertilising your trees.

I am sure Mae and Blue would like the fertiliser approach!

Louise