What's ahead with a vaginal vault?

Submitted by Cecilly on November 1, 2014 - 11:11pm
Body: 

Not sure, but it seems I may be developing a vaginal vault prolapse now (my bulge sometimes sounds and feels gurgley) and it is present almost constantly when I am upright. However, I have no pain, no incontinence, no infections, or other problems that I hear often accompany vaginal vault prolapse. My question is, what should I expect in the future if I do not seek surgery? I am 55, had a hysterectomy about 15 years ago, still have 1 ovary, and am in good health. I have tried to follow the WW recommendations for posture, breathing, exercise, etc. for the past several years now. I have bad days and not as bad days in terms of how heavy my bulge feels. I can get everything to move up when I bend over into a downward facing dog position or manually push things up (which I do numerous times during the day). My bulge may be just at the opening for a few hours after getting out of bed, even staying put during most of my morning walk, but as soon as I go poop, it's down, and persists in staying there.

I have no interest in surgery given the nightmares I read about that are most likely in store afterwards, but I'd just like to have a heads up on how bad things could get without it. Thanks.

Forum:

Surviving60

November 2, 2014 - 4:50am

Hi Cecilly, it is good to hear from you. It sounds like things have been relatively stable since your last big post in May. I'd like to put a link here for that conversation because Christine gave some good insights and there is nothing really to add.
https://wholewoman.com/forum/node/6122

All you can do is continue to work on holding the organs forward with diligent WW work. A vaginal vault that completely goes inside out will require surgery. I'm not sure if anyone here can tell you what that's like. It is a common post-hyst type of prolapse which hopefully you can manage the way we manage our other prolapses. - Surviving

Cecilly

November 2, 2014 - 7:02am

Thanks Surviving for your reply. I guess what I'm asking is whether a total vaginal vault prolapse (inside out as you mentioned) is inevitable, or can any further progression be managed? I can find no testimonies from women with this situation who have managed it into their old age without surgery.

Aging gracefully

November 2, 2014 - 7:35am

Hi Cecilly,
There aren't any testimonials on this site that I am aware of. The hope is that if you do this work gently and diligently, you will be able manage your prolapse as it is or improve it slightly.
All this can depend on the type of surgery you had and wether or not is has changed you so dramatically, that you will end up with the total vaginal vault prolapse, anyway.
Only you can really determine that for yourself.
I guess the question is, if you have been doing this work for three years, how are you feeling? Does the prolapse seem better, the same, or worse than when you first started?

Surviving60

November 2, 2014 - 8:52am

I haven't looked back through all your old posts so I don't know if the following items have been discussed before.

Vaginal vault prolapse is so common after hyst, that according to Christine, at some point in history it became routine to tether the top of the vagina to the spine after hyst. Do you know if this is the case with yours? I suppose that if you have had this, and it fails and causes the vaginal vault to prolapse significantly, another similar procedure would be the only fix.

The other issue is whether or not enough vaginal length was left for the vagina to be able to close and flatten against intraabdominal pressures. These things were discussed in the thread I linked to above.

As AG says, there is no one on this forum that we can remember who can speak from experience on this topic. Christine would know the most about this, from her research. You might even want to try HysterSisters, where virtually everyone who posts has had hyst. - Surviving

Cecilly

November 2, 2014 - 12:20pm

Things were holding steady (no indication of any gurgling at least) until I got that stomach flu last year. The violent vomiting put such forceful pressure onto my pelvic organs, things haven't been the same since. Everything tho seems to be effected by what's in my bladder and bowels, so if I keep them moving, the bulge isn't as bad. I do a LOT of bending over to let my organs reposition themselves (and I can feel them noticeably moving forward). I avoid long standing times and take lying down breaks during the day when I'm at home doing house work, etc. I'm also working on loosing 20-25 lbs (most of which is in my belly area from peri menopause redistribution)! Hoping to get some of the added abdominal fat out of the way so my organs have more room to move forward. I've discovered some helpful chair exercises using a Kettlebell and drumsticks. I am able to hold WW posture the whole time, and after a short workout I follow with WW yoga moves. Then I walk 2 miles in posture or ride my bike 4 miles. I do notice that if I have a large meal, eating past the full mark, there is a fullness in my lower abdomen, so I try to eat just to satisfaction, with small snacks in between if needed. Anyway, I'm too healthy and active to even consider surgery which most likely will lead to an end of my healthy and active life as I know it. So I will guard whatever stability I can find for as long as I can. A bulge of something is always present tho, not always gurgly. When it is, I lay down and take it easy for the day. Thanks for your reply and for the support of this site.

Surviving60

November 2, 2014 - 3:14pm

Just a couple of thoughts after reading your last post.

A bit of belly fat does not worsen prolapse, and in fact, if you lose weight too fast you could see your symptoms worsen, as least for awhile. In that previous thread of yours, for which I posted a link above, Christine even discusses how belly fat might even be beneficial as long as you are holding the organs forward. Cecilly, I reposted that thread because it already contained so much good information. I hope that you looked at it. It was your discussion!

I have seen some kettle bell exercises that I would consider extremely bad for prolapse. So I will assume that if you are doing them only when sitting, in extremely good WW posture, and only with great care, you are probably OK. Are you targeting a particular area? What exactly are you doing?

You seem to be extremely active and I want to remind you that post-hyst women need to be gentle on themselves. Always walk with cushiony shoes and socks. Do you in fact have sutures that tether the top of the vagina? Was this part of your hysterectomy procedure? It frequently is, so if you don't know, you might want to try and find out. Overzealous exercise of the wrong type can dislodge these. Maybe that is what you have going on now.

Some women with prolapse do try and do too much. There is a tendency to think if some exercise is good, then a lot of exercise must be really good. We've seen this happen post-partum and I think it could also happen in post-hyst women who have learned about the true anatomy and are hoping to regain as much of it as possible. There is a potential for damage if you overdo. - Surviving

Cecilly

November 2, 2014 - 4:50pm

I so appreciate your concern Surviving. My exercise is not as vigorous as it may seem. I have walked for over 20 years nearly every day...with my dog. And to preserve my knees and feet, I wear good running shoes with insoles and cushy socks for sure. When I ride my bike, my dog is also running beside me so I don't go too fast and rarely break a sweat. As for the Kettlebell, I sit on a low stool allowing my upper legs to be at a 90 degree angle from my torso with feet on the floor. The Kettlebell is on the floor between my slightly opened legs and I do straight lifts from the floor close to my body up to chest height and then back down. Then I do some swings up to chest height using my core, back and glutes to propel the bell. Then I swing up overhead in the same way. I do these for the duration of about a 2 min. song doing each move 8 times each. I also break this up by passing the bell around my body 8 counts in one direction and 8 the other. The bell is 10#. I sometimes also do upright rows with the bell one side at a time leaning slightly forward but with proper back alignment. That's it. All of the other exercises I do are straight from Christine's videos. This is my morning warm up before walkin and it takes about 15-20 min. I do these 2-3 days a week.

I was talking to my husband earlier today about tracing my records of my hysterectomy. It was actually 15-16 years ago and the hospital closed, plus we moved since then. We're trying to remember the name of the Dr.but will try to face my records. The hysterectomy was for a uterine prolapse. He also mentioned that he did a bladder tuck. (Boy if I'd known then what I know now, he wouldn't have touched me)!!!

About the belly fat...it will be very slow going to loose it, believe me. I am extremely short waisted and there's just no room for everything plus a soccerball's worth of blubber! I'm working on weight loss to lower my cholesterol and triglycerides mostly, to avoid taking meds. And I weigh 165 and would be thrilled with 145 someday.

Don't know if that helps give a clearer picture. I have reread my previous post and Christine's response many times and so appreciated everything she said. Thanks.

Surviving60

November 2, 2014 - 5:15pm

Hi Cecilly - any time we hear the word "core" in connection with exercise, alarm bells go off and red flags start flying. Modern exercise programs are saturated with moves that strengthen the abdominal "core" which is OK for men, but not for women. I am sure that you will have come across this issue many times if you have studied Christine's work for any length of time. Women's "core" is at the level of the sacrum, and bodywork that is intended to build a strong core invariably is targeting the abdominals, which is exactly what you don't want to be doing. I can't evaluate this kettle-bell work that you are doing, but the statement that you are "using your core to propel" a 10-pound weight kinda makes me wince. I can only hope that your understanding of Christine's work is profound and thorough and that you know what you're doing. - Surviving

Cecilly

November 2, 2014 - 8:58pm

Hmmm...I will reexamine things. I use the word "core" to describe the muscles in the hip area. For example, I also lay on my back with my legs straight up in the air and pulled into a strong right angle to my torso. I do scissors wide and small in this position. The muscles that are engaged in this seem to be the same as when I do the Kettlebell. But to be on the safe side, I will discontinue the use of the Kettlebell. Thanks so much.

Surviving60

November 3, 2014 - 5:55am

As I said....I am not in any position to evaluate your exercise program. But since you are post-hyst, post-bladder-repair of some kind, and now experiencing a worsening of something that might possibly be a vault prolapse, you may be endangering yourself in your efforts to lose some pounds. Even Christine's exercises could contain moves that are not designed for women who have various sutures holding things in place. Only your surgeon, or someone else qualified to interpret your medical records, can really say what was done to you and what is "safe" now. I know there are several women on this forum (myself being one) who aren't as flexible as Christine and have some trouble keeping our legs all the way up to 90 degrees and working them there without feeling a strain. I would rather see you use dietary measures and more gentle bodywork to help you reach your weight goal. - Surviving

Cecilly

November 3, 2014 - 3:38pm

Thank you again for your insights. I think I will abandon any exercises that could put me in a potentially worsening situation. I went to the hyst. sisters and from what I read, they seem to be all about surgery, so I'm confused. Also, today after my shower, I decided to get out my mirror and take a look. I had pushed things up after drying off, then propped my leg on a chair to be somewhat in an upright position, and then took a look at what was happening below...everything was up, but it didn't take long for things to start moving. The bulge was definitely coming from the back and just gradually slipped on down to a position like a water balloon partially protruding out of the vaginal opening. I think this was my rectocele tho as the bulge did not gurgle or feel as if anything was in it. Almost like it was easily deflated when I pushed it back up. How far out does a prolapse have to come before surgery is the only option is what I'm wondering the most? I did dig out my V supporter which I think is really a large and not a med as marked. I have the straps pulled to their smallest and tightest position and could even stand to have them smaller (and I have hips 45-6"). Anyway, I put it on and am wearing it now. Can't really tell if it is providing any more support than my jeans would provide, but I'm going to keep it on.
I guess I just need to find a sympathetic Dr. to give me a full exam and status report. Because I have no pain, no lower back issues, no bleeding, no infections, no problems urinating, and I am keeping my bowels moving well with magnesium supplements, I don't want to rush into a surgery that could alter my life drastically with future surgeries and worse conditions a very real probability down the road.
Sigh. I feel rather alone in this as here you all deal more with those having a uterus, and at the hyst. sisters site, what is recommended there seems to fly in the face of all I've learned from Christine. Thanks tho for your insights and concern.

Surviving60

November 3, 2014 - 4:09pm

The reason I suggested looking at HysterSisters was that you were looking for women who have experienced vaginal vault prolapse. We do have some post-hyst and post-repair members here, but none that I can remember who had the kind of personal experience you were looking for. It is a site for women who have had hyst or are considering it. I thought someone there might have more relevant answers to your question about what happens to VV prolapse over time. But definitely not the place to find support for non-surgical management of routine prolapse. - Surviving