post partum question

Welcome to Wholewoman. We are a ton of ladies with a million symptoms. You might like to look over the FaQs page and also use the search engine. I am sorry you are having this trouble. You may like to try emptying your bladder on your hands and knees each time you pee and see if that helps at all. You also might like to experiment with your water intake- try drinking 6 ounces at once every few hours and see how that goes.

Sounds to me like you have gotten some good information from doctors but I understand the desire to hear from other women who have this same condition.

Hi Ellen,

Although there’s no way we could possibly know the cause of your symptoms, your story is thought-provoking nonetheless.

You say you’ve been told you have an extremely anteverted uterus. But what is sitting atop your uterus? It wouldn’t surprise me if your doctors never thought to investigate or that they would even know what to look for because their perspectives are so very narrow. Take this quote from a well-known pelvic surgery book published in 1990:

“The abdominopelvic cavity extends from the diaphragm above to the pelvic floor below, and is the box or house within which reside all of the abdominal and pelvic viscera. Our concerns in gynecology are with the bottom of this box, which becomes the most dependent portion of the cavity when the person assumes erect posture.”

This framework is not only narrow, but also entirely wrong. The abdomen and pelvis are not one box, but rather two boxes positioned at right angles to one another.

Your history is very significant and caused me to wonder if part of your abdominal organs herniated into your pelvic cavity to cause both the anteversion and bladder symptoms. It is obviously a problem of increased intraabdominal pressure, as you only have symptoms while standing. The base of the bladder is extremely nerve-rich and easily irritated with alterations in natural anatomy.

Regardless of the cause, the question remains what to do about it. I would certainly read the Nauli discussions going on in the Bodywork Forum if I were you. Also…my most recent blog post on kegels.

Hope you can get this resolved soon!

Christine

Hi Ellenb80

Welcome. You are by no means the first woman who has come here with a story of prolapse without having a pregnancy before it. We also have new Members every week, it seems, who have prolapse in the first few months after giving birth. Hey lady, you're in good company!! ;-)

First thing to do is to know that it will take a full year or more after birthing for your body to reach its best state, not the six weeks we are led to believe. The lochia has commonly stopped by then, but the body's structural recovery takes much longer. If you do nothing at all, it will get better by itself. However there are things you can do to help it along, and make yourself feel better physically. You will find out about these in the FAQ's at www.wholewoman.com , particularly concerning amending your posture which will give you more belly space for your uterus, so it is not pressing down (or in) on your bladder. Also, search 'postpartum prolapse' using the Search box at left, then use your brower's 'Find on This Page' function to search each hit. You will find heaps of info to make you realise that prolapse after birth is very common amongst Members. It seems to be worst around 2-3 months, then the improvements start.

I really don't understand the situation with your uterus. From what you have said, the uterus is anteverted. This is normal, ie more women have an anteverted uterus than retroverted. Does severely anteverted mean severely normal??? That's fear tactics for ya! ;-) Normally the body of the uterus would be sitting on top of the bladder, quite close to the front abdominal wall. It sounds like yours is pressing down hard, or in front of the bladder (that is if your uterus has anything to do with your bladder problems at all! It may be something else. Continence can be quite a complicated business).

But seriously, the urodynamics test also showed that your uterus bends forward more than normal. You need to be a little careful interpreting adjectives used by health professionals. They are often used as subjective ways of describing things that cannot be measured with a tape or scale. In everyday use 'severe' means just that! And is usually a cause for alarm. I would not be *certain* that there is cause for alarm medically. You would need to ask the doctor to be more specific as to the implications of it.

Christine is right. You would be wise to ask the doctor what is pressing it down, and justify his opinion. Get another opinion if you need to. I have recently been told by a very wise old orthopaedic surgeon that medical specialists know very little about any other medical specialty. He actually said that there are very clear delineations in the body for where one specialty stops and another starts. It sounds like there are crooked dotted lines throughout the body, past which each does not venture.

*On the other hand* you may have been wandering around since adolescence like me with an abnormal posture, knowingly or not, and trained your uterus downwards at the top somehow. The organs are very easily repositioned by pressure over time (eg tightlacing and corsetry which literally moves organs around and reshapes them inside a body which is literally reshaped over several years). The uterus often gets retroverted somehow (which mine is, or has been in the past. Not sure now, as it seems to be normal again when I examine myself these days), so I guess your uterus could get pushed forward somehow. What I am saying is that WW posture may help you over time to get your body back to how it is supposed to be, perhaps with a little more lower belly room, and more of your body carried up front, and the uterus and bladder being carried further forward, over the pubic bone. Any chance of getting yourself to New Mexico so Christine can help you hands on?

The walking only urgency sounds a little like what I get when I get out of the car after a long journey, and suddenly need to go, or when I get up in the morning. It could also be urethra-related. Sometimes the fascia surrounding the top of the urethra breaks down and the top of the urethra opens out into a 'cone', rather than staying tubelike. So there is a lot more area of urine putting pressure on the rest of the urethra. When you sit, the urethra might get a kink in it, which acts like a sphincter, closing off the urethra. When you lie down, gravity is acting at right angles, so there is little pressure on the urethra at all.

Also, check out low grade UTI. Have you ever had your urine cultured?

Hope this has got you thinking. Call back again.

Cheers

Louise

I'm curious as to how you got a doctor to check you in standing for prolapse. Like you I have had pressure complaints in the pelvic floor ONLY IN STANDING. Although I do have a small perineal rectocele my specialist has checked me twice (in the standard lithotomy position) and says I have no evidence of prolapse - thinks I have a residual compression nerve injury from delivery causing the pressure complaints.

As for emptying your bladder, have you the "football" position? You are bent forward like getting ready to punt? the ball when you are urinating. My urogynecologist recommended this the dribbling I have at times with positional changes. But it sounds like you have minimal post residual volume, so proper emptying is likely not a problem.

I've been doing some intravaginal electrical stimulation and that has helped with kegel performance and overall pelvic floor tone/support. Keeping your pelvic floor spasms in check should help.

My sympathies go out to you.

Hi,

I was in a very similar situation to you after the birth of my first baby. I constantly felt the need to urinate etc and I also had this problem but not quite as badly before I even became pregnant. I also had the urodynamics done and was diagnosed as having bladder spasms with the prolapse. I was put on Detrusitol. I know it's a medication but it helped me until I could improve my strength and work on the ww posture to a point where I could walk comfortably again and 'hold on' a bit.

The good news is I found heaps of improvement over the two years after having bub to the point where I've just had a second baby confidently. The ww posture and firebreathing helped me a great deal as did some, but not too many, kegel exercises under the care of a pt. Not getting constipated and sitting forward on the toilet also helped empty my bladder completely. Christine's method of emptying the bladder on all fours in the shower a couple of times a day where I could also helped. The last thing that helped me was wearing the V2 supporter. It made it possible for me to go for walks without the constant feeling of needing to urinate. Hope that helps a bit.