Something broke

Hi Saddleup,

Isn't is amazing that the female bladder bends backwards to stop incontinence? I consider this a great blessing and figure most women would choose a bulge over uncontrollable incontinence any day. Few women here with cystocele have serious incontinence.

It remains a mystery why different women, with quite similar anatomy, respond so contrastingly to living and working with prolapse. We've told you everything we know and will tell it all to you again, if you wish, but it really is up to you to decide what to do from here. For some women, the effort to stabilize prolapse will only end with their last breath. For others, only until their next appointment with yet another urogynecologist.

I do sympathize, Saddleup, and there is no right or wrong here - only tough work and tough choices. Maybe you have really lousy connective tissue and perhaps your cystocele is really, really bad. I actually had a dream a couple of weeks ago that I had a 4th degree cystocele, and it was not fun!

Your vagina is turning inside out - that is a fact. But it's that way for all of us - that's what prolapse is. I can tell you that is seems to be the nature of the vagina to only allow prolapse to go so far. The upper supports to the vagina have a lot of leeway, whereas the lower supports are so strong that virtually never does the vagina prolapse much beyond the introitus. And we have shown that reversal is possible even at that stage.

Maybe you would be happier with surgical repair - we really have no way of knowing one way or the other.

(((Hugs)))

Christine

Hey Christine- I am not so sure about that. I think Saddleup wants to continue to ride :) which I think is probably contraindicated after surgery.
Saddleup- I wonder if you just finally passed that milestone that Louise talks about- where everything seemed to fall further and then all of the sudden she was much more comfortable. Wouldn't that be great?
I can't remember- have you tried a pessary yet?

What is this phenomenon of which you speak, Christine?! The bladder bends backwards to stop incontinence? So when the bladder is not in its anatomically correct position (bending anterior and on top of the pubic bone) then there is less incontinence? Can you or anyone else explain this a little more...
Hope you are hanging in there Saddleup; sorry to ask questions in your thread but it caught my eye. Sorry to hear about your pinching and bulging. You are a horsewoman? What sort of influence do you think riding has had on your POP?

HI Saddleup,
I haven't been around for a few weeks as I've been sick. I'm sorry to hear that things are tough right now...
Just wondering, I'm forgetting where you are geographically. Anywhere you could go to visit Christine and work with her for a few days to see if any other tweaks might help? I was hoping to get there earlier this year but it all fell apart, but am determined it will happen next summer (don't book any holidays yet please Christine!). Whilst I feel like i'm doing the posture fairly right, i'm sure there is a lot i could change that would help even more...
just don't know if it's possible for you?

Kiki

Hi Saddleup, I'm so sorry things are bad at present. I really do think a pessary might help, certainly worth trying. I have posted lots about my experiences with pessaries. I was a bit scared of mine to start with, but now it seems like just a normal part of my life and quite harmless - a bit like my spectacles. My most optimistic idea is that perhaps the pessary can support things and give my insides a chance to heal some, in the same way that a physio once strapped up my foot to give my arch a break, and managed to heal my chronic plantar fasciitis. Less optimistically, at least the pessary seems to help some, and I am quite happy with the idea of wearing one for ever more.

In the UK the usual thing is to leave the pessary in for at least 6 months between checkups. This may sound unhygenic, but as mine have both been ring shaped, I think my secretions are able to flow out unimpeded. Certainly there is no bad smell or untoward discharge (just the white secretions we have discussed recently). I feel it is kinder to my vagina not to keep wrenching the pessary out. All the medical literature and professionals say you can have sex with a ring or doughnut pessary in (see previous discussions for Louise's ribald comment on that). I don't know, and I have yet to see any testimonial by a user one way or the other. If you really wanted to keep taking your pessary out, I would recommend the rigid ring pessary over the doughnut, as I failed to get the latter outmyself, but perhaps it depends on one's anatomy. In my experience the doughnut is a bit more supportive, I think. Good luck!

Hi Saddleup

Been away from cyberspace for a few days and just caught up. Really sorry to hear about this latest development. I do hope you can get some mileage out of a *well-fitted* pessary, which seems to be a rabbit you still have up your sleeve.

I too wonder if your POPs have not yet settled, like mine have. This pinching you are feeling could be a sign of that. I feel much more comfortable post-settling, and don't have the instability that I had previously. Under Lyricmama's topic "What do you make of this?", I have just posted a second link to a related article, which touches on how much discomfort women experience at different POP stages.

This group of scientists discovered that lower doesn't necessarily feel worse, though it is scarey just thinking about how low it can go, especially when I hark back to what my doctor said about "getting the surgery sooner rather than later, cos you will need surgery regardless, and it will be more complicated surgery if you leave it too long."

Well, my current situation, about two years after the final settling out, and with menopause seemingly come and gone, is that my POPs are not worse, or not in my perception anyway. They can come lower but I can keep them higher with posture etc, and I seem to be able to hitch them up better if they do descend. Maybe I have just honed my hitching skills! Who cares, if I feel better?

I am currently working on another technique related to 'jiggling', for an instant hoist after overdoing physical labour. It worked last night. Let's see what happens tonight, and I will report back.

What I am really saying is, "Don't opt for surgery until you have tried all the solutions you can, and the final settling is stable. I really cannot see how a surgical fix can be more complicated than what I was 'offered', except perhaps sewing up my vagina for good. Why couldn't I just get a surgically implanted zip? No, perhaps that wouldn't be such a good idea...

Fear, and its management, plays an important part in this process. How much do you trust your body? And are you willing to forego riding, if necessary, for the sake of keeping your original pelvic structures intact?

I would also be casting around in your older women's horselovers' network to find out if other women who have had pelvic repair surgery for POP are still able to ride. If you cannot find any, then I guess that means that they no longer ride (though there are often other reasons why older people in general give up horseriding). What would giving up riding post-surgery mean to you, especially if riding does not look like a long term option without surgery?

Give your horse a hug and a carrot for me. I know that won't be hard.

Louise

:-)

Hi Saddleup,

I'm so sorry about this, I can understand how it might feel to have a major setback, I had one myself a few months ago and for a while honestly thought that my life was ruined and that I'd never have sex or roll out pastry again.

I need to keep this fairly brief, so some suggestions based on my experience of what's worked for me.

Set yourself a deadline for getting out of despair and back into action to fix yourself

Take Kiki's advice about 1 to 1 with Christine, if that's not possible geographically try a couple of Alexander technique lessons to give yourself the experience of being in good posture and see if you notice a difference before and afterwards. I'm also a fan of cranial osteopathy, but not all cranial osteopaths know much about prolapse. If you can get the POPs feeling different as a result of any physical therapy that can motivate you and give you hope

Try out different pessary approaches, incl tampons and sea sponges, leaving them in a long time so that everything gets pushed back into position

Assume that you've got perfectly ok connective tissue but that it's been a bit challenged by jiggling around on a horse. You can make it even stronger by giving yourself a few months on appropriate supplements and then next time you ride use a pessary/sponge etc.

Surgery or not is a totally personal choice, I can't imagine ever going for it myself. I was wondering idly the other day about some kind of Heath Robinson device (does that phrase mean anything outside the UK?) where you insert the pessary/sponge whatever and then use something like masking tape (ouch, sort of joking) or a harness/thong contraption to hold it in if it threatens to escape.

Ridiculous lengths to go to I know, but at least it's all easily undone! Also, don't rule out the possibility that you'll spontaneously self-correct, the body is wonderfully adaptable and resilient.

I really really hope that you can stick your broken self back together and can enjoy riding again. Judith

The idea of a January visit to Christine sounds fabulous. A great way to start the year setting you up for a positive year!
Then, you can see where improvements can be made, and hopefully see some real progress. And you'll know you've put your all into it...

I didn't find the sponges too hard to get out, but depends how comfortable you are fiddling around for them...

must get mine out again! just not sure how to clean them super well as i get recurrent thrush. anyone know best way?

I think this was the place I saw some discussion on whether one may ride horses again if one has a hysterectomy. I am new to the group and found this website while I was awaiting a surgery date for hysterectomy and cystocele repair. I cancelled the surgery, and I think my gyn thinks I will be back shortly to make another surgery date, as when I told her why I was putting it off, she was skeptical it would work acceptably. I am hoping to not have the surgery if I can help it, or live with the prolapses.

However, if you decide on a hyst, I just wanted to let you know that my sister is a horse woman and has been her whole life, She rode before the hyst and she rides again. She told me though, that the dr told her she would need 6 months to heal before riding and she said it took her a full year. She had weeks of incontinence after the hyst, which she did not enjoy, but she said that eventually repaired as well. She has never had children and the hyst was done because she had a tumor in her uterus and they felt it was inoperable in terms of saving her uterus.

txswimmer

My old boss had a surgical repair for stress incontinence and she had WONDERFUL results. SHe swears by it. I am thinking of the surgical repair for my bladder. With the pessary in i leak urine when I run or do jumping at the gym WAY more than ever before. I do not want to not wear the pessary though so I have been wearing a pad and underwear at the gym under my work out pants ONE in case my pessary falls out which it totally feels like it is going to do and TWO to catch the pee!! Between my varicose support stockings, the pessary and the pad.....SEXY huh?????!!!

peace....sadie

Sadie, I have been wearing black under the knee support stockings (in effect, long socks) for my varicose veins for about 18 months, and I actually think they are quite sexy in a kinky sort of way - there are Toulouse Lautrec paintings of prostitutes wearing similar (though I think they may actually be long black stockings rolled down).

About 10 days ago I had sclerotherapy injections in both legs to suppress some of my faulty veins, but it's far too soon to know how far that has been successful. In any case I have already made up my mind to wear the stockings for life (I'm 67) to keep my legs in the best condition possible. I walk in the hills and run, and I notice that compression garments including tights are now marketed to sports people as improving performance. My heroine Paula Radcliffe wears flesh coloured support stockings when she runs marathons, so why should I be ashamed (though I do think black look better!)?

Incidentally, off the peg compression tights, flight socks etc are surely a racket, as in order to work compression stockings have to be graduated in tightness from tight on the foot and ankle to looser below the knee, to encourage the blood to return to the heart. To achieve this fit, I, and I imagine most people, have to have them made to measure, which involves a trained person in a pharmacy's taking innumerable measurements from toes to knee on each separate leg.

Hey Alix

You are right. They are stockings! I just had a flashback image of my grandmother putting on her thick stockings. I remember she used to roll them down to just above the knee. I think she put garters on them and just rolled them down to the level of the garters. This meant that she didn't need to wear a girdle. She was a tiny slim woman, so wearing a girdle to keep her body under control would have been ridiculous!

Louise