Cystocele

Submitted by Magical Wombat on March 11, 2011 - 9:06am
Body: 

HELP!!!! I'm afraid I have fallen into a big hole & am having trouble convincing myself to climb out. I'm indulging in self pity and am feeling pretty sorry for myself :(

I am 60 years old and was diagnosed with a bladder prolapse in 2010 & referred to a gynaecologist in June 2010 but put off seeing him because I in my heart I am not convinced that my bladder has prolapsed. I have always felt that my bladder is in its correct place and believe that there could be some other reason for the bulge, pressure and dull ache I feel in my abdomen. I have been advised to have bladder surgery but I am not taking that path. My recent pap smear was clear. My symptoms are bulging into my vagina, abdominal pressure (dragging feeling), dull pain, occasional urination frequency (depending on how long I have been on my feet) but no incontinence. I have strong bladder control, can start and stop stream and have been told by my physio I have reasonably strong pelvic floor (what a joke) muscles.

I have been doing the Whole Woman workout now for two months and initially I felt very enthusiastic and positive. Lately however, I feel as though I have reached a plateau and don't seem to be improving which is making me feel very despondent about further improvement and keeping myself motivated. I am ashamed to admit I have doubted the effectiveness of the fire breathing exercises as each time I do them I can feel my organs (I presume) move forward but when I stand up the bulge comes back and I feel I am back to square one. I know I have a small fibroid (13x16mm) in my uterus and wonder if this could be some of the cause of my problems. I have decided to see my gynae to ask this question. My mother was advised and had a hysterectomy in her 70's because she was told she had a prolapsed uterus. After the removal of her uterus she still had the symptoms ie; dragging, pain and pressure. Eventually she was diagnosed with an orange size cyst on the outside of her stomach which was removed. She is now 86 and has never been overweight in her life. She was also told by the surgeon who removed the cyst that it was most likely the cause of all her problems because it had been putting pressure on her uterus and bladder. I know I am grasping at straws but mothers and daughters.......I'm just wondering.

After reading the posts of prolapse horror stories and also how women can improve from some of the most dire prolapse predicaments, I should feel lucky, uplifted and spurned on to keep doing the exercises and have faith as my prolapse is only mild by some of the standards I have read about. However, most of the posts seem relate to younger women and I wonder what the improvement rate for someone of my age is. I have always kept myself fit and active and am not overweight.

Alas my self indulgence is pitiful I know.

Christine

March 11, 2011 - 10:03am

Hello Magical Wombat,

I think you have to listen to your instincts and further investigate your abdominal symptoms. The psychological burden of your mother’s condition may be a contributing factor as well.

If we are talking about “garden variety” prolapse, then yes, at sixty you are not going to experience the same level of result as our 20-30 year-olds. Also keep in mind that there are older women here who are still seeing results five and six years down the line.

It sounds like you may be over-tiring yourself with the exercises in the dvd. How about if you simply spent more time sitting with a full lumbar curve and doing more exercises on hands and knees? Firebreathing works well on hands and knees as well as sitting upright. Practicing the posture sitting will make it easier to maintain while standing.

Long hamstrings and strong buttocks muscles allow the organs to move toward their natural positions in the standing body. If firebreathing was all it took to pull the organs forward and keep them there, there would no longer be any prolapse! The key is slowly changing the body shape to hold the organs against the lower abdominal wall while standing.

An important concept to understand is that the body walls (abdominal and pelvic) do this by stretching to their functional dimensions. When the tailbone is raised and the lower belly relaxed, the pelvic wall closes like a pair of elevator doors. It is this function that is weak in prolapsed women, not contracted sphincters. We have had many prolapsed women joke that their pelvic sphincter muscles are strong enough to shoot ping-pong balls - lol.

Someone out there (I won’t bother mentioning names) has started to teach something called “kegel breathing” - basically our firebreathing concept, but contracting the pelvic wall with every outbreath throughout the day! She states that the body just learns to do this naturally, which is ridiculous. Contracting with every outbreath ruins natural anatomy by shrinking the dimensions of the pelvic wall and elevator door function of containing intraabominal pressure so forces become directed toward the back instead of at the lower abdominal wall. If you are constantly contracting your sphincters, the organs are going to be slowly drawn backwards.

The point being, by constantly breathing your organs into your lower belly, while maintaining a taut pelvic wall, eventually you will see results - two months is very early. I developed this work in my late forties and was well into my fifties before I saw dramatic improvement.

And then again, there are no guarantees. Some women cannot do this for themselves and finally opt for surgery.

Please keep us posted on your progress and by all means indulge in self-pity, as it is an early stage of prolapse stabilization.

Wishing you well,

Christine

louiseds

March 19, 2011 - 1:55am

Ah Wombat my dear, I know that wombats are very tough, persistent animals, and are capable of digging very big holes, apart from the less endearing descriptions they are given.

It certainly does sound as if you do have a prolapsed bladder, even though you have good bladder continence. This can be explained by visualising the bladder in its non-prolapsed state, with the urethra coming out of the bottom of the bladder. When the bladder prolapses it actually rolls backwards and the urethra now comes out of the front surface of the bladder, halfway up. It is stretched by being pulled upwards, and kinked flat against the bladder wall, so the kink forms another impediment to the flow of urine. This is probably why you, like I, have no continence problems.

Having a prolapsed bladder does not mean that you will need an hysterectomy like your Mum. Your uterus is an important part of your pelvic architecture and is best left in place to stabilise your whole pelvis, even if you have inherited weak fascia from your Mum. See Christine's book for details on this. I doubt that the cyst on your Mum's stomach could have any effect on her uterus because her stomach is higher than her belly button, and her uterus would have been way down in her pelvic cavity, and very small by her seventies. However, if her posture was slouched with little lumbar curve in her spine all her abdominal organs *would* have been pressing her uterus down into her vagina.

It is raising your chest that will tilt your pelvis forward slightly, and move your bladder and uterus forwards. This will get them out of the way of the intra-abdomiinal forces that would otherwise press down on the pelvic cavity and push your pelvic organs down the plughole. The posture is the most important factor in managing POP. The workout helps to strengthen your whole body and increase your awareness of your body in space, and make good posture happen more easily. But if it is too strenuous for you, then slow it right down, or skip it for the more gentle suggestions from Christine. I don't do the workout. I am too busy with other active things and tasks, and just remain conscious of my posture at all times, which is now easy. Remaining active seems to be the key.

I am one of the women whose prolapses get better and better after six years of being on this site. I have just turned 58, so I am not far behind you.

Last weekend I spent about 35 hours sitting mostly cross-legged on a cushion at a music festival while everyone around me was slouched in low beach chairs. I did have a little lower back pain during the weekend, but I didn't have any night time pain, and felt good in the mornings. I also did a lot of walking between venues. I certainly felt well-stretched and flexible after it. I felt a lot worse after the 3 1/2 hour flight home. I had no POP problems at all during the weekend, despite my changed routine and warm weather contributing to constipation, which has now resolved.

As an older woman you certainly can expect a lot of improvement in your POPs, but you will have to put in the hard work needed to coax an older body back into action again. I have now resolved to sit on the floor more in everyday life if it means greater flexibility and helping my body to retain its abilities to manage itself.

So, uncurl yourself my dear Wombat, and start clawing away at the walls of your hole, and make them into gentle slopes that you can waddle up, and smile at the world again.

We all age. We all die. We might as well do it as well as we can. Dance on.

Louise

gardengirl

March 19, 2011 - 4:58am

perhaps self indulgence can in this instance be reframed as purging which can be good for the soul. Sometimes a girl just needs to be able to talk about her woes and sorrows.Then you feel a bit better and able to tackle the trials and tribulations that come your way.
Sometimes, males just don't get that- they like to go into fix it mode. So I love the fact that we have our WW site with lots of ladies to lend us an ear.
I am nearly 58 and like magical wombat - am not overweight, reasonably fit and active and eat all the right foods. So why did I get get a cystocele?
I was not happy about it.
Overcoming the problem has been slow and frustrating. There seemed to be so much to overcome and I was so tired of the miserable bulge. I felt overwhelmed with all that I wanted to learn and understand. I was confused about the whole kegel debate.
Then one day, I realised that I was learning to live with it. Bit by bit my posture is improving. I still have to remind myself daily that I am slouching.
I realised that I had so much to gain from my POP.
Now I am really looking at a much bigger picture. Posture is so important in so many ways. It just doesn't stop at our POPs. At present, I am helping friends with plantar fasciitis. I have helped a friend who works at a computer all day and had chronic wrist pain. I am noticing how people walk, sit and stand.
If I had never developed a POP, I would never have been able to to understand and help others. I might like to think "I wish I did not have a POP" but I know that there has been so much I have gained from it.

Magical Wombat

March 26, 2011 - 5:24am

Christine, Louise & Gardengirl,

I cannot thank you enough for your support, you are all so knowledgeable and generous with your time and encouragement and please know it so much appreciated, I don't know where you find the time to write such informative and caring replies. You have certainly lifted my spirits and I feel much more determined than ever to take your advice and also ownership of my cystocele & yes like a wombat, who is a magical creature, I WILL dig myself out of my burrow & embrace life and the sunshine again.

Yesterday (25th March) I visited a specialist (male) who confirmed that I also have a prolapsed uterus as well and the sooner I have a hysterectomy & my bladder repaired the sooner I will get on with my life and be back to my "old self". His next comment and this is where I stopped listening, "......after all doing hysterectomies is my bread and butter and I do know what I am doing..." Needless to say I was quite affronted by this comment and declined to take up this option to which he further added, in a very condescending manner, "....you are obviously not sick of it yet but I will wait until you are and I will be here when you come back, because you will come back through my door begging me to do your hysterectomy...." I almost walked out on him and perhaps I should have because I certainly did not get any satisfaction from him and he was not worth the $150 I had to pay for a less than 15 minute visit. Christine it certainly vindicates, in my opinion, everything that has been said about the medical profession and the money to be made out of unfortunate women having unnecessary hysterectomies.

I have got my chin up, or is that my whiskers, I am sitting in the whole woman posture writing this and I will certainly be making time now for my firebreathing exercises and keeping myself in posture. Incidentally I am walking more now which is also helping me to be more positive.

I will report on my progress in the future.

Kind regards and thank you.

louiseds

March 26, 2011 - 5:31am

It sounds like your perspective is getting better, MagicalWombat. Continue coming back for guidance, and to report your successes (and the occasional whinge is OK too!).

The thing is that none of us really knows for sure that we have beaten the scalpel, but every day that goes by I become more convinced that we have.