WW position

Hi maggy - if you go to the "FAQs" link at the top of this page, the last question is a description of the posture. Good luck!

Hi and welcome, Maggy,

It is good to hear from you, but posts such as yours are the most difficult to respond to. You are the woman I wrote my book for, in hopes it would arrive in time.

First of all, it is crucial to understand what was done through these surgeries. Your uterus was removed and the shortened pocket remaining made even shallower by the anterior and posterior colporrhaphy. The erroneous concept being that you have a vaginal opening at the bottom of a “floor.” If that opening can be made narrow enough, other organs cannot so easily fall through.

The reality is, you have a wall of muscle behind you that contains outlets for the bladder, vagina, and rectum. Your true pelvic floor is the pubic bones that come together underneath the torso like straps of a saddle. In normal anatomy, your organs are carried at the front - behind your lower abdominal wall. This anatomical truth has been ignored and denied by the now global industry of female pelvic reconstructive surgery. Natural pelvic organ prolapse is a dynamic state that can stabilize and reverse under favorable musculoskeletal conditions.

Because your vagina is now at risk of literally turning inside out, it has been sutured to your Sacrospinous ligament. That ligament is located deeply under your buttocks. Here you can see the sacrospinous and sacrotuberous ligaments as they cross each other from spine to pelvis. In between those two ligaments runs the pudendal nerve that innervates much of the pelvis and perineum. A sacrospinous ligament fixation places women at great risk of severe nerve pain from the disruption of these important anatomic structures. Because the vagina is not long enough to reach both ligaments, the muscular vagina is usually tethered to only one side of the lower pelvis. There are no studies of the musculoskeletal and ambulatory implications of this surgery.

What has been studied is the failure of the operation. Not in terms of pain or dysfunction, but whether the surgery “fixes” prolapse. This is commonly the only factor considered when labeling them a success or failure. Because the sacrospinous ligament fixation pulls the bladder down and back, it is widely reported in surgical literature to be “unanatomic” and has been discontinued by many surgeons in favor of sacrocolpopexy - tying the vagina to the anterior sacral ligament of the spine by way of a mesh bridge. You should have been informed that sacrospinous ligament fixation often leads to intractable cystocele.

When I speak to a woman who is post-hysterectomy, I am always relieved to hear that she has had a “simple” hysterectomy - with no further vaginal or suspension surgery. This means the possibility exists that her vagina is long enough to close down against intraabdominal pressure. In normal anatomy, the vagina is a closed, airless space. If the vagina is long enough, it can bend in such a way that the intestines exert pressure in a more natural way. A moderate cystocele-rectocele acts as “Nature’s Pessary” to help keep the vaginal vault from everting. We can suggest to these women that the WW work of moving the pelvic organs forward is very important for them as well.

Hopefully you can understand from this short introduction to the problem that such a level of pelvic reconstruction makes it impossible to know what the effects of Whole Woman posture and exercise might be in a case like yours. We are moving the organs naturally forward, while yours are being permanently pulled toward the back. These surgeries should never be performed - which is what the Whole Woman work is all about.

I do believe there is hope, but you need to decide how you are going to respond to your situation. I cannot give you a next step, nor tell you not to take the advice of your doctor. I can tell you that the entire practice of urogynecology is based upon anatomical error.

You still have the rest of your body to work with, which would undoubtedly benefit from WW posture. Our breathing apparatus tries to place the bones, muscles and organs in particular positions with every breath we take. From my perspective, even if a woman is in a wheelchair, her posture is still very important, for how we sit and stand supports our central nervous system.

All that said, I cannot know how you will do over time. I do hope you will keep us informed of your condition and let us know how we can further help you.

You can find a description of the posture here on YouTube:

http://www.youtube.com/watch?v=RvGROzIYN6w

Wishing you well,

Christine

Hi Maggy,

The vagina is normally about 9 cm long at the back wall and 7 cm long at the front. When the cervix is removed it must be made shorter through suturing and scarring. You can find many explanations of the SSL fixation on the web. There is no way for me to know what would result from the stitches being removed. They do tear out quite often because of the soft nature of the vaginal smooth muscle tissue. I would refer you to the HERS Foundation (hersfoundation.org) for more post-hysterectomy information.

Best wishes,

Christine

Maggy, you would do best to consider a consultation with Christine. Perhaps you can request one as part of the program that you purchased. It does include a 30-minute practitioner consult, and perhaps when you schedule this, you can see if she is available.

If you read over what Christine wrote above, 3 years ago, you will realize that your combination of surgeries is pulling your remaining organs in the opposite direction from the WW work. Use extreme caution and please book a consultation. - Surviving

This thread is a fascinating "must read" for all of us! My heart goes out to you Maggy, and hope you can find a resolution with Christine. If anyone can advise you, she certainly would have the answers.