possible prolapse, please help

Submitted by running girl on January 2, 2013 - 4:42am
Body: 

Hello everyone. I'm new to this and am really after some help as I feel pretty much broken at the moment. Really sorry about the lenght of this post.

I'm 3.5 months pp, after the birth of my lovely baby girl and have a suspected urethral prolapse (i'm 34). Around a month or so after the birth, I noticed I needed to go to the bathroom frequently, went to the doctor and was prescribed 2 courses of antibiotics for a UTI but this didn't work and a urine culture came back clear. I then saw another doctor who gave me a physical examination (lying down, bearing down) and said everything looked fine but diagnosed overactive bladder and prescribed bladder training and kegels. I was already doing this and was already seeing a physio who also examined me with the same diagnosis/treatment.

After this things seemed to get worse, not better with an added feeling of an air bubble-type thing down below! I went back to the doctor and she was very understanding but still believed this thing would get better in time although she referred me to see a gynaecologist. At the same time I'd also been swimming and noticed a dragging feeling which caused me to stop. When I explained this to my physio, she decided to examine me standing and explained that she felt some soft tissue and wondered if there might be a very mild urethral prolapse. She recommended a tampon for swimming but I've noticed a tampon makes things worse.

I then saw the gynaecologist who once again examined me on back whilst coughing and also felt around and diagnosed no prolapse but said that it was overactive bladder. She could see I was in a state so prescribed vesicare to ease the urgency. I questioned her about a possible urethracele and she said no, although the urethra was 'prominent' but this was what she would expect in someone 3 months pp and much better than most.

This has all left me so confused and upset. I haven't taken the vesicare because my frequency is under control (every 2-4 hours) as I simply don't go when I first feel the urge since I know I don't really need. I have just stopped breast feeding (this was always my plan to stop around 3 months) and have started taking the birth control pill (once again always the plan).

Having read some of the posts on here, all my symptoms seem to tie in with mild prolapse but why wouldn't the gynaecologist have spotted it? I've had a good look down there myself in standing and lying and to be fair, there is nothing obviously wrong but it just doesn't feel right and constantly needing the bathroom is a real drain on my energy. I'm so worried I won't be able to be active/running/swimming etc again (I used to be a competitive runner and triathlete) or even run around after the little one when she starts walking. I find myself in tears every day and really don't know what to do for the best. I hope some of you can help/advise me. thank you in advance.

Forum:

louiseds

January 2, 2013 - 7:13am

Hi Running girl

Yes, your body post-baby can give you some surprises, and not all of them predictable.

Why didn't the gynaecologist spot it? Because pelvic organ prolapse (POP) is a slippery little creature. Sometimes it is there. Sometimes it is not. You know that there is something not right down there, and that is all that matters. The whole diagnosis thing must have been a very frustrating business! This is why we don't put a lot of emphasis on diagnosis, although it is important to rule out more serious conditions.

Your postpartum story is be very normal, with POP appearing several weeks postpartum and accompanied by frequency of urination. Your body will recover a lot more, particularly from 6 to 12 months postpartum with reversion of your skin, organs and connective tissue basically complete by 2 years postpartum.

The most important things for you to do are to adopt what we call Whole Woman posture, a tall, primitive, regal, feminine posture with a relaxed belly; and learn to breathe with your diaphragm, so that every inhalation will push your uterus forward and down over the top of your bladder. By lifting your chest and keeping your shoulders down you will pull your abdominal muscles up and make your belly quite a bit firmer. Your lumbar spine curve will be reinforced and your coccyx will lift. This moves the bladder and uterus forward onto your pubic bones, rather than hanging back over your pelvic floor. In your case this means that your urethra will stretch out more and be less prominent. Your pelvic floor moves from horizontal to diagonal at the back, so it stabilises, rather than holds up the pelvic organs.

These changes might all sound unacceptable to you as an athlete, who possibly pulls her tummy in and tucks her butt under. I ask you not to pre-judge this change. Just try it and see if it makes a difference before you diss it. You can find out more under the FAQ's tab and the Resources tab, where there are videos.

Whole Woman is about learning new ways of using your body, to support your pelvic organs rather than allowing them to slide back, and down the plughole. You will find in time that you will probably be able to return to athletic pursuits, but for now, I suggest that you simply learn this new posture and figure out ways in which you can apply it in your life. It really is a lifestyle change for the rest of your life, that can have many health advantages.

Louise

Spamelah

January 2, 2013 - 7:38am

Don't think it is the end just yet. Your body can heal and repair post partum. It is encouraging that your gyn did not see universal prolapse in the standing/bearing down exam (at least I think so!). The symptoms might be frightening and annoying and (for now) life changing, but delve into Whole Woman posture, exercise and diet and enjoy that little baby!

I struggle with no longer sucking in my tummy to stand tall, but the improvement in symptoms is amazing when I am successful. My situation is much different than yours (I do have vaginal wall sagging with posterior/anterior prolapse). My uterus went from Stage 2 prolapse on initial standing exam (with 4 weeks of very prominent symptoms) to Stage 1 and minor symptoms in 4 weeks of following advice on this site. Contrary to your experience, I CAN see something strange when I do a self exam with a mirror.

My biggest recommendation to you is this: If and when your body feels back to 'normal', please do not forget about Whole Woman. I spent years running and jumping and heavy lifting and ignoring signs and symptoms that ended in universal prolapse developing (seemingly overnight to me) about 3 months ago at age 47. Symptoms were there for a few years (some incontinence when coughing or jumping, minor abdominal fullness) but never was I warned of prolapse even when I went to the doctor specifically to address these symptoms. I was praised for my efforts to stay in shape and sent on my merry way.

Good luck to you! Congratulations on becoming Mommy.

running girl

January 2, 2013 - 8:28am

Hi Louise and Spamelah. Just wanted to write quickly to say thank you for replying to my post so quickly. I made myself go for a walk this morning after posting (I'm in the UK) and tried to think about the posture. Feels a bit weird and I kept forgetting, then remembering to think about it and not slump over the pram! It's gonna take some practice but I will keep going and look at the videos. You have been really encouraging already - it was so nice to come back in and read your posts so thank you and fingers crossed this thing will improve.

Surviving60

January 2, 2013 - 5:13pm

Hi running girl - I think that post partum is such a wonderful time to adopt this posture. Your organs are still in the process of moving around and you can help move them in the right direction. I so wish I had had this knowledge at your stage of life. After my babies I went right back to sucking in my abs and tucking my tailbone under. Another couple of decades of that, and it was prolapse on the menopause menu for me! These days I manage beautifully and never felt better. This isn't a quick fix. This posture is for always, and it is as much about hip and spine health as it is about prolapse. That's for the long run. For the short run, you learn that your stuff isn't going anywhere and that you can stabilize things to the point of being quite comfortable and happy and fearless as you go about your day. It has been life-changing (life-saving really) for me. Good luck to you! - surviving

running girl

January 3, 2013 - 10:22am

Thank you Surviving. I really must try to keep a positive attitude to this but at the moment symptoms are worse so I'm going to try and get some anti-depressants today. Basically I feel like I'm managing the whole urgency/frequency thing really well and this is pretty much back to normal for me but the problem is now that I dread going to the bathroom as I feel like I need more immediately after voiding and the 'bubble' feeling is also worse immediately after. I've had another look and still can't see anything at the vaginal entrance but there is a lump/bulge near to the entrance to the urethra. I'm really confused again. The other thing that's slightly bothering me is I recall the sonographer saying I had an inverted uterus when I had an antenatal scan and wonder if that is causing the problems (although this didn't bother me pre or during pregnancy and can't see any prolapse of this nature). arghh this thing sucks!

louiseds

January 4, 2013 - 9:40pm

Hi Running girl, Use the search box to look for posts about retroverted or retroflexed uterus. I posted a Topic on these Forums just the other day, in response to a post on the Womens Quest website, where I couldn't post a long answer.

They are different. I think inverted uterus is probably the same as retroflexed uterus. They do seem to be related to prolapse, ie retroversion is when the uterus stands upright or bends back towards the sacrum, rather than bending forwards at the cervix and resting on top of the bladder; and retroflexed uterus where it bends in half backwards and can end up inverted, and trapped between the vagina and the rectum. Some doctors say that retroverted uterus is not a problem for women, but the real story appears to be a bit different. Google retroverted or retroflexed uterus, then look at Google Images. There are heaps of good illustrations. They are all in non-WW posture, so you can see how a young woman chronically in the normal medical posture will have an almost vertical uterus and can tip her uterus back just by tucking her butt under and pulling her stomach in flat. A few years of that, and it kind of sticks there.

Mine flipped from retroverted to anteverted (normal) a few years before menopause. This resulted in much less painful periods and back ache, and much less flooding. such a relief. Prior to my pelvis loosening up after my first pregnancy I used to get a lot of pain with penetrative sex. I was a tummy and butt tucker all through my teenaged years. I am sure my uterus was upside down and getting a real pummelling with sex. After my first baby it was probably more mobile and able to get out of the way!

Also, until you can get the Whole Woman book and DVDs, and can find out all about firebreathing, Search the Forums for jiggling. Jiggling after emptying your bladder might help your empty bladder and urethra (which might be the lump) to reposition themselves further inside, so they are in more comfortable positions.