Differing diagnosis, Cystocele?

Submitted by VSarajevo on February 11, 2018 - 4:11pm
Body: 

I'm hoping to get some wisdom from you ladies to understand if I do have a cystocele, as I have three differing diagnosis from three different doctors in the past two months. I live in Sarajevo, and am having a hard time finding a good Gyn. I had felt that my tampon was not inserted correctly and when I checked it, I felt a bulge at the opening of my vagina which was not there previously.
The first Dr I saw said that it is not prolapse, but a descended bladder which can be fixed easily by laparoscopy surgery. I had also complained about a reoccurring UTI, so after prescribing Bactrim (elevated CRP and WBC) and vaginal supp. with a brochure about the surgery, sent me on my way.

The second gyn I went to was in Hungary, someone who specializes in prolapse. He diagnosed me with a 2nd degree lateral traction defect Cystocele. I think what he explained to me was that it is the vaginal walls that are collapsing, not neccesarily my bladder that has prolapsed yet, although if it worsens that will happen. He mentioned that the laparoscopy surgery wouldn't be helpful for my condition, and if I did opt for it to have vaginal repair surgery but suggested I avoid surgery by learning some special excercises and using a pessary (which will also help my bladder to empty completely to avoid another UTI). He fitted me with a cube pessary, size 1 (cube was the only type he offered me), told me to remove it every night and reinsert every morning. I was told by using the pessary and learning pelvic floor exercises, I can avoid any worsening of the condition. When I asked him what the exercises are like, he said kegals are not effective but mentioned some type of egg? (First time I heard about that!) as well as others that I need a therapist to teach to me, or else I might make my condition worse. I wore the pessary for a few days but because of continued UTI discomfort, I stopped using it until I got rid of the UTI. Which brought me to...
Dr #3 back in Sarajevo. This one came highly recommended but after what he told me now I'm not so sure. He gave me a comprehensive exam with 3D ultrasound, and said he saw no prolapse, just a minor descent of my bladder. On the ultrasound of my bladder, we could see little particles floating in my urine and by that concluded that the UTI is still not healed despite two rounds of Cephalaxin and Bactrim (the first I prescribed myself, the second by another Dr after lab results). The bulge in the front top of vaginal opening is "normal for my age with no pathology". (I'll be 40 this year, have had three vaginal births and have done a fair share of heavy lifting, not knowing the dangers of prolapse.) This Dr said I should not wear the pessary, that it will cause infection and they are only for old women anyways. He told me to do 200 kegals a day (red flag), said I have no prolapse, but confirmed my bladder is descended and that is why the UTI is recurring. I am now on my third round of antibiotics in three months (this time Funusol/ Norfloxacin with Clortrimozol supp). I'm not sure who to believe and what is the best protocol. Do any of these Drs sound like they know what they are doing? Even though I don't have to do everything they say, I would like to be able to have regular check-ups with someone who I can somewhat trust.
So does it sound like I have a cystocele or not? I definately have the feeling of heaviness that many have described. I find it very uncomfortable to wear jeans anymore, sitting is very uncomfortable as well. How can I best keep the condition from worsening? From what I have read here, it sounds like the posture and exercises are key. I am considering purchasing the fundamentals program. Does that contain all the important pieces? How can I best avoid another UTI, if I'm not going to wear the cube pessary? Is it basically drinking plenty of fluids and emptying my bladder completly? How do I know if I have emptied it all the way? There is no sensation of urine left inside my bladder, it feels empty after I urinate.

I appreciate any wisdom you can send my way! Living in a foreign country can make things pretty complicated at times.
V in Sarajevo

Forum:

Aging gracefully

February 12, 2018 - 6:01am

Hi VSarajevo and welcome,
It sounds like you have been through the ringer with these doctors, and they may not be able to tell you anything differently from here on out, but that is really up to you if you want to continue that route. I personally didn't go to the doctor when I found my prolapse; I think your instincts are telling you something is happening in your vagina, and you are right to question that.
Here is the prolapse self exam to better clarify things a little better:

https://wholewoman.com/library/content/articles/prolapseselfexam.pdf

With whole woman you will find the most natural way to help you pull those pelvic organs out of the vaginal space and into the lower belly where they belong, and that starts with learning the whole woman posture. Have a good look around on this site and learn about Christine's teachings and methods that will help you better understand what is actually happening to your body and proactive measures to start reversing those nagging symptoms.

Surviving60

February 13, 2018 - 5:32am

I agree with AG, you need to get off the merry-go-round with these doctors. You are getting useless and even harmful advice from them. One big red flag for me was the suggestion that your vaginal walls are collapsing. A vault prolapse is virtually non-existent among women who have their uterus. If you avoid surgery and all this kegeling and egg stuff, and start to learn how to manage your pelvic organ support system naturally and make sure you are emptying the bladder completely, you can end this ridiculous cycle.

We cannot tell you not to see a doctor if you have a concern. But if it's important to you to be able to have regular medical checkups, then I guess you need to keep looking for someone you like, and arm yourself with enough information to enable you to take or leave what they tell you. I am another one who has never sought out a formal diagnosis of my prolapse. I have never felt the need and frankly don't want to hear their take on the matter.

I think your instincts are good and I think you'll find what you're looking for here! - Surviving

Typicalme

February 13, 2018 - 4:10pm

Hi vsarajevo - I think the diagnosis isn't as important. I know in the beginning it WAS pretty important to me but from what I've learned, the organs are constantly moving so depending on the day, time of day, whether you were lying down or standing up - it's always going to look different to whoever's examining you.
If they're saying your bladder is decending, then that's a cystocele. I think the one dr who told you your vaginal wall was collapsing *may* have meant that your vaginal wall is bulging... and that's a prolapse.
the recurring uti's is also another indication - as well as that bulge you felt yourself.
So i'd take the safe road if i were you and continue on as if you have a cystocele.
the solutions that you will find here won't hurt you, even if it's not a cystocele whereas surgery might.... i personally will try everything before surgery.
The good news is that you can live with this and you can reduce any symptoms you're having.
You'll definitely want to stop wearing jeans - unless they're pretty loose. I actually went out and bought new maternity jeans even though i'm not pregnant.... and lots of leggings. I don't want any waistband cutting into me when i sit, and I sit a lot between work and getting to work.
that's not to say you can't wear whatever you want - you'll just have to learn what feels good, better or worse. I actually wore a skirt with a firm waistband for a function I went to- but I knew I'd be standing more than sitting.... that same night I wore panty hose and heels and I've come out none the worse for wear.... but I wouldn't do that every day.

As far as the materials, I started with first aid for prolapse and the book. That covered enough to get me started in the beginning of this journey.

VSarajevo

February 14, 2018 - 11:04am

After completing the self exam today (thanks for the helpful link Aging gracefully) I am confident that I do have a cystocele. While bearing down, the bulge gets bigger, and I can run my finger around the bottom and sides of it. I have a couple more questions. Since I am having a problem with recurring UTI's which video has an explanation of how to completely empty the bladder? Or is it as simple as getting down on all fours in the shower as I have read on the forum? Leaning and lifting forward while on the toilet doesn't seem to help but I have tried the shower position twice and got a little more out. After the first time in the shower, my UTI symptons returned and bothered me the rest of the day. I'm curious what that might mean. Having completed now three rounds of antibiotics, I am desperate to rid of this infection finally. So is there a video with helpful tips for recurring UTIs? Also is the First Aid for prolapse included in the Fundamentals program? From what I've read it does not. I was going to go for the whole program, but if First Aid is the most helpful I guess I will start w that. Can I just say I am bummed I can't wear jeans comfortably anymore :(

Aging gracefully

February 14, 2018 - 2:13pm

Hello VSarajevo,
Yes, the First Aid is a very good start into this work, and covers so much more than the Fundamentals does.
Complete emptying is only the beginning and just one of the tools we use, but there is really so much more to it than that. Pulling those pelvic organs into the correct alignment with the posture, proper toileting, jiggling and firebreathing all help get that bladder in better positioning so that complete empty is more successful. The urethra can be kinked preventing the bladder from being able to empty completely, but over time with this work, you will start to see these UTI symptoms dissipate as the urethra straightens out.
Another important factor here is that antibiotics kill off the healthy bacteria along with the bad ones. No one is suggesting that you don't take care of a UTI this way, but hopefully over time, you won't need to. Christine also has a lecture series on bacterial health in our bodies that would be well worth visiting. She tells us how honey is a very amazing prebiotic that helps build the good bacteria into our bodies. Once you have built back up a healthy number of the good bacteria that resides in your bladder, vagina, and anus, there will be less room for the bad ones to take over. There is more in her lecture that is so eye opening and shows us where our health really begins, and how simple solutions are all we need.
Keep practicing the complete emptying, but also get going on the whole woman posture and tools; there is so much wonderful knowledge to absorb, and keep reading the forum and whole woman site. Lots of great tidbits that only compliment the work even more.

Aging gracefully

February 15, 2018 - 11:37am

Another great post from Christine:

https://www.wholewoman.com/forum/comment/57401#comment-57401

She always has the best way of explaining things!

VSarajevo

February 16, 2018 - 2:54pm

I apologize for miscommunicating- I meant to ask if the First Aid video is included in the Whole Woman Solution to Prolapse pkg. (not Fundamentals). If not, then I guess I should still start with the First Aid video. It would be nice if it was part of the complete pkg.

Aging gracefully

February 16, 2018 - 3:17pm

Hi VSarajevo,
It isn't that I am aware of, but it covers just about everything else you need to know, and if you look, it has 5 bonus videos that are all helpful in their own way, including the 3rd wheel yoga video which is one of my favorites.
Bu then the First Aid is one of my favorites too! Decisions, decisions...