~He shrugged his shoulders and said what do you expect, you’re 50, have four kids and you run~
I first became aware of my POP in July of 2014. I was running, training for a triathlon when something from inside my body went plop into my vagina. I had no idea what had just happened but I knew that something had just gone terribly wrong. I was not in pain so I walked home. A few days later I went to a gynecologist. I assumed that I would need a hysterectomy and then I would be OK. After the exam, he diagnosed me with cystocele, rectocele, and uterine prolapse. He explained just a little what those terms meant and then he shrugged his shoulders and said what do you expect, you’re 50, have four kids and you run. He advised me to put a tampon in and keep running.
I was stunned. I walked away with a very strange diagnosis and no plan to address the issue. I was confused and scared. Just three days prior I was a confident, strong, driven woman, and now I was completely lost. I hit the computer looking up the terms he had written on the paper. I started reading about prolapse and became more and more disheartened. I was very disappointed that my body had failed me. I was angry that I did not even know what this POP thing was. I did not know what to do, so I just lived with it for a while. I didn't tell anyone. I had my parts coming out of my vagina. How do you tell someone that? I didn’t even know that was a thing.
As I researched this pelvic organ prolapse diagnosis, I learned that it is very common yet I had never heard of it. I learned that the chronic constipation that I had addressed many times with my primary care doctor was a big contributor to my demise. Over the past years it had gotten worse and I often strained in the bathroom, not realizing I was pushing all of my organs downward. Looking back, it was not so much constipation as it was a feeling of the stool getting stuck. I wondered if I had reported that as a symptom, maybe things would not have progressed.
I continued to live life but I was in a dark place and felt very alone. I continued to work and put a smile on my face, but my body was broken. When I was standing near others I felt unclean and self-conscious. My days were consumed with thoughts about my vagina and the fact that I had several organs pressing on my vaginal opening and some peeking out. It was exhausting. I was no longer confident and sure, in fact I was starting to feel hopeless.
On the home front, I continued life as a mother and wife. My relationship with my husband was strained at best. For years prior to the drastic plop described above, my sexual desire had been dwindling. I assumed it was all in my head. It never occurred to me that it might be physical. Now with the dramatic change in my POP symptoms things got worse. I felt so unattractive, unsexy, and undesirable. I was always uncomfortable. The last thing I wanted was sex or even intimacy. I just wanted to be left alone. My husband did not know what to do and I did not know what to say, so I just pulled away.
When I found the APOPS website and joined the POPS Facebook forum things began to change, and I started to formulate a plan. I learned that I needed to see a urogynocologist, made an appointment, and subsequently booked surgery for February 2015. For the two months I waited for surgery I was active in the POPS forum seeking advice and answers. My first several posts were about exercise. I desperately wanted to hear that I would be able to resume a life of running, tennis and triathlons. Tennis and triathlons were not only sports that I enjoyed but they were also family adventures. Two of my children competed alongside me in several triathlons and all six of us enjoyed getting on the tennis court. It was family time, great memories, great stories, and lots of laughter. My urogyn seemed to think that after surgery I could resume these activities, but the women in the forum and my Physical Therapist were more cautious and warned against it. In my head it made sense that these activities were not POP safe, but the thought of giving them up was daunting! I was not ready to face that.
Surgery, February 28, 2015: TLH, vaginal vault suspension, posterior colporrhaphy. I was supposed to have an anterior repair as well but during the surgery the bladder went back into place. Recovery went well. I had very good family support and leaned on the women in the support group for advice and comfort. At four months post op life was terrific. I was back at work feeling strong, confident and happy. For the most part I felt normal. My sexual desire had returned, a perk from surgery that I had no idea would occur! My husband and I were sort of in a honeymoon phase! All was good. I was still mourning the loss of the athletics, but I had not totally given up hope to pursue them at some point. Then, on July 5th, I felt that bulge again. I had had a busy week at work and pushed more than I should. I should have asked for help, but I thought I could do it all myself. I am very independent and I had not yet come to terms with asking for help. My bladder had indeed prolapsed. More emotional turmoil as I beat myself up for pushing too hard and compromising my repairs. At least I knew what was happening. I had a knowledgeable doctor and I had the ladies on the Facebook forum to lean on. September 2015 I had an anterior colporrhaphy with a porcine matrix graft. Less than two weeks in to that recovery and my posterior repair failed. I was disappointed and a bit angry, but by this time I was starting to put things in perspective.
I am one of the lucky ones. I don’t have incontinence issues, no pain, and I have a super support system. As I healed from this surgery I started focusing on the cans. I can swim, I can bike, etc. My involvement in the forum became more about giving support rather than just receiving. I was adjusting my attitude about asking for help with lifting and carrying things. I had to reinvent my identity and that was hard. I did end up changing positions with my employer so I am no longer a Recreation Therapist. I am no longer a runner, or a triathlete. I thought those things defined me. I thought by pursuing those things I was a good role model for my kids, especially my daughters. I wanted them to see a strong mom. But I have come to realize that they are watching my recovery. They are watching my attitude as I adjust to this new me. They are watching how I am handling the losses. They are watching me as I offer support in the POPS support group. This September my son, daughter and I will be participating in the very triathlon I was training for when I so acutely became aware of POP. I will walk the run leg, and that is OK. I hate POP, but I am also grateful for it. I have become a more empathetic, kinder, stronger woman.
SURGICAL SUCCESS STORIES:
IdB diagnosed at 36 I had T.V.T. in 2002 as I was suffering from urinary incontinence. I had a good gynae who had done many of these operations. No other surgery was an offer at the time except for hysterectomy and extensive repairs and I did not want that. My surgery was uneventful, they kept me in a week or so, and I had no after effects. It cured the incontinence and I was able to live an active life and raise my kids. I also used a pessary. I am really glad I had this surgery as it gave me back a quality of life.
MK diagnosed at 31 I had a vaginal repair, bladder lift and hysterectomy (my choice) after my 2nd child. I had a bladder and vaginal prolapse. My first repair failed because I did not know anything about this subject and trusted the wrong doctor. With the second repair I was not happy about it for a year. But now I am very happy and feel great! I would say really give it time before you think it failed. The doctor used my own skin to do the lift. I am happy, happy, happy. Always do your homework and try and go to the best. It’s worth every penny.
LG diagnosed at 32 Had anterior & posterior repair in April 15. Everything going well, I still have uterine prolapse but the success of the other 2 has helped to pull it up & we are now trying for another baby. It is a definite C-section but I'm ok with that as a vaginal delivery was what left me like this in the first place. I think the key to a successful recovery is rest, rest & more rest. My job involved standing & unguaranteed rest periods so I decided to quit & am currently a stay at home mom, money is tight but improving & I can rest when I feel like it, probably more than I need to but I'll enjoy it for as long as I can stay home with my son.
MT diagnosed at 26 In July 2015 I had an anterior & posterior repair. I am still in the "recovery window" which I hear is about a year, so I still get the 'tampon falling out' feeling occasionally especially during ovulation. But I would say I'm about 80% better. I used to have days where I'd be super depressed before surgery and constantly sit and think about my prolapses and not want to move. (Not ideal considering I have a now 2 and 1 year old). Now I can go almost all day without thinking or noticing my vagina. I still have some bothersome symptoms like I mentioned but it’s getting better all the time and I feel like it's given me my livelihood back again.
LK diagnosed at 31 I had a rectocele and perineum repair done in January 2013, when my son was 2. The surgery went very well and recovery was fairly swift. Sex was much improved afterwards and I was able to wear a tampon again without it slipping down. Although I have since developed a cystocele and mild enterocele, the initial surgery is still beneficial and I don't regret having it at all. Although more surgery is likely in my future, my prolapses are pretty much symptomless, so I will wait before doing it again. Other than limiting weights at the gym, I live my life as normal. I'm 36.
TMS diagnosed at 37 I had an A & P surgery with a TVT-O mid-urethral sling this past July. Recovery was tricky but bearable. Not leaking is "priceless." Not getting confusing signals from my bladder and repeat infections is freeing. I will occasionally have some Pelvic Floor Muscle tension or spasms and rarely will leak a drop or two. Sex can cause some tenderness still, but not enough to keep me from climax. My PT and I are working on remaining issues, but I am like a frisky new woman!!
LL diagnosed at 48 I had rectocele and perineum repair on 11 JAN 16. The rectocele was repaired using biologic mesh. The surgery was easier than I expected, less painful than I had anticipated. I took 2 weeks off work, and slowly eased back into activity. I am pretty much doing everything as before with the exception of lifting anything over about 10 pounds. I feel great...no bulges and much tighter. Bath rooming is all back to the way it should be. Sex has been great from about 9 weeks post...the first couple times were a little scary, but it is now better than ever. No regrets at all.
RJ diagnosed at 31 I had posterior and perineum repair using own tissue on 14th January 2016. All seems well and posterior wall now well supported. Pain was manageable and I now feel a lot better. My issue is odd symptoms from my mild unrepaired cystocele. Well worth having done up to now!
PG diagnosed at 37 Had anterior &posterior repairs for cystocele and rectocele with mesh bladder sling on Feb 11, 2016. I'm 9 weeks post op and I'm doing pretty well. Sex is getting better. I have twinges here and there in my low back, upper buttock but I don't need to take Advil or Tylenol. I've just started swim aerobics and I'm walking. I'm much tighter down there and don't have that tampon feeling unless I stand too much all day and have beautiful BMs! I'm feeling better every week!
RB diagnosed at 45 10 months post OP. TAH (only have 1 ovary left) Sacrocolpopexy, Perineorrhaphy, and Burch Retropubic Urethropexy. I'm healing well. Sex is greatly improved. I no longer have any incontinence or the daily tampon feeling. I went through PT before and after surgery and believe it really helped my recovery. I still have off days where I will have odd pains or swelling if I overdo it. My life is my new normal. I limit myself to lifting no more than 20 pounds (with the exception of my grandson when he visits, 23lbs.) I do low impact exercise (lots of walking) and I am mindful of my pelvic floor when doing activities that could affect it.
DLM diagnosed at 32 I have a great SUCCESS STORY!! I had abdominal repairs in 2002 (you read that right...2002!!!) and they are still holding!! I prolapsed after the birth of my first when I was 32 and went on to have my second baby at 35. I ended up with stage 3 UP and Cystocele, enterocele, stage 1 rectocele, perineal descent, and paravaginal defects. This was all repaired along with a supracervical hysterectomy (kept my ovaries) and a sacralcolpoperineopexy, site specific rectocele repair, paravaginal repairs, and perineoplasty. I had a great deal of help from family and friends as I recovered (a must). Had repairs when my youngest was only 16 months old. I still watch how much I lift and that I don't overdo it regarding housework, etc. You need to realize that prolapse really is a lifelong thing you have to contend with, but it does not end your life. You just modify what you do. Having the repairs let me be the mom and wife I was not able to be with my uterus and bladder hanging out. It was the best thing I could have done for me. Am I like I was pre-baby?? No. Is any woman? No. But I am my new normal and living with my modifications and having my kids grow up knowing mommy could not lift them was an okay tradeoff for me. I could still run and play with them and I was HAPPY! And that was what made all of the difference.
WCD diagnosed at 52 Almost 3 years since my repairs--grade 3/4 vaginal vault, cystocele, rectocele and cervical stump. I had a Sacrocolpopexy with mesh, A&P repair and bladder sling. Spent 18 months in post op PT. Yes, I have made changes to my life, but they have not affected my quality of life at all. Life is great. No regrets here. 55 years old and feeling better than I did when I was 40.
AR diagnosed at 39 I was first diagnosed aged 39 with mild rectocele following forceps and ventouse deliveries but it did not become sever enough to warrant surgery until 6 years later. Had I known what I do now about exercise and lifestyle I might have been able to slow down the deterioration. Rectocele repair Sept 2012 aged 45. Straightforward recovery (I took things very easy and was very cautious about returning to everyday activities). All is good to this day, I still limit heavy lifting/pushing/pulling and high impact exercise, which is frustrating but there are alternatives. I do ballet and Pilate’s classes weekly and feel pretty strong down below now. But I get the occasional twinge to remind me to be careful and I know I must stick to these lifestyle changes for life.
MP diagnosed at 50 Posterior colporrhaphy, TLH, and vaginal vault suspension. Fairly easy recovery...felt amazing first 4 and a half months post op. Had been terribly constipated for a decade...post-surgery was pooping everyday...in and out of the bathroom in 5 minutes! July bladder fell...anterior colporrhaphy with porcine matrix graft in Sept. 2015...excellent repair. Unfortunately, posterior repair failed two weeks post-surgery...but not as bad. No regrets! Sex is so much better, I am exercising daily, walking, cycling, swim, elliptical, habit DVD, PT exercises. I feel great. I am 52.
MM diagnosed at 55 First surgery at age of 55 and had extensive repairs, repeated 10 years later. If they hold for another 10 years then I'll be truly thankful. I'm a very positive person and use meditation, relaxation techniques daily to help with stress and health issues. I think it's the best thing I ever learned along with drinking herbal tea! I love life and live it to the full.
RB diagnosed at 45 I used a pessary with great success for about 7 months. I probably could have gotten by with it longer but it was an optimal time in my life to have my surgery. As my husband deploys a lot I needed him home and I found the right surgeon for me here. Knowing I would be leaving this area and may not find another great one I took my window of opportunity. I believe having PT before surgery helped my success. If I had to do it all over again I would not change a thing. Honestly combining a pessary with PT is what I would suggest to any woman starting their journey. And just a note here...Pessary's are not just for older women, no matter what they say!
DWT diagnosed at age 53 I used a pessary for 8 months until I had my surgery. By the time I got close to my surgery date I commented to my mother that I probably wouldn't have even scheduled surgery if i had known how well the pessary would work. I'm not sorry I had the surgery but I was able to power walk, work with preschoolers, and pretty much do whatever I wanted without feeling like I was damaging anything.
Brandy M diagnosed at age 30 I had surgery, but it wasn't successful. But, in a way it was a blessing. My failed surgery lead me to this group and to a new doctor. I LOVE my pessary. It's allowed me to get back to mothering how I want and exercising with more reasonable modifications. I also love my PT’s. They helped me learn what muscles are down there so I can feel if what I'm doing is putting too much pressure on my pelvic floor, as well as teaching me modifications and entirely new exercises so I could get back to more intense (but low impact!) workouts. I will have more surgery eventually, but between the pessary and PT I went from surgery needing to happen ASAP to feeling like I can wait until my kids are older and more self-sufficient so I can heal after surgery this time.
SUCCESSFUL NON-SURGICAL MANAGEMENT:
Sarah M diagnosed at 53 I have a ring pessary for mild uterine and bladder prolapse. It stays it for up to 4 months at a time. Can do everything as normal though I am careful not to run or jump. I swim often which really helps...Breastroke. The nurse at doctor's practice changes it once every 4 months. Can continue to use it til I am 90 says my doctor....no need for surgery. Surgery has to be last resort she says. Am happy. Can't feel it. Can still use tampons, have intercourse etc. Makes carrying shopping etc. easier too. It is literally holding things up, supported by public bone. Quite simple and remarkable at same time!
Becky K diagnosed at 32 I did 3 months of PT (3 times a week) and I am symptom free 90% of the time! The only time I am symptomatic is when I'm constipated. I'm pretty careful now to do things that are prolapse friendly. I have a list of exercises that I do (with weights and bands) and that keeps me sane! I had a prolapse after my 3rd child, it had mostly healed and then when I was 27 months PP, I took a few x-fit classes and they made things worse. That's when I started PT and that's why I am now very careful with how I exercise.
Danielle M diagnosed at 35 Bladder prolapse and slight recto. I started using a pessary about 2mpp and went to PT. I limited my lifting as much as possible i.e. had hubs carry baby and carrier when he was around, for dr appts I didn't carry the car seat in, etc. I stopped nursing around 10/11m. I would only take pessary out to have sex. I went to a new PT a few months ago and started another round because my urogyn said it was very weak. I did another round of 7/8 weeks and that included e-stim. I rented the e-stim and now do it at home along w my other exercises. My urogyno said that I wouldn't be a candidate for surgery at my level (grade 1) so I just manage to try and maintain. Some days are better than others because I get lazy but I'm nowhere near where I was when I found out at 6wpp. I had to also go to therapy for my mental state at the time too. All in all, in a better place. Took a lot of patience and adjustment but there's a light at the end of the tunnel.
Mandy S diagnosed at 31 I have a ring pessary and it has taken me a few years to come to terms with it, but I am ok with things now. I know I probably won't be able to run or do the majority of normal gym type exercises anymore but I can enjoy my life and do cycling, swimming, walking and yoga without too much trouble. I'm 36 so I may have surgery in the future but I want to manage as long as I can without having it.
Pat C diagnosed at 50 I have been using my pessary for 18 months. I use a ring with support. I leave it in and the dr. cleans and changes it every 2 months. I have grade 3 prolapses, meaning it was always outside of the vaginal opening. I had lots of bladder problems. With the pessary I have no bladder problems and I never feel the pessary, and it never slips. I can't say enough times how great it has been working for me. I waited 8 years to finally try a pessary. Finding this group gave me the courage to try a pessary. Just wish I hadn't waited so long.
EK diagnosed at 42 I was doing Habit DVD along with my PT sessions that I had ones a week. My physical therapist was able to see that my pelvic floor was getting stronger every week I went there. That was just by doing just Habit DVD 4 times a week and 30 min PT session once a week and nothing else. It improved my prolapse to a level where I didn't feel it at all and I had no symptoms. I was and I'm still breastfeeding so my prolapse is still there and it does come back around ovulation and my period but it's not troublesome.
DM diagnosed at 42 I am doing the exercises my PT taught me, I am going to a chiropractor, an acupuncturist, a massage therapist, a bit of Chinese medicine and when I have a chance I do an ENG stimulation sensor. I feel fine most of the time. There are days when I feel it more than other but I don't have major symptoms. For some reason I didn't think all these things I am doing were really helping until I went on vacation for two weeks and I didn't do ANY of those things. Nothing! So I started quickly feeling that things were getting worse. I am back doing all these things and I feel a difference already. So, anything you do, it helps believe it or not!
Amy D diagnosed at 34 I have a cube pessary due to levator avulsion and whilst it took some physical AND mental adjustment it has given me so much piece of mind. At only 35 I didn't want to go the surgery route. Having a pessary has enabled me to enjoy physical activity again (a HUGE part of my life and crucial to my well-being).
FJ diagnosed at 64 I have the ring with support pessary. Dr. removes & cleans. It is wonderful, cancelled surgery because the Pessary holds everything in and don't even know it is there. I waited 3 years to try and so sorry I did not try at first sign of prolapse. I was researching surgery instead of researching pessaries. Best thing I did was get the pessary. It prevented surgery and all the complications that can and does happen with Surgery whether right after surgery or later years having a re do surgery.
Michelle W diagnosed at 41 I have been using a pessary for 4 years, I also changed a lot of lifestyle habits and sports choices to eliminate as much pressure on my prolapse. I've been able to live my 'new normal' very successfully. Sports wise with a pessary.....I completed an ironman 70.3 (but walked the run leg). I love my pessary....it became my new best friend.
Maria M diagnosed at 48 At the moment I'm treading water and just trying to avoid anything which might make things worse (e.g. avoiding lifting heavy things) I'm not doing anything particular to improve things but I am doing okay so far. It's now been about 2 years since I discovered I have a cystocele and rectocele - at first I was distraught but having found this group and with a bit of support from friends I've come to terms with how things are for now. If things get worse I'll try the sponge or a pessary. I'm not a good candidate for surgery because I have EDS (which I only discovered when I got pop).
RTH diagnosed at 44 I had intimalase laser done in April and I am very happy with the results No more pain and I can exercise Zumba, bike, walks, swimming almost normal Still leaking when I cough or sneeze or jump but that is not so bad In my books the treatment was a huge success It seems that maximum improvement you can see after 6 months and touch ups have to be done yearly ... will see.
Vanessa F I use sea sponges since 3 years now and I'm happy with it. I can almost do everything I've done before (except for sports). But I do a lot of Yoga and love it. I can do almost everything with my 3 kids. In my first year of pop I had PT and tried some pessaries. But nothing worked like these sponges. So I'm fine now and want to avoid surgery as long as possible.
JL diagnosed at 36 I've been managing mine for about 8 years or so (I honestly lost count) and have no plans for surgery. Three prolapses - my uterine prolapse is well past the opening. But when I eat right, everything disappears (or, at least goes up higher) and I feel normal again. By eating right, I mean I have drastically changed my diet - no grains, no eggs, no dairy. When I eat these things, the various effects that each have on me cause my prolapse symptoms to worsen. Please consider trying just for two or three weeks removing these things from your diet and see if there is any change. Also, Habit DVD was a big help as well. The combination of the two, diet changes and Habit, I'm almost normal. I still feel heavy and bulge a bit before a bowel movement sometimes, but that's about it.
AP diagnosed at 60 In my mid-fifties, during my annual exam, my obgyn said that my bladder dropped a little, and since I did not have any symptoms and she said that it was no big deal and normal for someone who had three children, I did not think much of it. A few years later, this same obgyn gave me a prescription for PT for my osteopenia to strengthen my core. After three months of strengthening my core under the care of a PT, one night at a play with my husband, I felt my bladder drop during intermission. I had a lot of pelvic pressure and pain that felt like I had a really bad UTI, and went to my urologist, who diagnosed a cystocele. The pain subsided after 2 weeks and everything “settled.” That is when I started to do research and learned about pop. APOPS was instrumental in my education. I saw three urogynos and all diagnosed me with stage 2 cystocele, mild rectocele and mild uterine prolapse, and all said that because I was symptom free, I should leave it alone and monitor. At that point, the only symptom I had was a “loose” feeling below, but the psychological impact was enormous. I woke up with it, went to bed with it, and lived the entire day thinking about it. I grieved for a few months, and then with education and research, I took control to do the things I needed to help myself. That included going to PT and using a pessary. None of the physicians I had seed recommended going to pelvic floor PT, but based on what I read on APOPS, I asked my obgyn for a prescription referral for PT. Fortunately, I found an outstanding PT who showed me how to protect my pelvic floor; how do proper Kegals and strengthen my Kegals, how to do exercises to strengthen muscles of the pelvic floor, how to pick things up, how to get out of bed, how to massage my abdomen to help constipation, how to have a bowel movement, etc. It is now two years since I prolapsed on Sept 5, 2014 just shy of age 60. A year prior to that I had three UTIs, whereas I had never had UTIs before, so the signs were there, and if I had known about pop, I never would have done those core exercises, and I do believe I could have prevented it or at the very least, delayed its onset. I am grateful for APOPS as it was those women in the forum that gave me the info I needed to help myself. Hoping to stay this way forever, but if surgery is in my future, at least now I am really informed and know my options.
S.L. diagnosed at 36 – I want to share a positive story with those who are newly postpartum. At 8 months postpartum, I am asymptomatic most days. My first birth was a C-section due to a large baby (10lb 7oz). Looking back I likely had issues from carrying my son. Periodically, I would have the “tampon falling out” feeling and bubbly air down there but didn’t make a connection. I was pregnant with another baby 18 months later and delivered a VBAC in February 2016. The birth was long and traumatic including 4.5 hours of pushing (including counted pushing), Pitocin augmentation, a 2nd degree and internal tear, and a completely posterior baby who never turned and came out sunny side up. If anything was going to cause prolapse, it would be this birth!
After having my daughter, I had the tampon feeling every day that got worse with any activity along with bubbles of air, bladder leakage and painful BMs. I was uncomfortable all the time and I constantly thought about my prolapse. My urethra also looked very large and I could see both walls from the opening at first. I started PT in March 2016 and did about 8 or 9 sessions which helped me get stronger, but I was still having symptoms. At my worst, though I was never given a stage, my cystocele was likely a 2 and I also have anterior vaginal wall descent along with an urethrocele. I may have a rectocele too but that seems to have resolved for the most part.
Over the past 8 months, I have been extremely careful to not lift anything I didn’t have to lift and I also have not exercised other than walking. I believe really taking it easy and time have been the biggest factors in becoming asymptomatic. I’ve even been able to wear my baby in an ergo carrier periodically (I save it for when I really need to). Yes, I’ve gained weight as a result but I truly believe that giving my body a chance to rest has helped me recover. I probably will never be able to do high impact exercise or run again but I am okay with that if I can stay asymptomatic and avoid surgery for as long as possible. I plan on increasing my activity slowly and seeing how my POP reacts. For now, I’m happy to feel like I’m back to normal. My body is not the same after giving birth but my new normal is manageable and I’m able to enjoy being active with my kids again.