Coping With Vaginal Prolapse

I am 38 years old with two children (youngest is 9 months old). I had an anterior mesh repair and posterior colporrphy and perineal reconstruction in February 2008 - 4 months after the birth of my son. Since then I haven’t looked back. Some women cope well with a prolapse for years, I didn’t and disintegrated mentally and emotionally over a short space of time. During my journey I discovered that I had a number of risk factors that significantly shortened the odds for me in terms of prolapse. I had a family history of prolapse (previously unknown to me), a long labour with my first baby, damage to my perineum which meant less support to my posterior vaginal wall, a very fast second labour (1.5 hours)with a large 9lb baby, I also have a heavy toddler - he is 18kg at age 2.5 years. I felt so good after this labour compared to the first that I behaved quite foolishly. I did not rest,insisted on doing housework, lifting my toddler and often carrying both at the same time. I had also had a prolapse with my first baby but due to the trauma of a long labour, perineal damage and a colicky new babe I had ‘blocked’ it from my mind and only ‘remembered’ when trying to cope with this prolapse. My first prolapse resolved itself after about 8 weeks. It went undiagnosed but as I had nothing to do but sit on the sofa with a crying, colicky babe that wouldn’t settle I sat there and did my pelvic floor exercises and it resolved without me really realising that it had gone. i didn’t notice any discomfort as I was so sore with the lacerations, labial and perineal tears. I do feel that the quality of postnatal care with my first child that I received (not in NZ)contributed towards the second prolapse. When I spoke to the midwives about this thing protruding from my vagina when I went to the toilet I was told not to be silly and that they would visit and check me out. However as I lay flat on my back the prolapse disappeared and there was nothing to see. When I sought further help at 8 weeks postpartum for the pain from my labial and perineal tears which didn’t heal with suturing and had burst apart I was told “there is no infection”, “don’t wear tight jeans”, “it is too early for intercourse”, “have another baby - that will loosen things up (it sure did)”, and finally as I was leaving - “be thankful you have your figure back”. Instead of seeking a second opinion I took my stunned self home and got on with the job of coping with my new babe. I had always done pelvic floor exercises (religiously throughout pregnancy) and had no stress incontinence. The second prolapse occurred 2 weeks after my second baby. As my life was more active with an energetic toddler and a largeish newborn it didn’t stablilise. the vaginal pessary inserted didn’t really help and caused irritation and discharge, eventually in despair and anger I removed it. The oestrogen hormone cream was more effective but the prolapse still never really stabilised. i could hold the prolapse up for some time unless I had to lift or do any exercise e.g. brisk walking (which I love). I was fortunate this time to have a great family doctor, midwife, a wonderful gynaecologist and the great nurses at the women’s health clinic. My treatment included the ring pessary, oestrogen cream, neotonus chair and physio. My symptoms were discomfort, vaginal wind - a sound like wet wellington boots, poor bowel control (I still have permanent damage to my bowel from the fast second birth, constipation, bleeding, no pain during intercourse but not a lot of sensation either; and no urinary incontinence. I could lie flat and tighten my pelvic floors and make a hole the size of a golf ball with my vagina. I wouldn’t leave the house until I had moved my bowels as they could ’start’ whilst I was out (my worst fear), I practiced sitting and getting up so that I could attend meetings at work without ’squelching’ with vaginal wind. I was so conscious of the smell of me from the discharge caused by the pessary. If we stayed home I had better chance of holding the prolapse up for a few hours, if we went out then it had dropped by the time I had put the kids in the car. Walking to the park with the kids in the stroller and putting my toddler on the kiddy swing meant the prolapse descended for the rest of the day. For me it was socially isolating whislt I worked at trying to heal the prolapse, I tried hard - I stopped lifting my toddler, farmed out my housework, rested frequently, increased my pelvic floor exercises everytime I had a depressive episode (which was fequently)however I guess the damage was too great. I did get frustrated when asked by the nursing staff at the clinic how my urinary incontinence was and was I doing my pelvic floor exercises (only about 500 of them). The surgery was great, I summoned what positive energy I had left and decided to look forward to it. It took 2 hours, as well as the repair I had my perineum reconstructed and my labial tear repaired. the result is a scarred perineum but it looks great. I had vaginal packing and a urinary catheter in for 2 days. it was sore but worth it. The worst pain was from my reconstructed perineum. The bruising on the inside of my legs was significant but went. The day my catheter came out I started sneezing due to all the flowers that were arriving. i remember holding my rear end and thinking ‘well if I now have urinary incontinence I will find out’ as I couldn’t sneeze, squeeze my muscles and hold my perineum at the same time - a huge succession of sneezes and nothing happened which was wonderful.
Recovery meant having mum to stay for 12 weeks to lift for me as I couldn’t lift anything heavier than a milk bottle. I couldn’t have had the surgery without my parents support. My husband was wonderful throughout the whole experience. though I felt sexually unattractive, the prolapse made no difference to how he felt about me. He shouldered extra repsonsibilities, cuddled me as i cried every night and put up with my screaming and anger.
the old me is back and feeling great and I know I am lucky to have had so much support from friends, family and healthcare professionals in NZ. This has been a long story but so has the last 9 months. My best wishes and empathy to those out there dealing with a similar problem.