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Prolaspe pelvic organs + tummy tuck?

Prolaspe pelvic organs + tummy tuck?

Postby neya » Thu Jul 02, 2009 7:11 pm

I'm plannng on getting a tummy tuck regardless. But I went to the obgyn today to ask about this bad pain I've had since giving birth. It turns out I have a pelvic organ prolapse (bladder). He didn't seem concerned (for now, I'm seeing him again next week anyways after doing tsh & glucose tests anyways) but I looked it up and it's one of thosE things that seem to get worse- especially with age(I'm 24) and since I'm already in a lot of pain and it's ruining my physical relationship with my hubby because of pain I might push for a surgical fix.

I'm curious if anyone combined the two surgeries? Ie read wearing a girdle helps with the discomfort and pain so the mr might actually help
it too(not that I expect insurance to cover the tt/mr because of that) but I'd rather do one surgery instead of two (anesthesia, being cut etc scares me).
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Postby KayPT » Thu Jul 02, 2009 8:12 pm

You should get a referral for a woman's health physical therapist. There are a lot of things that can help you non-surgically that you should try first.
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Postby Luv2Cruz » Thu Jul 02, 2009 8:40 pm

I have this and have already had bladder sx 12 years ago. Back then the dr told me that eventually I would have to repeat the sx on my bladder. Mine is prolapsed again and was giving me some spasms. I was on a med Enablex to help with it. It worked great for me. Anyway before I decided to do my FTT I wanted to make sure that if in the future I did need to have my bladder sx again that it would not mess up my FTT. I also kinda wanted to see if I needed bladder sx now(at the time I did my FTT) I wanted to try to do them both at the same time (my PS does not do this) My OBGYN assured me that if in the future I need to have my prolapse bladder fixed that it would be done vaginally (OUCH) and nothing would have to be cut. I do not know if this helps you but feel free to pm me further.
My PS does not do two surgeries (with another doctor to fix something) in fear that it could compromise the blood flow and healing process to the FTT and to make sure not to get infection. It all makes sense to me but I know these double surgeries are done all the time.
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Postby neya » Fri Jul 03, 2009 6:27 am

Im not really sure who I should go to.
My first ob wouldn't even do an exam when I mentioned my problems. she was just sort of like "you had a baby, things change". During general exams she never mentioned anything. So I waited and did kegels once I got muscle control back (for 6-9 months I only felt bearing down pain and soreness and could not "hold in" anything for more then a moment).
Although maybe tmi, I can do kegels all day with strong response but I cannot hold the kegel. I'm wondering if something is more than just weakened but actually damaged

now I'm 2.5yrs post baby and still have problems but the new ob who mentioned the dropped bladder before we spoke symtpoms. I'm not sure he'll give me much insight (he's very very old school) as it's not causing incontinence and he thinks the pain I'm expiriencing is my uterues contracting. Which it's doesn't feel like a cramp or contraction at all it feels like I'm bearing down pushing a baby out or everything falling out and I can't hold it in. He didn't seem to understand the feeling.
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Postby myturn07 » Fri Jul 03, 2009 8:20 am

Look up iamluvdx2, she had both done at same time.


Matter of fact, I will email her and tell her to pop in, she probably has some good advise/insight for you.
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Postby iamluvdx2 » Fri Jul 03, 2009 12:15 pm

Hi neya! Elysia emailed me and told me that you had posted about prolapsed bladdder and yep! I can give you insight! Thanks Elysia!

OK you might know this. :wink: First, I had a cystocele, which is a hernia of the bladder wall. In other words, the wall between my bladder & my vagina weakened and it was allowing this pocket, so to speak, to go into my vagina. It would droop in there, fill then when I would pee, go back into place, then fill back up and back into my vaginal area again. Nice huh? :roll: All the wall weakening both walls and causing major problems. It was like I was on my period all the time. Like major period cramping. It also was not allowing me to empty my bladder fully. So surprised I did not have UTI or bladder infections. So you can see where there was always "something" left. How much I never really knew or understood until later. Sigh..........Another problem I had was that my bladder wall became adhered to the anterior wall of my vagina. Double whammy! And on top of that, I had a stage/grade 4 prolapsed uterus! So now I have two tension-free suburethral slings. One for my bladder and one for my vagine since I no longer have a uterus. Somewhere in there one is attached to my backbone. 8) But it's the best thing I ever did. It is possible that I may have to have the surgery to fix anything I might do, but I am intensily active, I run 5k's 10k's and workout intensively almost everyday. But I am ok with that having lived experienced the person I was before and my family living thru what I was. It would be done vaginally so I am not worried about that. My doctor, a specialist, performed everything, even my TT. He is especially gifted. While you may not feel comfortable with that and may not have that option, you do need to find two that are willing and able to practice together and that have the understanding of it. My specialist was a Uro/Gynocologist. He also had me lay down and push, like I was having a baby, to see the extend. What kind of testing did they do for you?

Kegels - I did them thru both of my pregnancies. I had two children unmedicated thru natural childbirth. I would do 500+ a day and then afterwards having kids. I know about strong pelvic floor muscles. Ask your husband, he can tell you about strong Kegels! :wink: :oops: . They did strengthen my pelvic floor wall but ultimately genetics (mom, g'ma, great m'ma had a cystocele), uterin prolapse and adhering is what did me in. I would recommend going to a Urologist if you have not. You can have Urodynamic testing. That is ultimately what lead me to my own suspicions. I thought I was just sweating all the time....... :roll: :( You can take meds but I went to the extreme. I was ready to take back my life and I was in horrendous pain and out of control emotionally,physically and mentally. It's up to you how far you want to go, radically or moderately. But go in and at least make sure you have all your options known to you available. Not all surgeries require being cut, my doctor HAD to look for cancer and do many procedures. More than I even listed but not as major. I am glad for me, that we made this choice. I am a totally different woman and back to what I was before I had kids. And to think they all said it was hormones and I needed anti anxiety pills? :evil: You can always go back after your TT and have less invasive of a procedure done but you owe it to yourself to find out your options.

I can't apologize that this was long. Anyone that knows me on this board knows that my TT and other surgeries changed my life. It was an extensive surgery and I was reconstructed inside and made a new woman :D But I am in a place now where I was not able to be for so very long. Life is very good. Feel free to PM me anytime!

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Postby iamluvdx2 » Fri Jul 03, 2009 12:28 pm

Oh forgot to tell you, my ins. covered. I received a check 3 months later totally shoocked. My doc sent it in and they rejected it. I am not sure what happened, maybe someone went back in later but I am not sure as I asked them and they said they never sent the paperwork back in na dI never called the ins. back. My doctor performed it all so maybe that is why? I do know that they weren't able to divide it all out in the OR with the surgical fee and anesthesia, etc. and it was performed the hospital, had to be. Still file for it, call ahead. I did that, maybe that is why. Ask what the codes are and then call your ins. co. Afterwards you can still appeal it. Also, file for the things that you use, ie garment, grabber, etc. Some of mine were covered as well. I was surprised as I did not expect that.
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Postby poulinsj » Fri Jul 03, 2009 1:41 pm

Back in 2003, i had a uterine suspension, paravaginal repair, A&P repair, cystocele repair and a TVT due to a weakened pelvic floor as a result of parachuting. I was only 26 at the time. I am an avid runner and run marathons and believe it or not, i'm continent with no prolapse. I also had 2 babies (C-section to protect the pelvic floor) since the surgery.

Kegals did absolutely nothing for me. Sex hurt!!! It took me a good year to recover from my surgery. I had extensive surgery and the stitches hurt for sometime after during sex. I used Premarin, but honestly it's been the best thing i ever did. I do have slight overcorrection. Sometimes my urine stream is slow, but i can live with it.

Anyways...i could of had a TT with my original surgery. The doctors would have worked together. I spent 5 days in the hospital with my repair surgery. The recovery was rough, but since i was young (like you) my sugery was aggressive.

If i can answer any questions...please let me know. There is a great website (uprise) that deals with all of these issues.

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Postby poulinsj » Fri Jul 03, 2009 1:44 pm

One more thing...skip the OB/GYN and find a urogynecologist that deals with pelvic floor issues:

http://www.mypelvichealth.org/FindaProvider/tabid/75/Default.aspx

Here is the prolapse board:

http://prolapse.hyperboards.com/
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Postby neya » Fri Jul 03, 2009 3:04 pm

iamluvdx2 wrote:Oh forgot to tell you, my ins. covered mine but my doctor performed it all so that is why. They weren't able to divide it all out in the OR with the surgical fee and Anesthesia, etc. Still file for it, call ahead. I did that, maybe that is why. Ask what the codes are and then call your ins. co. Afterwards you can still appeal it. Also, fill for the things that you use, ie garment, grabber, etc. Some of mine were covered as well. I was surprised as I did not expect that.

thanks for your reply- it means more than I can express in words.

I did some searching through my insurance and there's a urogynecologist I can see in brigham and womens hospital. A bit of a hike but worth it.
A lot of things you said sound famliar. So hopefully I can get to the bottom of it. Insurance isn't much of a concern since the reason I went to the ob was because I was planning tt anyways. If I could fix my problems surgically along with tt rather than 2 seperate surgeries it would put me a lot at ease.

Where are you from? I found I hard to find urogynecologists listings except actually in Boston and we have a lot of teaching hospitals in ma.
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Postby neya » Fri Jul 03, 2009 3:14 pm

poulinsj wrote:One more thing...skip the OB/GYN and find a urogynecologist that deals with pelvic floor issues:

http://www.mypelvichealth.org/FindaProvider/tabid/75/Default.aspx

Here is the prolapse board:

http://prolapse.hyperboards.com/

thank you so much. I figured based on my gynos response he felt pain was not important. Or so it felt. I'm glad you gave me a web based plAce too to talk to others in the same boat.

Like you said kegels haven't helped. Now it seems so many nagging problems have clicked.
If it was the prolapse
that caused the pain it originally did get alot better. Levelled out but nver all better. Although unrelated maybe my cervix seems to have dropped too as I have to check my iud. I used to not be able to reach my cervix without pushing or without sitting- Now I have no problem. I hope it's not uterine colapse too but I am feeling
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Postby iamluvdx2 » Fri Jul 03, 2009 5:29 pm

Absolutely see a speciality and have all your files from your GYN and urologist sent there. I am from SC. Sorry, I wish I could help. Had I not seen my Specialist, there is not telling what I would be like today. :cry: Specifically, my LAST visit with my GYNO said, "Well, you're just going to have to live with it" and told me to take 'Advil or something for the paina nd swelling and cramping referring my my pain and cramping and Adenomyosis and other things. My body was under attack and was toxic. My husband stood up and was in such a cool rage and said "That's not good enough!". He just shrugged. That was my during point. I was going down fast and everyone, especially our marriage and our kids, were suffering tremendously.

If you can afford the Urogynecologist go. Call your ins. if you haven't and find out since theyare a specialist how payment might be lower. For us, if there is not one in the area and we have to go out of netword they cover it as if it were. Speak to them in person. Also, they make 1 time exceptions, at least mine does. It is worth the time to call them if not.

Some other sdvise about combining the 2 is that the recovery will be a little harder and longer. But you want it done right so recover right. Right? Also, be prepared for them to possibly not have a clue about what you underwent combined. Make sure it's written in red/blue/aqua/purple whatever! lol And that you have someone repeat it to them if you can't. Some staff can have no mercy on someone who chooses to have elective surgery with a necessary surgery. We can discuss that later should you decide to do this. For now, decide how you will go about this, your time off that could be extended, how much you might be paying additional and so on. Also, consider complications that could happen with the bladder surgery. I had no problems at all with the TT but did have my ureter nicked when the Anterior Reapir work was done. This did cause other issues that were lengthy. I can go into that later. :wink: BTW, I was at a teaching hospital as well. They learned quite a bit from my surgery as it was almost 8 hours long. :shock: :? :roll: :wink: And the cervix issue? Well, at first I thought it was my cervix as I went to put in a tampon but it wasn't my tampon...... :cry: When I ent to my Uro?Gyn. appt. I found out that it was my indeed my uterus and not my cervix. Sorry! Go get checked out. Might not be what you want to hear but you are best to be safer than sorry going into these procedures. You'll be empowered and have all the knowledge going into this. Although already you sound like it.

Keep us updated!

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Postby lipotina » Fri Jul 03, 2009 6:51 pm

I had this done. I had a vaginal hysterectomy due to severe uterine prolapse 2 years ago done by a ob/gyn. Well, I should have gone with a urogynocologist. My bladder prolapsed and I then had my TT and bladder surgeries (and rectocele) done together in April of this year. So far everything is A-okay :D Happy with both procedures. I strongly suggest going to a urogynocologist. They are surgeons who specialize in this area. You mentioned you are only 24. Are you absolutely positive you are done having babies? If there's any doubt in your mind, wait. And also, you could probably have the uro tie your tubes while doing the bladder :wink: Good luck and feel free to ask me any questions you may have. I have done tons of research on this stuff.
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Postby neya » Fri Jul 03, 2009 8:18 pm

lipotina wrote:I had this done. I had a vaginal hysterectomy due to severe uterine prolapse 2 years ago done by a ob/gyn. Well, I should have gone with a urogynocologist. My bladder prolapsed and I then had my TT and bladder surgeries (and rectocele) done together in April of this year. So far everything is A-okay :D Happy with both procedures. I strongly suggest going to a urogynocologist. They are surgeons who specialize in this area. You mentioned you are only 24. Are you absolutely positive you are done having babies? If there's any doubt in your mind, wait. And also, you could probably have the uro tie your tubes while doing the bladder :wink: Good luck and feel free to ask me any questions you may have. I have done tons of research on this stuff.


I did find the only urogynecologist on my network finally. So I won't need a referral. Yay. I'm still surprised there is only one. She works at brigham and womens which is an amazing hospital and they have some great ps there I imagine.

I doubt any doctor will tie my tubes. It's very controversial here. They den refused my stepmom. Said she had to bear 3 children or have a dominant gene that would affect her children lives. My sis in law is 27 and her ob wouldn't until she had 3 children or hit the age of 26 plus counseling.

The children question I have been asked a lot lately(because of wanting tummy tuck) and have considered very much. I like being a mom, but the pain of pregnancy ,childbirth, prolonged pain after and complications were too much for me.
I definitely don't plan on more babies but always thought if it happend then ok. But I figured another baby would only make the symptoms worse.

Granted I'd want to avoid a Hysterectomy if my uterus is falling too for hormonal
reasons
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Postby vivi1 » Sun Jul 05, 2009 6:35 pm

Hi, I too had it done together, it's the best thing i ever done, i had 3 surgeons do it, a general surgeon, PS and urologist. the only thing i recomend is that you have home help as i had to do bed rest for 6 weeks, it's a very emotional rollercoaster afterwards as your hormones will go crazy as the uterus and ovaries don't like being touch :( , i had hot flushes and anxiety attacks which is apparently normal side effect but very upseting, i would suggest going on zoloft before surgery 4 weeks at least prior if you are prone to being a little emotional,, speak to your dr about it as i found him very helpful. whishing you all the best.

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