What is the best & safest procedure for uterine prolapse?

I had a rectocele and cystocele repair a couple of years ago and it went well however right now I’m facing the same issues as you- the severe pelvic and perineal descent brought it all back. I’ve yet to find a surgeon to help.

Where are you having surgery/who is your surgeon?

I am having surgery for my second time in October. I had surgery for rectocele and bladder repair (Can't remember the term used) over 20 years ago. (My ten pound baby boy did a job on my vagina - delivered naturally and tore all over). The surgery held for about 15 years. Because of colon cancer, constipation, etc., I have strained enough over the years to cause it to come back. The doctors here won't do it (until it's worse), so I am going across state lines, back to my gyno that did it last time. If he can relieve me from these symptoms, I will be VERY grateful. Advice for afterwards? I am going to live on smoothies for a few weeks, so I can heal . Then, I will be very careful not to bear down or stress too hard. It tears it right back to what I don't want. I take Linzess to help me go. I monitor what I eat as to not block myself and keep things moving. Hope this helps.

Has anyone experienced night pain from uterine prolapse? After several years of this I think it is prolapsed uterus restricting urine flow causing kidney pain. This causes me to wake up in pain and pass small amounts of urine several times a night. I have also developed renal cysts and suspect they were caused by this issue. I have not been able to get answers even after kidney ultrasound, gyn exams, ovary sonograms, and abdominal MRI. I do have a bifrocated uterus which makes things a little more murky. Has anyone else had a similar experience?

Can you consult a uro-gynecologist? These are physicians with specific training on all the gyn issues and impacts on uro-genital systems. Pelvic PT might be helpful but surgery may also be indicated. There's a test for urine flow dynamics which name escapes me.

Thank you for your reply. Yes, I am trying to get a referral to a urogynocologist at Mayo Jacksonville. I think that is my best option.

I am on the door step of surgery. I have had bladder prolapse and slight rectocele for over 10 years. The round pessary couldn't work. Every time I had a bowel movement it pushed out. I did phsycial therapy and it did help a lot and it was tolerable. I got lazy about my exercises and gained weight because I was afraid it might make things worse. Now, the bladder seems a bit less willing to empty fully and sometimes affects my bowel movement. Normaly, bowel movements are just fine.

I was told my uterus has dropped and pushing on things. I just dont' know if a different type of pessary could help. The one uro/gyn I saw said I would need a hysterectomy but didn't know if I needed a sling? I thought you had to have one to prevent vaginal vault prolapse after a hysterectomy? Does anybody know if that's true?

Also, I would like a second opinion. I live in Northern California and would love a referral. Anyone have successful results from surgeon(s) near me?

@prolapser

I can only address the pessary. I also went to 2 uro/gyn providers many years ago with a stage 4 uterine prolapse and slight rectocele. I had no intention of surgery or a sling.
The uro/gyn nurse practitioner tried a few pessaries until we got the perfect fit. None of the rings would stay put but the one that had the handle was perfect. It’s easy to insert and remove which is what a do twice a week when using an estrogen cream.

Wearing a pessary does make it easier to empty the bladder.
Bowel movements are never a problem. May I suggest you get with a oby/ gyn nurse practitioner ( or PA ). They will have more time and patience to work with you than the physician. I think you will get the same options of a sling or pessary from another physician. I don’t understand the need for a hysterectomy and the fact he was clueless about a sling.

Exercise is very important and there are vaginal exercises you can do at home or maybe some PT training. There are PTs that specialize in this.

But my thought is first to get ahold of your health lifestyle…lose the weight, get with the exercises and keep trying different style pessaries. If the provider doesn’t have the patience..try another one. You might specify that is your main objective when making an appointment. It’s the best thing I did. I also had an amazing young mother who was my oby/GYN nurse practitioner with incredible patience and understanding.

I hope this helps. Happy New Healthy Year.

FL Mary