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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46734
Experience:  Board Certified Physician
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I am a 53 yr old woman - I have a backwards tilted which

Customer Question

I am a 53 yr old woman - I have a backwards tilted uterus which I have known about since before I had children. I now have a double prolapse - bladder and bowel, and am waiting to possibly have surgery to correct the prolapse (possibly just the bladder). I have been getting a lot of pain in my lower abdomen, and below my tummy button. Could this be due to the mixture of things going on down there?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. David replied 4 years ago.

Dr. David :

This is Dr. David

Dr. David :

I am sorry you are having pain down in your pelvis.

Dr. David :

yes, this pain could very well be due to your double prolapsed bladder and bowel

Dr. David :

you should be doing kegel exercises to help strengthen your pelvic floor muscles.

Dr. David :

do you know what kegel exercises are?

Dr. David :

here is good information about them

Dr. David :

http://www.mayoclinic.com/health/kegel-exercises/WO00119

Dr. David :

let me know if you have questions.

Customer:

I have seen a physiotherapist who said my pelvic floor muscles are very good and that no exercises would strengthen them more than they are. I am considering surgery to fix the prolapse, although I am not sure whether to just have the bladder prolapse fixed and leave the bowel prolapse as I believe a double surgery is quite a bit operation?

Customer:

I also have diverticulosis and the doctors were unsure whether my pain was coming from that or the prolapse. I have three lots of different antibiotics for the diverticulosis, but the pain didnt really go.

Dr. David :

I would fix both the bladder and rectal prolapse both.

Dr. David :

you should be able to handle both repairs if your pelvic muscle are good and you are young as well.

Dr. David :

sometimes if bad diverticulosis is causing pain, you might need that part of the bowel cut out as well

Dr. David :

have you changed your diet to help your diverticulosis?

Customer:

Is that quite a big operation which would require a lot of time off work to recover? Also, I believe the surgery can cause pain with sex afterwards? Could you pls advise?

Customer:

I havent been advised to change my diet for the diverticulosis

Dr. David :

you have to keep your diet so it doesn't constipate you.

Dr. David :

constipation is bad for diverticulosis.

Dr. David :

you need lots of fiber in your diet, cooked fruits and vegetables.

Dr. David :

you can eat corn and nuts, but you have to chew them really really really well.

Dr. David :

diverticulosis bowel surgery is a big surgery

Dr. David :

repair of bladder and rectal prolapse would be easier than diverticulosis surgery.

Dr. David :

the vaginal canal can become shortened after repair of bladder and rectal prolapse.

Dr. David :

and after menopause, you can have vaginal atrophy and dryness.

Dr. David :

so there can be discomfort with sex afterwards.

Dr. David :

sometimes using a vaginal estrogen cream and extra lubrication can help.

Customer:

I am taking hrt medication now but do not currently have vaginal dryness

Customer:

would surgery just to fix the bladder prolapse not be less invasive and less painful?

Customer:

What is the recovery time for prolapse surgery, whether bladder or bladder/bowel?

Dr. David :

the recovery time can vary from patient to patient.

Dr. David :

some can recover in a few weeks.

Dr. David :

some patients take longer than that and can be a few months.

Dr. David :

it is very variable.

Customer:

It is difficult to know whether the pain is from the prolapse or the diverticulosis

Customer:

I'd rather not have surgery at all, but if it will help the pain and stop the stress incontinence

Dr. David :

stress incontinence is most likely coming from the bladder prolapse.

Dr. David :

diverticulosis pain can be more colicy and come in waves as your bowels contract and then relax.

Dr. David :

best of luck to you

Customer:

I cannot afford to be off work too long!

Dr. David :

let me know if you have other questions.

Dr. David :

I understand,

Dr. David :

but you can afford to continue to have your bladder prolapse as well.

Customer:

That is why I am wondering whether just having surgery to fix the bladder prolapse would be sufficient at the moment

Dr. David :

try doing the kegel exercises, there is no harm in doing them and strenghtening your pelvic muscles.

Dr. David :

that is fine to fix just that first and see how it goes

Customer:

I may try that first

Customer:

Thankyou for your help.

Dr. David :

you are welcome

Dr. David :

best of luck to you

Dr. David :

if done for now, please leave +++ positive feedback below the chat box

Customer:

would the recovery time be shorter for just the bladder prolapse?

Dr. David :

yes, recovery should be faster if you just have bladder prolapse repair

Customer:

Ok thankyou.

Dr. David :

you are welcome

Dr. David and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.

Hello Dr David, I wonder could you answer a further question for me?


 


I have seen my consultant today who says I have a mild prolapse, no 1 on a scale of 0-5. He says he is going to do a TVT surgery, inserting a mesh sling to fix my stress incontinence, but isnt going to perform surgery to fix the prolapse. Can you explain what the difference is?

Expert:  Dr. David replied 4 years ago.
fixing the prolpase would have to cut into the vaginal wall.

this is good news, your surgeon wants to do less cutting which is a good thing and means you can hopefully recover faster.

hopefully the bladder sling surgery will help lift your bladder up and help.

your pain is still probably from the diverticulosis

the sling surgery most likely will not help with your pelvic pain issues

did you talk to him about kegel exercises?
Customer: replied 4 years ago.

I didnt mention the kegal exercises. When I saw a physiotherapist she said my pelvic floor muscles were very strong, as I have always done pelvic floor exercises - she felt surgery was the only option for the stress incontinence. Hopefully the tvt will help. My consultant said today the prolapse wont be causing the pelvic pain, and that he would have suggested irritable bowel syndrome, but that as I have Diverticular disease it is most probably that.

Expert:  Dr. David replied 4 years ago.
yes, that is what I said about the diverticulosis.

best of luck with the TVT bladder surgery

let me know if you have other questions

if done, please leave +++ positive feedback for me

thanks for using JustAnswer.com
Customer: replied 4 years ago.

Thankyou for your help.

Expert:  Dr. David replied 4 years ago.
you are welcome

thanks for using JustAnswer.com
Customer: replied 3 years ago.

Hello, I emailed you a few times last week before my tvt sling surgery. I had my surgery last thursday at hospital - since I have been home I have quite a bit of discomfort in my abdomen, and I have been having problems with my right hip - it is difficult to put weight on it, feels like a trapped nerve. I have rung the hospital and they say it is probably due to the position the surgeon had me in for the surgery, and that it should go in a couple of wks. I am concerned about the abdominal pain I am now having, and that I am having to lie on the settee a lot. Also I have just sneezed and leaked, which I dont think is good! I am wondering if it has worked at all, and whether I should not have had it done?

Expert:  Dr. David replied 3 years ago.
I am sorry you hare having this problem after surgery.

your right hip pain could very well be due to a trapped nerve or scar tissue from teh surgery

hopefully as the inflammation comes down, you will leak less.

have you been doing your kegel exercises? you can still continue to do them now

and also to ice the area to decrease swelling and inflammation.
Customer: replied 3 years ago.

I hope so. I didnt expect that I would still leak when I sneezed - is this normal? Is it right that I have soreness and abdominal discomfort four days after the tvt surgery?

Expert:  Dr. David replied 3 years ago.
yes, this can be normal right after surgery from inflammation.

as the inflammation from the surgery goes does down, the leakage should get better or go away.

soreness and abdominal discomfort can occur after the surgery and should get better with time. for some patients it can take longer than others. hang in there, the pain should get better.
Customer: replied 3 years ago.

I hope you're right. I had some discomfort in that area before the surgery, which I wasn't sure was down to my bladder, prolapse or my diverticular disease. I just hope this surgery hasn't made this worse. I also have mild prolapse of bladder and bowel, which the surgeon didn't feel needed surgery. Does tvt surgery do nothing for the prolapse? I thought it was a sling underneath the bladder and round the urethra?

Expert:  Dr. David replied 3 years ago.
this is a good description of the surgery

http://www.nlm.nih.gov/medlineplus/ency/article/007377.htm

no, the surgery does not fix prolapse. it just puts some extra tension on the urethra to control urinary stress incontinence.