Belinda, Australia

Before Treatment
When I first started experiencing prolapse symptoms, I knocked them down to just unfortunate side effects of a posterior labour and forceps delivery – despite seeing my GP 9 months later who didn’t take it very seriously; she barely examined me and told me it was a minor rectocele and normal in births like mine. I continued with physio and exercises, nothing worked. I would think ‘you saw someone and it’s just to be expected, get over it.’

Over the next 18 months, it crept up on me. I could feel the bulge inside my vagina, and I was no longer able to wear tampons. I felt like I was sitting on a hard tennis ball. I could no longer get down on the floor and sit with my son. I put on weight, drank a lot of wine, and didn’t talk about it. It was impossible to exercise without feeling like I was making it worse or feeling the ache for hours after. Bowel movements would bypass where it was supposed to and sit in the prolapse pocket and it would be incredibly hard to empty my bowel for the next few days. Once I could, it required firm pressure and pushing on the perineum. If my bowel was full, I physically couldn’t empty my bladder.

Besides how this felt physically, it was incredibly draining emotionally. Every night it was the kind of ache and dragging sensation that most women with prolapse will understand. There is no relief or escape from it which I found would bring on anxiety or panic attacks. I felt some people assumed a prolapse was a cosmetic or a superficial issue but for me it created serious physical pain and impaction, chronic inflammation, lower back pain, UTIs, and high blood pressure. Intercourse was no longer something I looked forward to. If I wasn’t in discomfort, I would have urinary leakage during. As I was the one with ‘the problem’ I placed an enormous amount of guilt and pressure on myself. I was 36 years old. It was taking over my life.

Treatment
I made an appointment with a women’s clinic. I had a significant prolapse and was immediately referred to a urogynaecologist. A few weeks later I met with my surgeon. After an exam/talking through my experiences, he advised me that I had a uterine prolapse that was Grade 3. Involving both anterior and posterior the vault had collapsed and taken my bladder and bowel with it. He showed me a simulation on the computer and talked me through it. This would need surgery. The news couldn’t have been worse, but he immediately made me feel supported. Up until this point I was made to feel like what I was experiencing was ‘cosmetic or superficial.’ Never, not even after the birth of my son, was the risk of prolapse or what I may experience down the track discussed with me. It’s strange but I felt relieved. All of a sudden, I had options to fix it. I’d convinced myself for so long that this was the new normal but there is so much support and great specialists out there that will work with you on an individualised plan. Every woman is different, and we should feel empowered and importantly educated to make our own decisions regarding treatment options. Some experience prolapse in their 20s, others post menopause. Goals for treatment may be very different. For me, I was in my mid 30s and I had not fully given up hope of another child so we agreed that I would try a pessary device for 12 months. On 25th February 2021 (after 13 months using a pessary) and 3 years living with a grade 3 prolapse, I underwent surgery. A vaginal vault repair (sacrohysteropexy with abdominal mesh) anterior vaginal wall repair, posterior vagina wall repair and mid-urethral sling. The first 7 days were hard, everything you would expect post-surgery, but I was never in excruciating pain and the first 4 of those were spent in hospital where I was taken really good care of. I have found the emotional recovery slower and harder than the physical.

After Treatment
Today I am almost 12 weeks post-surgery and whilst I still have a long way to go on my full recovery journey, I’m not running marathons yet! However, my body is healing well. Short term I have already seen a fantastic pelvic floor physio experienced in post-reconstructive repair who will guide me on this next chapter of rehab. I can actually do a pelvic squeeze which prior was non-existent. I used abdominal mesh in my repair as I needed durability and so far, I am not showing any signs of exposure. I can empty my bowel in a normal fashion which I haven’t been able to do in 4 years. When I lay down in bed at night there is a sense of nothingness; there is no ache, drag, or bulge. That is taking some time to get used to. Everyone’s treatment journey and recovery is so different but anyone experiencing any pelvic floor dysfunction please seek treatment, talk to the women in your life. You’ll be surprised when you do how common it actually is and talk through it together. Know that it’s not just in your head, it’s not superficial and no you don’t have to live that way! It is important is to seek out a good specialist that you trust – an advocate as such. There are no guarantees with treatment but the one thing that changed how I approached my treatment was my specialist and how he made feel about how I could move past this.