**This article contains graphic information and is intended to help women who may be facing pelvic prolapse surgery. It is not intended to provide medical advice, it is strictly a recounting of my surgical experience.**
My journey began in early October 2019 after two long days of driving on our way from home in Tennessee to visit family in Maryland. Soon after arriving, I noticed a bulging feeling between my legs. I suspect my bladder had prolapsed and a peek with a mirror pretty much confirmed it. It looked like I was birthing a bald baby. I scheduled an appointment with my urologist who had treated me for several years of bladder infections. She confirmed my suspicions and because my visit to Maryland was for only four week, she gave me information on doctors closer to home that could help.
This was my first introduction to the specialty of urogynecology. Who knew? I had a choice between the University of Tennessee Medical Center in Knoxville or Vanderbilt University Hospital in Nashville. Knoxville being closer, I went with Dr. Bryce Bowling at UT Medical Center.
Urogynecology is a surgical sub-specialty of urology and gynecology.
I called and scheduled my appointment with the first available being in early November. Perfect timing. I read as much about bladder prolapse as I could and started to restrict my activities in an attempt to prevent further prolapse. Minimal walking, no heavy lifting, no straining, no tugging – those were the basics.
The examination was like most any general gynecological exam. No surprises there. The first surprise was discovering I had a prolapse of all three pelvic compartments. The second surprise was the doctor was three months out in scheduling. That meant it would be set for February, just when we were going to be gone for most of the month (driving the New Orleans for a 14 day cruise). So we moved the date to March 23rd.
The pelvic floor is divided into three anatomic compartments: anterior, middle, and posterior. In the anterior compartment lies the bladder and the urethra; in the middle compartment the uterus, cervix, and vagina; and in the posterior compartment the rectum, anus, and anal sphincter. source
In addition there were two other tests that needed to be done and they had to be at least ten days apart. One was to test for urinary incontinence and the other to test the thickness of the anal walls (yes, there was prep involved in that one). Once those tests were done, I met with the doctor again and confirmed my decision to have the surgery (your doctor should discuss all the pros and cons of surgery with you as well as lay out the procedures and any alternatives).
I continued to limit my activities, enjoyed my cruise, and came back to COVID-19. We skedaddled out of New Orleans as soon as we got off the ship. As my date approached, I started to worry elective surgeries would be cancelled. The day before my pre-op appointment (bloodwork, EKG, etc), I talked with the doctor’s nurse. She was concerned as well but they were being advised on a day to day basis. There was an April appointment open and we decided to move my surgery up to that date and cancel my pre-op appt (rescheduling it for ten days before then new date).
And guess what? The day my surgery was originally scheduled for, I got an email from the doctor’s office. All elective surgeries were cancelled indefinitely and they would get back to folks when they could go back on the schedule. So now April was out as well. But things did get better and I ended up with my surgery being scheduled for June 22nd, three months after the first day.
Surgery
The day of surgery, Stu got to stay with me until they took me away. I had visits from 2 nurses, lab tech, anesthesiologist, nurse anesthetist, my doctor and the assisting resident. I do remember being rolled down the hallway towards surgery, but nothing after than until the second recovery room area. They gave me Versed and that was all it took.
Surgery took two hours, found a little scar tissue (probably due to tears with two almost 10# babies) but it didn’t cause any issues with placing the sling. Everything else looked good. There were five incisions (done robotically), sutures and dressings will dissolve naturally. (NOTE: Turns out there were actually seven but the two in the pubic area are considered punctures and were used to pull the sling into place.)
First recovery room – I remember nothing. This was where the anesthesiologist told me he would remain with me until he felt I was ready to move on to the next recovery room. They told Stu it was taking a while to get me moved because my blood pressure was too low. About two more hours, they got me moved to the second recovery room. I vaguely remember the nurse talking to me at some point, but it was another two hours before I really woke up. No pain at this point (needless to say, meds were still in my system).
Finally moved to my room, I did move from the gurney to the bed myself (albeit slowly). That was my choice, they offered to move me. Just had to use my legs and arms a lot to not put pressure on my abdomen. Still no pain. At this point it was around 2pm (surgery was 7:30am). Kitchen called and I ordered dinner (I wasn’t hungry yet so didn’t ask for anything earlier). I ate a full dinner, still no pain, slept a couple hours off & on. They had planned to get me up to walk but it never happened. Oh, I did ask for my Tylenol before bed, just to be sure I could sleep. I was concerned about sleeping on my back since I’m a side sleeper as well as the compression cuffs on my lower legs constantly inflating/deflating.
Night was the same, sleep, wake, sleep, wake. 5:30 was blood work, and my blood pressure was taken regularly throughout the night. Oh, had IVs in both hands before surgery but the fluids were discontinued around 7-8pm since I was voiding (via catheter) quite well. I was drinking a lot of water and sucking in the spirometer as ordered. I was passing gas frequently and made sure to notify the nurses when they checked in with me. I was also given a dose of Colace (stool softener) to help things along.
Morning after surgery I saw the resident and then the doctor – all was good. Still no real pain but it was a little easier to move on the bed (the only pain was when I moved a lot – thank goodness for a good bed). Told me they would take out the vaginal packing and catheter after lunch and conduct a voiding test. If all went well, I would be discharged.
Before lunch I did a stand and walk around the room. Little lightheaded but nothing serious and only a little discomfort. Back to bed. Lunch, then more Tylenol before taking out the packing & catheter. That was uncomfortable and took a lot longer than I thought – how they got so much packing inside I’ll never know. The voiding test meant instilling sterile water into the bladder, removing the catheter and seeing if I could void within 20 minutes. I had no issues. Yay! The ultrasound showed no residual urine in the bladder either. So now it was time to get me discharged.
Now 4pm, we opted to go to the hotel for the night. Bumps in the car were a little rough. Sleep was pretty much like the night in the hospital except no one was waking me to take my blood pressure and nothing was wrapped around my legs. I used an extra bed pillow to cushion my stomach so I could side sleep. I did take two Tylenol. Still no real pain to speak of. The ride home the next morning was an easy 90 minutes, bumps not bothering me.
Recovery
Since then it’s been pretty much 1-2 hour naps once to twice a day. Sleeping 6-8 hours at night. Taking the Tylenol at night for the first couple of nights as a preventative. I wanted to shower on day two at home but spent about 45 minutes on my feet sorting out some stuff, ended up too tired. By dinner, felt really bad and took my Tylenol early. Reminder – don’t over do it!
Woke up feeling good on Friday (surgery was on Monday) and took my shower which felt SOOOO good. The incisions have glue over them – no scrubbing, they will wear off over time as the internal sutures dissolve. My restrictions are the same – no lifting, straining, tugging, pulling, etc. Very careful getting up and down and I use a pillow pressed against my stomach when I need to sneeze or cough. Cough – I actually do several throat clears rather than cough, sound like an old man repeatedly clearing his throat.
I did have a bowel movement on the first day home and in order to keep things moving, I continued to take Colace every two days or so. It definitely helps prevent straining during that function.
I had been told there could be spotting and that it was normal unless it was a large amount. I had one day in week two with very minor spotting. I also had some discharge at about twelve days out, asymptomatic yeast infection thanks to the antibiotics I got while in the hospital. The only other thing of note was being surprised by the amount of fatigue. I spent quite a bit of time in bed, coming out to the living room in the evening for a little TV watching with hubby. If I got up and on the computer, a couple of hours was the most I could do without fatigue.
I had a follow-up check-up at two weeks. All was good and my energy level is getting back to normal. I will have my final visit in another six weeks and then my restrictions should be lifted. (I will update this page at that point).
Final Thoughts
A couple of things to note.
If at all possible, please see a urogynecologist. This is definitely the way to go for the best results and worth the drive, if needed.
Wear comfortable clothes to the hospital, that’s what you’ll be wearing home. Your abdomen will be very sensitive and tender as well as bloated from the gas they instill. I have loose, knit yoga pants that are a size larger than I wear now. They were perfect with a long, loose over-shirt. Once home, I wore very large, loose flannel pants that I had actually put in the giveaway pile. I did wear leggings for my two week visit but was happy to get them off when we got home (six hours later).
If you are kept overnight (not everyone is), don’t be afraid to ask for things. I say this as I look back and realize I should have asked for a warm washcloth to wash my face and a basin so I could brush my teeth. I brought toothbrush/toothpaste but never thought to ask for them.
Be sure to have both Tylenol and some type of stool softener on hand at home.
Arrange for someone to be with you for at least the first couple of days.
Do NOT to any lifting, straining, tugging, etc until released by your doctor!!!!
Expect a certain amount of brain fog as your body rids itself of the anesthesia.
Do NOT rush yourself when you get home. Your body needs time to heal.