Bladder prolapse worsening?

Body: 

Hi, I am pre-menopausal and had a bladder prolapse diagnosed a year ago. My doctor referred me to a physiotherapist but of course this was simply to train me to do Kegels which did not help. I have been doing the WW First Aid for Prolapse exercises on and off last year and then every day for the last 2 months, as well as consciously working on my posture all the time. I had a bad cough for several weeks in December and this worsened the prolapse and it hasn't really gone back to where it was. Not sure what stage it is since sometimes it is a large bulge protruding out of the vagina (this is when I have a bowel movement) and other times it can be felt sitting in the entrance to the vagina. I recently started having Bowen treatment and after the first session when the therapist did prolapse moves the prolapse went right back in (but popped out a few days later). Generally the prolapse worsens when I have my periods.

Should I be doing more WW exercises to see results or patiently continue? I manage the first half of the First Aid for Prolapse exercises once daily.

Is it safe to keep pushing the prolapse back into place with clean fingers, along with fire breathing, when I go to the toilet which is when it pops out?

I am fortunate not to experience any incontinence issues and mostly the prolapse is not uncomfortable when I am walking around. My main concern is whether it will worsen further and present more symptoms. Is it realistic to think that with exercise and good posture I can actually reverse the prolapse and lead a fully normal life?

Thank you

Hi Rowan,

First of all yes, women report on a regular basis that coming back to their original structural shape has greatly reduced their symptoms and restored their quality of life. I call that reversal. You will likely be working with some level of bulge for the long term, however. Things will never be like they were when you were 19, but we fill the gap between our desired reality and our current reality with acceptance - understanding that the possibility always exists for further improvement. Women routinely report that after 10 or 15 years they are still seeing results with the WW work!

Without seeing you, it is impossible to know what might be going on, but perhaps I can help you reframe things a bit. Not only can you improve your symptoms, but you must as there are no good options. This means taking responsibility.

The bladder is strongly attached to the abdominal wall and easily manipulated through myofascial therapies. I never argue with any woman’s success in improving her symptoms, but simply point out that the pelvic organ support system is created and maintained while standing, walking, and running under the forces of gravity. Prolapse is a whole-structure problem that requires a whole-structure solution.

Hopefully you can visualize what I am about to describe.

From the anatomy chapter in FAFP you know that the urethra forms a sharp right angle with the bladder. The urethra travels up through your pelvis from the back opening toward your navel, and then your bladder drops down into your lower belly. The front of your bladder cannot go anywhere, but is tightly adhered to your abdominal wall. At the top of the back of the urethra where the bladder and urethra meet to form the “urethrovesical angle” a small bulge begins to appear in most women.

Because we are unaware of it, and what it means, we continue with the same lifestyle (pulled in belly, sitting in soft furniture, etc) that caused the bulge to form in the first place. That small bulge balloons further and further toward the back, eventually reaching the vaginal opening and beyond.

Now, instead of the back of your bladder forming a nice, straight wall, it has formed into the shape of a pendulous eggplant! When you get impatient that one therapeutic program or another isn’t fixing the problem, consider how tremendously deformed your bladder and vaginal walls really are. The vaginal wall is extremely compliant and will conform to the shape of nearby organs.

Also realize that there is no operation that addresses the eggplant. The best they can do is shove the eggplant forward and “strengthen” the vaginal wall in horrendous surgeries that are woefully misconceived.

The WW work addresses the eggplant. Our preference is to reach women whose eggplant is the size of a nose or smaller, so these tissues have a good chance of remodeling fully. However, a cystocele the size of a nose is asymptomatic (with the exception of stress urinary incontinence). Most of the women here are dealing with eggplants.

I have added a WW “Tools” section to FAFP, which includes several “go-to” exercises when you are feeling symptomatic. Whole Woman exercise programs are designed for strengthening the whole body around the pelvic organ support system - as it is a head-to-toe postural system. More and more exercise will likely add more and more stress, which is antithetical to the Whole Woman work. Thus the Tools.

Walking in the morning while taking long strides, and then coming home to do several rounds of firebreathing and belly tosses are bound to help. Keep these exercises up hourly if need be. Understand that the whole game here is moving the organs forward! You can even affect your symptoms by sitting up strongly in WW posture and doing several rounds of pelvic rocks. It may take a year or more, but the eggplant will be pulled up and straightened out. However, we must have realistic expectations. There is no reason for your condition to worsen appreciably. Make sure you have a good, anti-inflammatory diet and are using WW toileting posture.

Hope this helps.

Christine

That was an interesting summary from Christine. I have not been in touch for some time (2017) and just coping but doing exercises. Starting wearing the posture belt which I feel stabilises my pelvis. Not sure if continuing to do so may be detrimental?

The posture belt is a great aid in helping you remember to stay in Whole Woman posture. But you have to be the one to take responsibility for the posture. Doing the exercises and wearing the belt won't get you all the way to where you want to be. Do you understand how to achieve posture, belt or no belt? - Surviving

I too have been coping using the exercises until about a year ago. I have severe spinal stenosis which really makes it painful to do all of the Whole Woman exercises. Some of them help with the stenosis. Because of reflux, I have a chronic cough which has made my prolapse worse. When going to Urologist for bladder infection (the first one I've ever had), he had his associate teach me the correct way to do "exercises" for my stage four prolapse, also fitted me with a ring pessary. Since learning exercises here, the doc's were of no help. The ring helped for awhile till it started slipping, so he prescribed me a Gellhorn. It has certainly made things easier, especially when I have coughing so much. Recently, I have been having rectal pain when wearing the Gellhorn, almost as if it is rubbing. I have to remove it after just a few hours, wondering if I have rectal prolapse (is this even a thing)? At this point, being sooo uncomfortable, I become tempted by friends who have had bladder surgery to follow in their footsteps. Then I come to the Whole Woman page and, once again, read Christine's marvelous explanations, read what all you ladies have to say and I just can't bring myself to have the surgery. So, still doing Whole Woman exercises, even though I don't do them justice because of back issues. I have no curve in my lower back and bad discs in mid back cause slumping. I do so enjoy the Celtic-type dancing in the video. I am constantly aware of and struggling with my posture. Lately I have been dealing with extreme inflammation all over. This happened suddenly and is quite puzzling. Any ideas, information, comments are most welcome. Bless Christine and all of you ladies for your willingness to impart wisdom.

Shelf pessaries like the gellhorn hold the vagina open to intraabdominal pressure. In normal anatomy the vagina is a flat, airless tube. This is how it is protected from surrounding organs being pushed into its space. Anything that holds the vagina open (pessary, jade egg, etc) sets the vagina up for new-onset or worsening prolapse. New-onset or worsening rectocele is most common with pessary use.

You have a special condition, but what else is there to do but support your spine and work with natural breathing to come as close as you can to the dynamic shape and function of your pelvic organ support system. I would pay much more attention to WW Posture and breathing. Don't try to "create" lumbar curvature. Relax your belly and lift your chest.

I first found this site some months ago. I have read and read and bought some of the tools for uterus prolapse and inconstancy. Sometimes I have thought I was a bit better and sometimes I felt like I should just give up. But I have a partner and we travel and I wanted to be better for him and better for myself. Sometimes it was a bit better and thought to myself I'm thinking just give up and it's the way it is so these conditions are the way it will always be. But thought I'm thinking of these conditions anyway so think about making them better. And you know what !!! Today I was freed!! I am so excited. I know there will be days when I will have problems but for one day I felt normal. I can not believe it! So blessed. If I can do it one day I can go through another day and then another day. Of being normal.

My bladder prolapse occurred suddenly four months ago. It is severe with slight bulging out of the vagina. I am 64 years old in otherwise excellent health. My prolapse has been shocking and life altering.
Over the years I have enjoyed running, competitive tennis, golf, yoga, high impact aerobics, mountain hiking, kayaking, etc. Athletics have always been a big part of my life.
I use a ring pessary with support. My day to day life is more or less back to normal when I wear it. However, even with the pessary, I have not been able to resume vigorous sports at all; and I have had to settle for low level engagement in the others.
Without the pessary my bladder drops into my vagina just being up and walking around the house. I need it to function. I am learning WW postures and exercises with the pessary in place.
Is the pessary an impediment to fully realizing the benefits of WW practice? Will I be able to fully enjoy athletics ever again? Should I find replacement activities like dance and swimming?

Hi MissWilly,

Welcome to Whole Woman! It is no wonder you have blown your bladder toward your pelvic outlet - because no doubt your athletic body has been configured toward tight abs and a tucked pelvis.

The pessary is not a final solution, but of course wear it for comfort until you are getting enough result with the WW work that the pessary becomes obsolete. Hopefully it is a ring-with-support and not a gellhorn or shelf-type pessary, which holds the vagina open to the forces of intraabdominal pressure. In normal anatomy the vagina is a flat, airless space, which protects it from the tremendous internal forces coursing through your abdomen and pelvis with every breath you take.

There is a whole next level of describing our natural WW alignment, which I’m still trying to find words for. Everything about our natural structure, including the length of our breath, and the frequency of our heartbeat, fits the universal Golden Proportion. This means that we are thoroughly wired to maintain perfect health - which of course includes the natural placement of your pelvic organs. Whole Woman Posture is pulling your abdominal organs up so your pelvic organs can move forward toward their natural positions. Your upper abdomen should be the leading edge of your abdominal wall, with your lower belly behind. This does not happen overnight and may take years of consistently pulling the abdominal wall up, never in.

From a WW perspective, you would want to return to all the activities you describe (except maybe the aerobics only because so many of their movements are not graceful - for lack of a better way of putting it - and therefore not supportive of our natural shape), but now in a completely different configuration. Consider running forefoot-first and in WW posture if you are not already doing so. Consider walking forefoot-first as well. Bring WW posture to the tennis court - it may takes months of steady practice but you will be a much better player coming from your natural form. Practice up-on-your-toes balance.

All planetary bodies, galaxies, and every sort of atom spins on its own axis. All life on earth conforms to the Golden Proportion, as do our music, our gait, and the shape of our bones. Whole Woman Posture is the only way of being bipedal where natural breathing and the Golden Proportions of the body are supported. Pull in your abdominal wall at any level and the natural axis of the female body - which is evidenced in our development as human beings - collapses. You will still go on, but never at peak performance, and steady decline is guaranteed.

Enjoy living in your intended shape!

Christine

I have had a couple of days of perfectly normal days. Wonderful! Other days not perfect but better than they were. One problem is that I need to take a water pill because of Blood Pressure and is so harsh and it forces me to urinate
so quickly. Otherwise almost every day would be normal. How I love that of feeling of being normal. Is there any way to rid my body of excess water instead of taking that dreaded water pill?

Christine, you are so right about the shelf pessaries. After wearing the gellhorn pessary, I now have a new rectocele which causes me to have gas and some rectal leakage. I have been trying to wear a sea sponge pessary while doing the WW exercises but that is causing me pain alslifting my chest I am seeing a slight bit of relief. Also, I'm going to decompression on my mid-back and it helps quite a bit. I breathe deeper and sleep like a baby. Still hopeful, just tired of being in pain and limited in what I can do. I do enjoy the easy dance moves in the exercises! My husband plays in a Celtic band and the music in the video is very familiar to me.

Sorry, my computer locked up on the above comment. In wearing the sea sponge pessary, it slips out of place and causes me pain and allows my bladder to bulge out around the sponge. Maybe I need a larger one while doing the exercises? It has helped me greatly not to try and create and lumbar curvature anymore. Just relaxing my stomach and lifting my chest have started to help.
Thank you, Christine for your help and wisdom. Always grateful to you and the ladies on this forum.