Bladder Prolapse? I can fix that with surgery!

[@lindabarber1718]

I saw you recently about this problem, and you were the best! At that time, I wasn't having a lot of problems, but that has now changed, so I'll be calling your office tomorrow to set up another appointment to see where I go from here. . . A good bedside manner is critical in finding a good doctor and/or surgeon . . and you are one of the nicest, most professional surgeons I've ever met! I'm 70, so I've known a lot of doctors over the years and have many medical professionals in my family as well! Thanks and hope to see you soon!

[@DrJeffreyMcQueary]

Glad to help in any way I can.

[@claraausten]

I live in the UK and have seen 7 Urogynaecologists both privately and on the NHS. I have cystocele and rectocele. When I first used a pessary I felt like a new woman but after it was removed and replaced I started to leak with every step I take and this has continued. From reading the results of surgeries I am not confident about going down this route as the failure rate of 40 % is high. I have a friend who has had 2 surgeries and she is worse now than she was before the surgeries, she wishes she had never had them. I have not read any reviews from people who have had surgery which has been a great long term success. One would think that as it affects so many women that greater progress would have been made by now for a successful long term solution. I tell myself that there are people with much worse problems and try to not let it interfere with my life. Obviously I have to adapt to dealing with the constant leaking, but adapt I do. I hope the many suffering with this find some solution.

[@DrJeffreyMcQueary]

In the UK they don’t have a lot of solutions that are very good to help. Even though mesh got a bad name it was very effective as a long-term solution for pelvic repair. I had great success with it. there is a pessary with an incontinence knob that can really help with urinary leakage as well, and you may consider that.

[@BobbieStankowski]

Thanks for this info. Very valuable to be able to understand a friends issue.

[@DrJeffreyMcQueary]

Glad it was helpful!

[@icbratbrattz7909]

My sis dr.. did a hysterectomy and fixed her all her prolapses. She did a great job

[@DrJeffreyMcQueary]

@@icbratbrattz7909 I’m glad that worked for her, but her doctor may have also reattached ligaments that pulled everything back up.

[@Yisraela]

I have an appointment tomorrow and I am thankful for all this information before hand. Thank you!

[@DrJeffreyMcQueary]

Wonderful!

[@Cocozen]

GYN said Im between a stage 1 and 2, and I can get a sling and have a surgery that they cut a triangle or something to remove extra tissue. Ive had 3 kids. She said my pelvic floor is really toned. Im on estrogen cream now, but have to see urologist before any surgery to rule out everything else for causes. This surgery scares the crap out of me.

[@DrJeffreyMcQueary]

Yes, they will typically place a sling but if you have a cyst to see all that should be repaired as well so that you don’t have any complications with voiding after your sling. It sounds like that is the plan and you just need to feel comfortable and confident in your gynecologist that is suggesting this to you. Understand the experience level of your surgeon and based on that you can decide your confidence level.

[@robinlabranche6147]

@@DrJeffreyMcQueary What's the difference between a sling and mesh? I have multiple prolapse (bladder, cervix and uterus thick uterine lining and fibroids but had UFE in 2010 vagina is atrophy). I've been told need hysterectomy to fix bladder prolapse.

[@DrJeffreyMcQueary]

⁠ a sling is mesh, but there are other mesh procedures that can be done. A suspension to the tailbone is called a sacral colpopexy, and that may be what you need with the severity of your problems. Typically that is done in combination with a hysterectomy.

[@mamacindyrogofsky495]

The more I hear the mess i want surgery. ​@@DrJeffreyMcQueary

[@pavla2055]

Thanks for this additional info . I'm currently waiting for a pre-op workup for a hysterectomy and bladder repair. With all I've learned so far I don't know if surgery will improve my life at all or just present more or different problems .

[@DrJeffreyMcQueary]

Certainly don’t be fearful. I have patients that surgery has tremendously changed their life. There are problems that go along with surgery including scar tissue but if you’re healthy enough, I think the benefits of surgery long-term outweigh the risks.

[@annac1678]

I am getting a hysterectomy and bladder repair with sling next month and have so many doubts about the sling. I don't have trouble with incontinence but I do have a prolapse. Did you go through with surgery? Please if you don't mind, how was your experience?

[@loisperkins2767]

Great presentation. Explained everything and was easy to understand. Thank you Dr. LP.

[@DrJeffreyMcQueary]

@@loisperkins2767 Glad it helped!

[@martarivera9779]

Dr. L.P. thanks for your outstanding presentation. Simple and easy explanations to understand. Thanks, again

[@DrJeffreyMcQueary]

Glad it was helpful!

[@gloriawressell681]

I had a stage 3 bladder prolapse repair in June I had a complete hysterectomy and a sling made out of my own ligaments. After 3 months my bladder prolapsed again. My gynecologist said the surgery was successful but my bladder is a heavy organ and my muscles are weak so it slipped through the sling. I don’t understand how they can say this was successful. I’m not very happy and my activity level is not what I’m used to. I weigh 128 and am 5’4. I can’t even dance with my students ( I teach music 3-5). My doctor has recommended PT. Which I’ve been doing for about a month and a half. I can’t say it’s helping me. My doctor said the next step would be a bladder lift. I just can’t keep having surgeries. I just don’t know what to do

[@DrJeffreyMcQueary]

I would need to know what type of surgery you actually had and what ligaments that they actually tied to. Also, what type of sling you may have had and I can make better recommendations for you.

[@gloriawressell681]

I had laparoscopic vaginal hysterectomy. A Bilateral salpingectomy a Bilateral salpingo Preston’s A sacrospinous ligament fixation

[@DrJeffreyMcQueary]

Most likely your bladder prolapsed and was not repaired during the previous surgery. This is pretty common and even if it looks good during surgery that can happen even my patients can have some recurrence of bladder prolapse at times despite the best effort to do a good procedure. The bladder is the weakest part of the procedure.

[@gloriawressell681]

What is the next step? I’ve been doing g physical therapy for 2 months Do I see a urologist? I just want to be able to dance, walk, exercise. Right now I can’t do any of that I don’t want to keep having surgeries that don’t work.

[@gloriawressell681]

What is the next step? I’ve been doing g physical therapy for 2 months Do I see a urologist? I just want to be able to dance, walk, exercise. Right now I can’t do any of that I don’t want to keep having surgeries that don’t work.

[@AV-tm5zf]

How does a urogynecologist determine where the tears are? I have anterior cystocele 3 and rectocele grade 1 due to my bladder. Feeling a bit defeated because my PT isnt specialized in PFT. Thanks for being so informative for women's health!

[@DrJeffreyMcQueary]

We determine this by exam and experience. Many defects and tears are not seen before the time of surgery and so your surgeon needs to have a plan to repair any defect they encounter during your surgery. Feel comfortable that your surgeon has the expertise to truly help you!

[@irinairina844]

Thank you for all your information

[@DrJeffreyMcQueary]

I am happy you found the information useful

[@lindajoy716]

Thanks for this. Good information.

[@DrJeffreyMcQueary]

Glad it was helpful!

[@barbaramorgan7073]

I had a stage 4 prolapse repair and hysterectomy last December. Took things very easy for 4 months and still no lifting. Felt like a new women. I now find my bladder has prolapsed and I’m devastated. Have been doing kegels religiously since the operation, so why has this happened so quickly? I’m 65 years old, living in the UK and no chance of the NHS doing anything. What should I do? Thank you

[@DrJeffreyMcQueary]

Sometimes after hysterectomy the upper vagina can fall again but it all depends upon how the surgery was performed. Not sure if mesh is available in the UK but it can help safely if done well.

[@reneesanchez9805]

😅

[@marilufresquez8943]

Same problem here. I find no success stories being reported. Nothing works. If males had bladder prolapse we would have an answer by now. This is horrible

[@JDG2023_]

I’m so sorry this has happened.

[@beverlyeaston2821]

I love this video

[@DrJeffreyMcQueary]

Thank you for your comments

[@lolachatrie]

Knowkedge is power

[@DrJeffreyMcQueary]

That’s why I produced the videos just to give a simple perspective of some difficult problems.

[@gloriawressell681]

best of luck to you. I’ve been very disappointed. I’m 66 and 125 lbs. but had 3 BIG babies 8.5, 9.5, 10.5 so there you go!

[@DrJeffreyMcQueary]

Babies do cause most of the prolapse issues later in life.

[@simonetrailor2280]

Kegel exercises, or pelvic floor muscle exercises, can help with mild to moderate cases of pelvic organ prolapse and improve symptoms or even reverse it ! I am definitely going this route first before considering any surgery.

[@DrJeffreyMcQueary]

I agree but exercises cannot repair torn tissues leading to prolapse. It always can help to start with exercises though.

[@mkl8706]

Is it possible to have surgery with you doctor if I live in a different state? I would like to recognize and correct all the issues in one surgery.

[@DrJeffreyMcQueary]

I would certainly be happy to see you in my office if you could arrange that. I am at HMG Urogynecology in Bristol, Tennessee.

[@susannaisrael8580]

Thanks doctor I had a hysterectomy 20 years ago and a sling mesh surgery for a prolapse bladder on July now I’m feeling so sad because I’m pee to much overactive bladder and leaking sometimes my doctor told me to do 48 hours bladder diary to see what’s going on. It’s the surgery failed? O I gonna be like that now and my stomach is big

[@DrJeffreyMcQueary]

Very common after a sling and it often gets better over time but medication can help.

[@susannaisrael8580]

@@DrJeffreyMcQueary thank you so much doctor

[@annac1678]

Hi, I'm having a hysterectomy and my doctor has suggested a sling even though I don't have incontinence problems. But I do have a prolapse. I'm terrified of getting the sling because of the potential side effects that I've been reading about. Can you please share your experience now that it's been a few months?

[@torpearce558]

How does your doctor/surgeon go about finding where the tears are and where to stitch?

[@DrJeffreyMcQueary]

Often under anesthesia weaknesses can be detected. An experienced surgeon will understand what to repair.

[@dianepayne9100]

I live very close to Tennessee and have been suffering for at least 5 years with a prolapse bladder - stage 2 and a rectocele. I've seen several specialists over the years and I'm not any wiser then I was 5 years ago. All they are suggesting is I do kegel exercise and use vaginal hormone cream. Nothing is helping and my quality of life is almost down to zero socialization. How can I get an appointment with you?

[@DrJeffreyMcQueary]

Of course, I am in Bristol Tennessee

[@jessajeannapuli-quirong8321]

Is this spinal anesthesia doc or general anesthesia? I was diagnosed with stage 3 cystocele requirong surgery. Thanks for the very informative video.

[@DrJeffreyMcQueary]

Either type of anesthesia can be used but typically general.

[@lynnburnett5070]

Do the surgeons look to see the day of if you have additional prolapses

[@DrJeffreyMcQueary]

They do look at all problems and should consent you to fix all defects.

[@gloriawressell681]

I had a uterine prolapse that was pushing on my bladder causing it to extend outside my body The surgery was laparoscopic vaginal hysterectomy Bilateral salpingectomy Bilateral salpingo proctor Sacrospinous ligament fixation that is what my chart says

[@DrJeffreyMcQueary]

The bladder was not repaired during the surgery, but the upper vaginal area was re-suspended to the sacrospinous ligament. At the time of the surgery, they may have felt that suspended the bladder well but it’s not uncommon for it to fall again.

[@kogienaicker8988]

How can I get rid of bladder prolapse pain. Im very uncomfortable.

[@DrJeffreyMcQueary]

A pessary might help. Find a good doctor that understands how to help you!

[@marilufresquez8943]

@@DrJeffreyMcQuearypessaries don’t work. No simple answers for this women problem

[@DrJeffreyMcQueary]

@@marilufresquez8943 they can work very well for some patients. Sorry a pessary did not work for you!

[@anitalornie1743]

Thank you for all your information, it has shown me some of the questions that need to be addressed before any surgery.

[@DrJeffreyMcQueary]

I’m glad I was able to help. You have more questions that you could intelligently ask your doctor and get the best information to make good decisions about surgery. Hope all goes well.

[@carolynmeaux1161]

I have stage 2 bladder prolapse. I saw a urologist. He said he won’t do surgery because of the mesh now used. He said there’s no other way to do surgery.

[@DrJeffreyMcQueary]

I can definitely tell you there are other options and you should certainly see a urogynecologist or your regular gynecologist. Now, if you do have upper vaginal prolapse or uterine prolapse that can complicate matters, but still mesh does not have to be used.

[@carolynmeaux1161]

@@DrJeffreyMcQueary thank you so much for responding! I’m glad to hear I have other choices.

[@dinapalkowski8146]

How long would a reconstruction surger y last how many year

[@DrJeffreyMcQueary]

@@dinapalkowski8146 realizing that your pelvis has weakness that cannot be completely repaired, it is important to not do too much heavy lifting or straining. With that a pelvic surgery can last for many years if not the rest of your life.

[@darciaridenour5296]

I’m post menopause for 5 yrs now from complete hysterectomy, I’ve had 5 children 3 vaginal, 2 c-sections. I’ve been over weight for years and gained 63 lbs after hysterectomy. I have now lost 55lbs but still need 100lbs off, my prolapse is pretty bad. I have a lot of skin hanging in midsections and big flap hanging from gut. Should I wait to fix bladder with mesh and get skin flap removed at the same time?

[@DrJeffreyMcQueary]

If you can wait to get things fixed with the prolapse until after you have lost the weight you need that would be helpful. You may or may not be able to have both the bladder fixed and the skin removed at the same time. Two different surgeons would probably have to do that. Sometimes it can be coordinated.

[@musam00]

لدي هبوط في المهبل من الامام والخلف بسبب الولادات المتكرره هل يمكن علاجه 😌

[@DrJeffreyMcQueary]

Prolapse of both front and back can be repaired. Seek help!

[@musam00]

@@DrJeffreyMcQueary thanks🌸

[@sar1142]

Hello from Australia Dr McQueary, can any defects (such as paravaginal) be detected before surgery? With a vaginal exam or any imaging? Thanks so much.

[@DrJeffreyMcQueary]

Yes exam and CT or MRI can see defects but often at the time of surgery you need a surgeon who can evaluate and treat and fix any defect that is seen.

[@pushpalakshminagarajan3631]

You are sooooo kind . It's very much informative 👍. From India. Thank you doctor. I have been diagnosed as stage 2 cystocele and recommended for surgery. And i have 2x3cm sized one fibroid in my uterus. And the doctor says i have to remove the uterus and hysterectomy had to be done. Do i need to remove the uterus please advise me

[@DrJeffreyMcQueary]

Ask if your uterus has actually prolapsed as well as the bladder. If the fibroid does not change over time and it’s not causing you bleeding issues in the uterus itself, may not be a problem. So if you’re having symptoms such as bleeding or pain from the fibroid, then hysterectomy would be appropriate. Otherwise you can just have the cystocelel repaired.

[@gloriawressell681]

So now what do I do? My doctor suggested a bladder lift. I’m afraid to keep having surgery. I’ve been doing physical therapy for 2 months. So far not working

[@DrJeffreyMcQueary]

Pessary or surgery are your only options that could help.

[@KarenB-jp3tx]

I have a bad prolase. Also terriable pain in my knee and leg?? Is this from the prolapse. Its uterine, mostly. Could i have a blood clot in my leg from this?? I didnt have surgery. 5 days ago dr. Put a pessary in and had tremendous relief.. but my leg and knee hurt like hell. Ive been yo orthopedic drs. Abd pain mgmt. No results or helps. Concerned about a bloof clot. I was tested a year or 2 ago. But nowvim concerned. The pesssry gave me imediate relief. Bit theres no guarentee they will help me after i go back to have it cleaned and check. The pesssry helps alot. But its not perminanant.. ??? The prolapse is huge.

[@DrJeffreyMcQueary]

@@KarenB-jp3tx a pessary can help for many years and does give tremendous relief. Keep using it. Upper thigh pain is common with prolapse but not knee pain so you should have assessment for a blood clot.

[@VinoSaki-j3r]

Hi doctor I'm 35 years old I'm 12weeks pregnant and I have prolapse, is this not going to be a problem to my unborn baby and how am I going to give birth and the prolapse not going to be worse the more the baby grows.

[@DrJeffreyMcQueary]

I have certainly seen prolapse as a consequence of pregnancy many times. Sometimes this is just genetic weakness of your tissues. Often you will have continued prolapse problems, but I have often seen it kind of resolve after giving birth. It should not give you any trouble with childbirth And should actually get better as your child grows, and the uterus becomes larger because it can’t prolapse as much. Good luck with your baby.

[@carolynmeaux1161]

Where is your practice located ?

[@DrJeffreyMcQueary]

In Northeast Tennessee

[@Heatherearnest2]

I was just diagnosed I have to have surgery and I am scared. I am only 31 and also going through pre menopause also. It's been rough. The back pain is unbearable.

[@DrJeffreyMcQueary]

I have had many patients in their 30’s with prolapse and the positive thing is the surgery is typically strong and works. You can have pain though so just get through it and you will be better.

[@carolynmontgomery7815]

Dr. McQueary, I had a total hysterectomy 18 years ago. every now and then I feel like my bladder has prolapsed, but it seems to go back?? Recently, like the past 2 or 3 weeks, I'm beginning to have that collapsed feeling. My Gynecologist told me a few years ago that I had a cystocele. How long can you wait before surgery becomes necessary and is there any danger of the bladder compromising my vaginal wall and should sex be put on hold? Thank you for your time and attention.

[@DrJeffreyMcQueary]

@@carolynmontgomery7815 main issues are if you have difficulty with emptying your bladder that’s when cystocele becomes a significant issue. Also, if you have start having significant urinary tract infections. As far as repair, it would be appropriate to consider it at that time. Typically intercourse is no issue and will not make the problem.

[@dinapalkowski8146]

What are my options if i dont want mesh? Can i do re construction surgery not take my uterus out?

[@DrJeffreyMcQueary]

Absolutely you can have reconstructive pelvic surgery without hysterectomy in fact that can be a very strong repair. Biological skin graft is a great option.

[@dinapalkowski8146]

@@DrJeffreyMcQueary is that a longer surgery? Longer recovery?

[@DrJeffreyMcQueary]

@@dinapalkowski8146 actually can be a shorter procedure because it is all performed vaginally.

[@dinapalkowski8146]

@@DrJeffreyMcQueary how long is the recovery?

[@DrJeffreyMcQueary]

@@dinapalkowski8146 6 weeks

[@hereandabout]

. what if i don't do anything ?

[@DrJeffreyMcQueary]

Things may stay about the same and the prolapse not get worse or things may progress over time with worsening symptoms.

[@eastergerman70]

i go to urologist.is this the right doc for fallen bladder.also have frequent utis and bladder spasms.had bladder tac 30 yrs ago but its fell some again causing me problems.

[@DrJeffreyMcQueary]

Yes a fallen bladder called a cystocele can cause retention of urine leading to UTI’s. Some urologists can tack bladders but a gynecologist or Urogynecologist is specially trained. Always seek other opinions and feel comfortable with any surgeon who may treat your problem.

[@robinlabranche6147]

After listening to this.... Why would I have my prolapse fixed. What can happen if I choose to do nothing? I gave stage 2 3 bladder cervix and uterus prolapse.

[@DrJeffreyMcQueary]

@@robinlabranche6147 you certainly don’t have to do anything about this, and it won’t cause you any major harm. But prolapse often will give you bladder issues with difficulty with emptying your bladder. This can lead to persistent bladder infections and some bladder issues such as urinary urgency and retention. Still don’t hesitate to see an expert in, dealing with these problems as well as fixing these problems and do the right thing for you.

[@sar1142]

Hi there! I have 1-2 stage cysto-urethrocele. The urogyn said that I might have problems with retention if he “tightens things up too much” during surgery. I scared of bladder issues after surgery!! My pessary works but I can’t use it forever (i am 32). Is the risk of surgery worth it?

[@DrJeffreyMcQueary]

Retention can be an issue after surgery, but still is fairly uncommon. If you are not happy with that surgeons talk on the subject then I would probably seek another opinion.

[@AkosuaSerwaa-f8o]

I have urethral prolapse or cystocele and have only about three symptoms, frequent urinating, constipation, and pain during sex. My doctor suggested a surgery for me after prescribing estrogen cream to apply for 30days and there was no improvement. But am scared to go for the surgery because of how young i am, 25yrs and i have not given birth yet. So please your advise?

[@DrJeffreyMcQueary]

I would seek another opinion because these problems are rare before children.

[@EBoshoff]

I feel n smaal ball when i wee its gone whats that.

[@DrJeffreyMcQueary]

if you bear down it could be your bladder or rectal area falling. See your doctor for further exam.

[@nancytaylor9293]

I can feel a budget and stitches does that mean my bladder has fallen .

[@nancytaylor9293]

Buldge

[@DrJeffreyMcQueary]

A bulge could be prolapse. Have you had surgery recently, I don’t know where the stitches would come from?

[@mattowens9876]

Thick walled collapse Bladder what should i do

[@DrJeffreyMcQueary]

Was this diagnosis based upon an ultrasound or CT scan?

[@mattowens9876]

@@DrJeffreyMcQueary

[@mattowens9876]

CT SCAN

[@jammmin64]

Typically you would need a cystoscopy

[@DrJeffreyMcQueary]

You would need a cystoscopy either by Urology or Urogynecology

[@deidreakinedwards220]

I am 65 yo and I have a stage 3 cystocele, rectocele and I have NO uterus. I would like to hear/learn about the Uterosacral or Sacrospinous Ligament procedure. I've had one doctor offer this and another doctor has only offered Anterior & Posterior repair. I need to know so I can decide which one is best for me.

[@DrJeffreyMcQueary]

When you have no uterus, it is very typical for the upper vagina to fail and start falling as well. This is not always recognized well by a lot of gynecologists. So they will often offer an anterior and posterior colporrhaphy with no upper vaginal suspension. it is very important that your surgeon be skilled in vaginal suspension with either a uterosacral, or a sacrospinous ligament. These two ligaments are very strong, but typically if you have no uterus, then the sacrospinous ligament fixation is chosen. Hope that information helps. I think it is very important that you know your surgeon can do that procedure if needed. A lot of times at the time surgery other prolapse problems are seen that we’re not seen without anesthesia.

[@harrymyhero]

I had that surgery and my stitches tore loose only 5 days after surgery. I was laying in bed and only tried to place my glasses on the dresser beside the bed; and I felt it all rip.

[@DrJeffreyMcQueary]

I personally don’t see failure that quickly very often. Not sure what happened. But your vaginal area is very weak and could be reinforced with a skin (dermal) graft. Pessary can help as well.

[@harrymyhero]

@@DrJeffreyMcQueary I tried pessaries first. They would not stay in. As soon as I stood up, they fell out. I had a hysterectomy 20 years ago and have no cervix either.

[@Tammy-q4b]

Wow I'm glad you shared this because I'm going through the same symptoms too I had blood clots in my leg threw child bearing and than cancer 40 yrs later I have tilted well had hysterectomy to remove everything but my overies now I have bladder prolapse and pain in one leg and knee in the same place I had blood clots before and severe pelvic and back pain so I think we should be checked thank you

[@DrJeffreyMcQueary]

Yes you should definitely seek help from a specialist who can evaluate and treat you appropriately.