Urogynaecological conditions: prolapse, bladder and pelvic floor problems

Well I think after, after perhaps a couple of months of experiencing these symptoms I obviously suspected it could possibly be a prolapse and I think the first thing I would do would have been to look up an NHS website, possibly other websites that I felt were-, were reliable and it did lead me to think that probably a prolapse was what I was experiencing and that gave me some information. I probably after a while, I decided I would speak to my GP about it, which I did. It was a telephone appointment, as so many are in the time of the Covid pandemic and the GP told me, suggested that she agreed with the diagnosis, it probably was a prolapse and she said, she implied that pelvic floor exercises were kind of more or less all that could be done certainly for the time being so- she, I think she pointed me in the direction of a YouTube video showing how to do the pelvic floor exercises. Also, the NHS website I think has a link to a video talk, describing pelvic floor exercises, so all that is quite useful.

I developed urinary incontinence and became aware of it when I started running about six to seven months but I think it was starting to be an issue about four to six months postpartum and it was only when I went back to work that I sought help because I had a few incidents in the office where I stood up and I just had a total loss of lack of bladder control and I think for me at thirteen months postpartum I’d act-, you know, I had some headspace because at work, you know, you, you can go to the loo by yourself, you can make coffee by yourself, you can think about yourself a bit more and I thought, ‘oh I need to go see a doctor about this because it’s affecting, you know, work me.’ So it, it’s probably a common story, it took me far too long to seek help but I, I think if I had had a better conversation at that six-week postpartum check about what to be mindful of and aware of, I would have been better served and probably would have sought help sooner.

I think the best example I would was obviously suffering with them the whole year and continuously going up into the doctors every two weeks, every week for months and months and then I just thought, “No.” You know, I was, my life was very busy, my work life is very busy and it got to the point where I thought, ‘No, there’s definitely something wrong’ and I went up again and he just looked at me and just went, “Oh I’ll give you these antibiotics,” and I went, “No,” I said, “this has been going on, look at my records and you can see I’ve been suffering for nearly eight, nine months and you have not even asked to investigate this any further. I need you to do something and that’s when they did all the blood tests and they come back and they said, “Oh yeah, you’re not producing Vitamin D,” and since then I obviously I take my Vitamin D and I’ve been quite lucky touch wood, so yeah.

I went to my first smear test after having my daughter and then the nurse was like, “Oh have you got any gynae problems?” I was like, “Well I haven’t really got any gynae problems but I’ve kind of got this bulge and I don’t quite know what it is, you know, it’s not caused me any discomfort or pain but I think I should get it seen to” and she kind of said, “Yeah actually I think you should like it, while you’re here book in to see a doctor-, female doctor,” which I did after the appointment and basically it wasn’t until that appointment that I got diagnosed with the prolapse.

I think it’s also, also something very big culturally, you know, where it really feels like a weakness to be ill and just, you know, I’ve just got a lot of shame about having such a constant seemingly mild problem that causes me so many problems. Yeah, because there’s definitely a lot of culture, you know, my family, things like that people think I haven’t seen a GP for thirty years or, you know, things like that and it’s very unhelpful that kind of, that kind of way of looking at our bodies I suppose. I think that that really has an effect on people who, where that’s just not their reality where they can go around as if they don’t have a body, you know, yeah. That definitely played into my relationship with my husband I think as a as a man who doesn’t have any health problems, I think he definitely has this where he just sort of thinks, ‘How can it be such a constant thing in your life?’ you know, I think he just doesn’t, doesn’t understand.

[In past internal examinations and coil fittings I’ve had] they move your parts inside or, or they pull things to, inside you but then I don’t know when are they going to finish so I need somebody to be talking to me and saying, “So listen, I’m doing this and it’s going to be this, it’s doing okay, it’s just be a few more minutes,” and then also to be truthful, because when they said uncomfortable, uncomfortable to me is that you give me a pinch. You pinch my cheek, that’s uncomfortable. Not, what they call uncomfortable is excruciating pain. So, the last time I had, not this time, the previous time I had my, my Mirena coil inserted I was in such an agony, and they said to me, “Oh if you’re feeling much pain we will stop.” And then they didn’t stop, I was sobbing.
 
I find it [internal examinations] very undignified, you know, you know, I have to take my pants and then they, of course they’re not seeing me naked, I know, of course they put a thing for, just the fact that you have to put your feet on those metal reins and open it up, and then pretend nothing is happening. And then they insert that thing that sometimes is very cold, uncomfortable.
 
And I’m terrified, I’m just like mm, nah, maybe another day, nah. No. So I’m avoiding it [seeing a doctor about urinary incontinence], I literally avoiding it, consciously avoiding it. 
 
And it’s really worrying because I know that at some point I can actually physically force myself to just to go the doctor, but then for some other people no, and then might not be the case, and then it can cause even more problems, because-, in the long term.
 

I really didn’t know what it was and when you go on the internet, you go on the NHS website it says, you know, sometimes these symptoms can be caused by vaginal atrophy, can be caused by vaginal dryness, can be, bl-, bl-, there’s a whole long list of things it can be so then I want, I want somebody to actually knows about stuff to tell me which one of those things it is.
 
Because we’re in the pandemic, so the first-, what they do first of all is they give you a telephone call and that was with a man, a male doctor and I found that quite difficult to talk to a man about it. And but he said, he was lovely, and he said, “Oh yes, come down to the surgery and we’ll get you booked in,” and they had booked me in with the female GP which was much better and she was lovely, she was just very matter of fact about it. She, you know, as soon as I lay down and you get into that sort of smear position, you know, with your legs apart and your ankles together and she said, “Oh yes I can see it.” Well, that’s not what you want to hear [laughs]. But yeah. And she did an internal examination and she said, “Yes” and she said, what sort of prolapse it was because at that point I had no idea and what stage it was so I think both of those things were helpful. But once you’ve got some information then you can go away and you can read things and you can look at things.

I don’t know whether GPs are not particularly interested and they just think, oh, you know it’s, it’s another old woman with a prolapse [exhales]. I mean, I might be entirely wrong about that. But I don’t know, I just felt almost as though I was being a little bit dismissed. ‘Oh, you know, it doesn’t look too bad, you know, you’ll be alright’ was the sort of attitude. So I sort of came away thinking ‘Oh well I, I probably will be alright’, you know. But though, of course, it wasn’t until the symptoms carried on that I thought ‘Well, actually, no, I’m not alright.’

So, having had a radical hysterectomy back in 1999, everything was going along marvellously, yes, I did have to have a hernia repair afterwards. But it had no problem at all. But became aware probably about sort of six, eight years ago that something wasn’t quite right. Went to my local GP who diagnosed a prolapse and basically sort of said, “Oh well, just go home, do pelvic floor exercises for three months and see how it goes.” Well, I did that having done that for I don’t know how many years before anyway. Went back after three months and she said, “Oh yes, it looks to be improving. Just keep going.” And that’s how it went. So, yes, I did, but progressively, you know, yes, it was affecting my bladder, you know, there was like I need to go to the loo and I need to go to the loo now, different stuff like that. So I went back probably about three years ago now, and saw another GP and she examined me and she said, “[mm] You’ve got a very bad prolapse. Nothing on this earth is going to help it you know, just by yourself doing sort of yeah, pelvic floor or anything like that. I’ll refer you.”

I can’t remember when my UTIs started just because I’ve had chronic infections since December 2013, and they’ve been random so I can’t pinpoint where the UTI specifically started from and I think I’ve also mushed it together with the periods because it’s all in the same area, so everything’s mushed together. But I would say I think I would start with the GP because that primary care right my first GP that I had. Again I would go in, do my urine samples and then they would just dipstick it and be like, “There’s nothing there and you’re fine.” Then I would be so confused because I had all the symptoms and ‘Why is it not showing up, is it because there’s nothing in there or is it just in my head?’ because that my old GP had a tendency to tell me that I need a therapist and not a consultant since I was eight years old that was her thing. Anything I went to him for he was like, “You need to see go and see a psychologist,” and he’d just refer me for therapy instead of doing further tests which also put me off because when you’re rep-, when you’re told on a, you know, regular basis that it’s in your head, there’s nothing wrong with you then you start to question that as well, especially when the dipsticks are coming up wrong, I just kept thinking maybe it is in my head because I went and I did the test and even if I have the symptoms but nothing’s showing up so maybe it’s just in my head and if I stop thinking about it it’ll disappear.