<p>I will be bringing my elderly yet very active MIL to a specialist tomorrow morning for this problem. My job is to help her to ask questions and take notes, and be able to convey to my husband (her son) accurate information about her condition and the recommended treatment. </p>
<p>I am unfamiliar with this condition, except for what I’ve read on the internet, and I don’t have a medical background. I plan to write out questions in advance so that I don’t forget to ask them. </p>
<p>Can anyone suggest the types of questions that will yield the most useful information? Thank you.</p>
<p>My aunt had this condition. It was a considerable nuisance.</p>
<p>I think that one of the things your mother-in-law will want to know is whether or not she is a good candidate for surgical correction of the problem. She might want to try other approaches first, even if she is eligible for surgery, but it’s also possible that surgery is not an option because of her health or age.</p>
<p>In my aunt’s case, surgery was ruled out because of her age (mid-80s when the problem started). The problem was dealt with through the use of a pessary (a ring around the cervix that helps to hold the uterus in place), but unfortunately, a pessary can cause irritation and may need to be removed periodically. During the periods without it, the problem goes back to being as bad as it was without treatment. My aunt found those periods of time, and the activity restrictions that they involved, to be a real bother. She would have loved to have surgery if it had been permitted.</p>
<p>I’d never heard of this condition. Apparently it is fairly common. Women need to educate themselves on this topic; organ prolapse doesn’t receive nearly the attention as other medical conditions.</p>
<p>I would seriously consider reading the book <em>Saving the Whole Woman</em> [Saving</a> the Whole Woman](<a href=“http://www.savingthewholewoman.com/]Saving”>http://www.savingthewholewoman.com/) Although I <em>by not means</em> agree with all she says, it is very eye-opening about the failure rate and the expected life of prolapse surgeries. I couldn’t believe that most prolapse surgeries need to be repeated every five years! This is definitely something you should ask the doctor about.</p>
<p>I know quite a few women who have reversed uterine and bladder prolapse through exercise and wearing a pessary during the meantime. They all report very little discomfort with the pessary and a lot of relief.</p>
<ol>
<li><p>You need to know the extent of the problem - there is actually “staging” based on how severe the prolapse is. Which organs are prolapsed ? - there can be several involved.</p></li>
<li><p>It’s not fun for Grandma, but get second opinions - check out a Urogynecology specialist, in addition to the typical gynecologist or urologist.</p></li>
</ol>
<p>3 Determine if there are co-existing issues - typically rectocele,cystocele, or a few others. </p>
<ol>
<li>Realize that there are very stong feelings regarding saving the uterus vs hysterectomy - so beware of political agendas in any material you read.</li>
</ol>
<p>Hope this helps. Google Urogynecology, Pelvic Floor Reconstruction for more info.</p>
<p>Thank you SO much, everyone! CC is the best! Your suggestions were very helpful. I’ve been online for the last two hours researching some more. Huguenot’s book suggestion led me to a good website and forum that went beyond the standard medical descriptions.</p>
<p>After the appointment, I am driving my MIL to the nearest Apple store so she can sign up for lessons for her new Mac laptop! She hasn’t used a typewriter in 30 years so the keyboard is unfamiliar and it hasn’t been easy for her, but she is determined to learn how to use e-mail. She is making progress. I hope when I am 88 that I’ll be as with-it and spunky as she is.</p>
<p>I had never heard of this and just looked it up. Sounds scary! I’m glad some informed CCers were able to give you some advice. I hope everything goes well at the appointment. Your MIL sounds amazing, getting lessons on her Mac! Wonderful.</p>
<p>Multiple studies have shown no difference risk of general anesthesia versus epidural anesthesia for most patients and most surgeries. Epidural anesthesia may allow for better post-op pain control if the epidural is left in after surgery.</p>
<p>BTW, the Mac laptop keyboards are particularly flat. Your MIL may benefit from a free standing USB of bluetooth keyboard.</p>
<p>A little-known, non-surgical treatment for this is the use of a ‘rebounder’ (small trampoline). Jumping on this strengthens the pelvic floor muscles. It’s useful for various types of related issues.</p>
<p>Having recently dealt with this issue involving my mother, I can tell you that the pessary has been a lifesaver for her. All of the people recommending surgery need to keep in mind the age of the patient, and the fact that it is a very involved surgery. It does usually have to be repeated.
With that said, there are many different varieties of pessaries, and it is vital to have someone who specializes in these issues to select and fit the proper device. The pessary prescribed by her regular OB/GYN was very painful and did cause irritation. Once she consulted a physician who specialized in these issues, she was prescribed a pessary that has completely resolved her problem. It does have to be taken out and cleaned periodically (every two months or so), but the doctor does that for her. She no longer has any limitation on her physical activites, and has no discomfort whatsover from the pessary.
Hope this helps.</p>