I can't begin to tell you how often I hear of women being "dismissed" when they tell their physicians of POP symptoms; it is frustrating beyond words and one of the paths I hope will shift is getting the medical community to recognize the need for screening in ALL women 6-12 months post-partum and ALL women in menopause. These are the 2 leading causes of POP and there is not screening in place. That needs to change. When we recognize symptoms like bulging tissues, chronic constipation, pain with intercourse, vaginal/rectal pressure and tell our drs, they need to listen to us. There is a huge shift in motion now and I'm so hopeful in a year the protocol will be an entirely different page.
I'm so glad you continued to pursue an answer, so often women start to question themselves after they are dismissed a couple of times.
To have gone through surgery and not have a resolution to POP is extremely frustrating and many women experience this because the physicians who do their surgeries are not properly trained. When I say it truly takes an expert, see a urogyn, I mean it from the bottom of my heart. These specialists go through an additional 2-3 years of fellowship training and are the best bet for repair. Additionally I recommend women check the physician "watchdog" websites to look up their physicians records like ratemd, vitals, and healthgrades to find out how well their dr is rated. All women should go to their urogyns with a list of all their questions written down and demand answers-we need to remember our drs work for us not vise-versa.
The additional benefit of seeing a urogyn is this physician will address all the POP issues not just one during the same surgery. I had 3 types of POP fixed, we knew about the rectocele/cystocele going into surgery but not the enterocele which was large, but it wasn't a problem once she got in there and found it-she just fixed it.
Since you are so fresh from surgery, I have no doubt your urogyn will address the repair you've already had done. Often drs don't want to use mesh on younger women, some urogyns worry about complications, the top shelf urogyns look at it as the best long term fix is the most viable option. When mesh is not used, once you reach perimenopause and muscle tissue starts to get weak (all women have this issue with menopause, estrogen impacts muscle tissue strength and integrity), often non-mesh surgery will fail and you'll need additional repair. In my case I was already menopausal but I was also concerned about the fix being permanent because I am an aggressive exercise nut. I didn't want to repeat surgery in a few years.
Write down all of your questions and make sure the urogyn addresses them all. Talk about mesh with your surgeon, there is currently a debate on the good/bad of transvaginal mesh procedures (through the vagina rather than with abdominal incision-I feel it is a good procedure and is what I had done) but complications from this procedure are typically related to improperly trained physicians who are not urogyns doing the procedure. I not only discussed mesh but also what kind of mesh-I wanted to know the mesh my dr would use had passed the tests of time.
Step one is finding out what all is going on POP wise. The good news of no mesh being used in your June surgery is there won't be any "undo" factor mesh wise. Once women have progressed to grade 3 and 4 POP, physical therapy is not as effective for treatment, but it is always a woman's choice whether or not to have surgery or treatments. If you are seeing a PT, it is vital that you see one that specializes in women's health-this is a separate division of APTA and there is a list on the APOPS website to access their listing.
There is a chapter in my book that has "questions to ask your dr" but adding any and all questions you have is important. There is no silly question. The more info you have, the more comfortable you'll be making your treatment choices.
There is a POP Risk Factor Questionnaire on the APOPS website, print it off and see how many risk factors fit your situation, you can take it to your urogyn.
Here's links to 2 posts of mine that may be of help for some basics.
http://www.medhelp.org/posts/Pelvic-Organ-Prolapse-POP/LETS-TAKE-PELVIC-ORGAN-PROLAPSE-OUT-OF-THE-CLOSET/show/1531725
http://www.medhelp.org/health_pages/Womens-Health/KEGELS-AND-KEGEL-BREATHING/show/1133?cid=994
The Kegel piece can be of benefit post surgery as well for maintenance but first step is finding out exactly what is going on. Trust your gut, no one knows your body like you do-you've been doing a great job of continuing to look for answers!
It's hard to say what your urogyn will recommend, it will depend on your specific POP issues. Once you've made a connection and gone for your office visit or after you read more POP info, send in your specific questions and I'll do my best to address them.
You know where to find me!
Sher