Continuing pain

[bellegirl31]

Hello, you may recall I asked a couple of months ago about vaginal pain during intercourse after a TOT procedure that I had in April.  You advised that the pain had persisted too long (at that time, eight weeks) and that I should see my dr for a follow up or seek another opinion.  I finally made it back to my dr today (now nearly five months after surgery); he says everything looks fine and I just need to wait for scar tissue to form to be rid of the pain.   I'm still feeling like it's too long, and I'm wondering why, if this is so normal, my dr never told me that I wouldn't have comfortable intercourse for five months or more after my surgery.   What do you think?  Does this all sound typical?  Or should I go for that second opinion after all?

[sherrieP]

I am so happy you had an appt with a good urogyn, this cements how I feel about ob/gyns doing these procedures-too many complications. I am not surprised the urogyn wants you to address the situation with original dr, he probably does not want to get in the middle of someone else's mess. He gave you honest feedback, that is vital. And he is right if your dr won't address it properly, you need to find a new doc. I do feel if that is the case however that you should find a urogyn who will adjust the mesh-I would recommend you check with another urogyn to see about that potential. I know many urogyns who fix ob/gyns screw ups all the time so it's worth digging in that direction. Bottom line is however you do need a good gyn you can feel comfortable with.

Good luck, please keep me in the loop as things progress!
Sher

[bellegirl31]

Hi Sherrie, the appointment went very well, I'm glad I went.  The urogyn spent tons of time with me and says my pain has gone on too long and probably isn't going to resolve without intervention.  His recommendation is that the sling be cut, he says it's too tense on one side.  The problem is that cutting the sling may (or may not) cause the SUI symptoms to return. Other alternatives include steroid shots, ibuprofen, or just living with this, but he said he was 100% certain it won't get better on its own.   The weird thing is that he believes the original gyn needs to treat this as it is his procedure, so now I have to go back to my own gyn.  The urogyn said if he won't act at this point I need to find a new doctor...so we'll see how it all turns out; I was just glad he spent so much time with me and did not tell me this was all in my head!

[sherrieP]

Hope this gets to you in time, I was out of town. Just give the urogyn all of the specifics you gave me regarding time frame of post op heal curve and running. I'm sure the urogyn will ask any questions necessary to fill in the blanks. Please keep me in the loop after your appt.

[bellegirl31]

Hi Sherrie, going for my second opinion with a uro gyn this week as my pain persists...any advice for that appointment?

[sherrieP]

I'm really shocked your dr released you to run at 6 weeks! I truly understand the need/desire to exercise, I am an exercise nut myself; yoga, floor exericise, free weights, bowflex, Pfilates. Swimming, yoga, and pilates are supposed to the best for us with POP but I like something "more physicial".Personal call; your running falls in to the same path. Please ask the 2nd op dr about the running stuff and see what he/she has to say-at this point if things were healed up the way they were supposed to be it would be fine (still promote internal support though for all runners-ask dr about that too).

Let me know what you find out!
Sher

[bellegirl31]

I started running probably 8 or 9 weeks post surgery; my dr had cleared me with no restrictions at six weeks.   It's not very intense running, trust me!   But more than I had ever been able to do  before my surgery.    

I had the pain immediately after surgery, and while it has abated some, it is definitely still present.  Maybe the running is aggravating it, I don't know, but the whole reason I had the surgery was to be able to exercise more aggressively.   We'll see what happens with my second opinion, I do appreciate your help and concern!

[sherrieP]

When did you start running? I hope you waited at least 12 weeks, it is so vital to be completely healed to return to athletic activities. Sciatica is typically in the back of the leg but a few people get it in the front or side. I don't think this would be related to the surgery though. The sciatica issues from POP surgery are related to where the mesh is attached.  I don't think this is "in your head" from the info you are hearing on TV, you've had this concern prior to the ads.

I do have to wonder though if running is aggrevating things. Did you have it prior to running? Women who run should have internal support, ask your physician whether or not you can use a pessary-it is a diaphragm like device that supports internally. When you run, everything on the inside is being jarred down repetively. May be part of the problem.

[bellegirl31]

Hmm what about pain at the very top of the thigh, where it bends, that sometimes runs down the leg, especially while driving?  I have had that for awhile but thought it was from running, which I started after my surgery?

[sherrieP]

I am glad you will follow up with 2nd opinion shortly if things don't level out. In the meantime, keep track of if discomfort is in certain positions only, if you have pain any other time, and  pay attention to any pain in your butt cheeks that goes down your leg-can be flags of improper mesh placement.

Good luck and please keep me posted.
Sher

[bellegirl31]

Thanks for your help, I think I will give it a little more time and if things aren't better at the six month mark will seek the second opinion.   I do trust my doctor, I have been with him a very long time, and he seems to think that this is somehow a psychosomatic reaction to all of the recent bad press around the use of mesh in these types of surgeries.  Who knows, maybe he's right.

[sherrieP]

And the majority of issues you are hearing about with mesh are related to improper utilization of mesh (improper technique).

[sherrieP]

I'm sorry I forgot to send the website links for checking physician records, it just occurred to me-I'll send them over shortly.

Going home with a catheter is not unusual, so that is not a huge concern by itself. However 5 months is a bit long to still have issues. There are aspects of TOT prodedures that can be variable from physician to physician; proper technique is pivotal for a good end result.

I will send over the websites to check your physicians record. If you see any flags I would recommend you seek a 2nd opinion. As much as I hate to say it, urogynecologists tell me on a regular basis that have to do repairs on procedures performed by ob/gyns. It does not mean the gyns are not good physicians, it is simply a matter of this being an extremely intricate area of the body to perform surgery in.

Minimally, when you seek counsel from a urogyn if everything is ok you will at least have peace of mind. In the event something needs to be adjusted, you will have the option to address it while the repair is still relatively new.

Please keep me in the loop with what you find out. I'll send those links over now.

Sher

[bellegirl31]

Thank you I appreciate your help.  The dr who performed my surgery is a gyn but he assured me he had performed the procedure over 200 times and had never had any issues. I believed him until I went home with a catheter for a week, something he assured me had never happened to any of his patients previously.  If time is the answer I can definitely wait, but I have also heard if there are issues with the mesh it should be addressed sooner rather than later.  

[sherrieP]

Also I'm going to transfer this to our new POP forum.
:)

[sherrieP]

I can't remember if I asked you if the physician who did the procedure was a gyn or urogyn. Sometimes physicians with not enough experience do these procedures and don't get the mesh application right-it can't be too tight, has to be positioned correctly, the area it is attached needs to be prepped correctly. At 5 months things should be pretty level-it often takes up to a year to get back to balance  but sometimes pain with intercourse at this point indicates improper procedure. If your physician was a gynecologist, it might be worth while checking the drs records to see how well rated he/she is (I'll send you a PM to tell you where to do that) and followup with a consult with a urogyn.