Should I have surgery?

[pirategirl150]

I am 58 years old. I had four vaginal deliveries between the ages of 17 and 35, the most recent 24 years ago. I tore my episiotomy after the birth of one of my sons and never had it repaired. I have no leaking of urine, but after a sonogram for kidney stones six years ago, I was told I wasn't emptying my bladder completely. Later, I began to recognize that it was also difficult to defecate completely sometimes unless I pushed down inside my vagina with my fingers. I was thinking seriously about having all these things repaired (cyctocele, rectocele, and torn episiotomy), but have read and heard so many horror stories, I am afraid to do anything until or unless I develop worse symptoms. One gynecologist I consulted with said she could use a laser in her own medical office (out of the hospital) to repair the cystocele, rectocele, and torn episiotomy, and also tighten my vagina to it's pre-childbirth status; but she said she wouldn't file for my health insurance because she said my cystocele and rectocele weren't bad enough to be covered. Another gynecologist I went to see said that the kind of surgery the previous gynecologist had recommended to me was not approved by national accreditation boards and that these kinds of people are nothing more than "charlatans." He also said that laser surgery for this kind of repair was more dangerous than regular scalpel surgery and he said that because there are five other possible hernias that can develop in this pelvic floor area, I would be likely to develop additional problems with the others if I fixed one of them. He referred me to a urogynecologist who said that he would fix everything for me if I really wanted to do it (because it's not that bad) and he would file insurance for repair of the problems because I do have some mild symptoms, and the surgery would take place in a hospital. Because of the hospital fees, the scalpel surgery will cost more than twice as much as the procedure with the female gynecologist in her office. I have a $10,000 deductible with my health insurance, so most of the $16,000 cost of the urogynecologist's procedures will have to be paid by me, out of pocket. I am totally confused now and really don't know what to do. I am not obese, (weigh 170 lbs, 5'6" tall) so I don't think any of this was caused by excess weight. Any advice?

[sherrieP]

MCFOR gives a lot of background in her posts, it may be helpful to you to read her posts as well as others whose titles seem appropriate to your symptoms to get some additional info to help point you in a direction. Know that there are millions of women suffering with POP, it just doesn't get talked about-trying to change that!

[MCFOR]

I had stage III POP surgery Jan 201l an I am doing well with my recovery.  Please read Sherrie's book "Pelvic Organ Prolapse The Silent Epidemic" and you will find 99% of all your questions and answers there.  I call it the POP Bible.  It was a tremendous help to me prior to and after my surgery.   See my post under MCFOR "MUST READ" for the history of my journey to finding answers.

[sherrieP]

Sorry for delay in response, was out of town &still playing catch up.

First of all, I am so happy you did not jump to the procedure recommended by the first gynecologist. Yes there are 5 types of POP and a urogynecologist is your best bet. The reason you read so many horror stories on the net is many women are unaware they should seek consult with a urogynecologist and procedures are being done by physicians not schooled well enough in them. The field of urogynecology is a relatively new field-urogynecologists are THE specialists for POP and your best bet. They can advise you on both surgical and nonsurgical procedures. (Some physical therapists are pelvic floor specialists and advise on non-surgical procedures.) If cost is an issue, I'd recommend you consult with a urogyn to find out exactly what kinds of POP you have for sure and then a PT can try treatment options. High deductibles are so common now and make it extremely difficult to make a medical treatment choice. If your degree of POP is on the lower end of the range, it is possible that some treatments may help you. Are you currently doing Kegels at all? What all symptoms are you displaying (the 2nd post on this forum lists POP basics including symptoms)? Have you tried a pessary? Myofascial release therapy can be beneficial. Are you taking any hormone replacement supplements? Estrogen is a key factor in muscle tissue strength and integrity. Many paths to dig into.

Once I have more detail I'll try to be more specific.
Sher

[sherrieP]

Hang on hon, just got back in town and will get a reply off to you later tonight.
Sher