surgery question

Would you recommend surgery for a one and two level of pop.  I have bladder, rectal, I think he said something about my intestine pushing down.  He said he would do a hysterectomy, leave my ovaries.  I am really nervous about the surgery.  I am fine with the bladder and the hysterectomy.  The rectum has me worried.  I think I am not bad enough to take a chance that something will go wrong.  Im 46 have had bladder problems since I was 26, learned to cope.  Past two years have been worse on me, standing 9 hours a day.  The small of my back hurts constantly, my periods are worse, cant keep tampons in.  I had a colonoscopy and I have been able to go to the bathroom with no problems.  It has since then always been soft.  I have had to go back to straining to get relieve, even though I havent had a hard movement since the colonoscopy.  I have never been regular unless I was pregnant.  My question is my bowel movements.  I am set up for surgery for next month.  I have been putting things off cause I am worried.  The main reason for my surgery is my bladder, I have meet my deductable for my insurance and I thought this would get this out of the way now, instead of starting again next year.  I have alot more things Im anxious about, but have to get ready for work.  Thank you.

[sherrieP]

Hi Susn, first question is what kind of dr is doing your surgery? I always recommend women who need POP surgery seek advice from a urogynecologist, the specialist in pelvic floor disorders. You certainly have several indicators of POP and the comments about intestines (that would be an enterocele) make it sound like you have 3 types of POP (there are 5) rather than 2. The hysterectomy might not be necessary unless you have uterine prolapse; some physicians do one automatically when they do POP surgery but if you aren't having problems with your uterus, it isn't necessary to remove it. Take a hand held mirror and look at your vagina to see if you see tissues bulging out-the more tissues bulge out, the greater the degree of POP-you may be grade 3.

Women with more severe levels of rectocele have great difficulty having a b/m-chronic constipation is both a cause and a symptom of POP. Your bladder may be your main concern (I assume incontinence is pretty bad-grade 1 and 2 you have leakage, grade 3 & 4 you can't get the pee to come out) but it is important to look at this as one stop shopping-if you have to have surgery to correct POP, may as well get all types you have going on fixed at the same time-you don't want to have surgery twice if you don't have to. A urogyn is the only physician trained to address all 5 types of pelvic organ prolapse-truly your best bet. Please send additional questions over if you need more info.

Sher

[susanbee48]

I will or did see a urogynecologist.  He told me that I didnt have to have surgery unless I wanted to.  When I wanted to if I chose to call him.  I go in a couple of days for my two week pre certification.  I still feel nervous and I appreciate your help.  The bladder and the uterus doesnt bother me, I just worry about the intestine and rectum.  I read alot of stuff on the internet about the mesh being a problem.  I know my dr. was talking about the mesh and it being new and they use it on the heart patients, but I will hopefully see him in a couple of days.  Also the only test so far he done was a vaginal and rectal exam lying down.

[sherrieP]

No one has to have surgery for POP unless they want to, there are both treatment options and surgical options. A good urogyn will recommend a physical therapist for treatments if you don't want to have surgery. Mesh complications with surgery are the result of the wrong physicians doing the surgeries, that is why I recommend women seek help from a urogynecologist rather than a ob/gyn so they are being treated by the specialist for pelvic floor disorders. The pelvic cavity is very intricate with so many organs and tissues coming together in one space and it takes a specialist to get it right in most cases. You will need more tests to determine what all is wrong and what degree you have. Do take a hand held mirror and take a look to see if you have tissues bulging out, if you don't you probably are in a lower grade of POP and treatments may be of benefit. Do find out for sure if you physician is a urogyn or ob/gyn and ask about his experience with mesh procedures. When no mesh is used, the repairs can fail as we age because when estrogen drops the tissues get weak. The idea of mesh is for the repair to be a one time thing.