Urogynecology Community
Repeat failure of bladder suspension
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WELCOME TO THE UROGYNECOLOGY COMMUNITY for WOMEN: This Patient-To-Patient Community is for discussions relating to Female Incontinence and Pelvic Floor disorders such as, Cystocele, Drooping Bladder, Intercourse Pain, Pelvic Organ Prolapse, Vaginal Relaxation and Vulvodynia.

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Repeat failure of bladder suspension

I am 56 years old.  I had a TAH and bladder suspension in 2002.  Three years later my gynecologist referred me to a specialist for total pelvic reconstructive surgery because I had another cystocele, a rectocele, and an enterocele, not to mention the fact that one of my vaginal supports had torn loose.  That surgery also failed, and in 2009 I had it performed again, this time with mesh.  I was not experiencing stress incontinence prior to that surgery, but it began after that surgery so six months later, I had a TVT sling placed.  I no longer experience leakage, but it has been only 11 months since my third bladder suspension, and I already feel the bulge in my vagina so I suspect failure again.  I am supposedly seeing "the best" in the area of urogynecology.  I am at my wits end.  I cannot live like this.  For the past couple of weeks, I have had to dip into my leftover pain meds to get through most days.  What else can be done for me?
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Hi Betseybleu, welcome to the Urogynecology community.

I am so sorry to hear your POP issues continue, it’s easy to see how this would be extremely frustrating. It is unfortunately that some women to have more than POP surgery; there are a couple of reasons for this. Many women have their first procedure done by a physician other than a urogynecologist; although gynecologists, gastros, and urologists are wonderful physicians and surgeons, the pelvic cavity is such an intricate area of organs and structural supports and it truly takes a specialist to know the techniques needed to perform successful surgery here. Another factor that comes into play is often times women return to routine activities prior to being completely healed up; lifting anything heavy too soon is a recipe for disaster. Often women who have POP procedures don't think about the impact lifting young children or grandchildren has to their pelvic structure, particularly after POP surgery. It is also important for women to continue to do routine maintenance once they are completely healed up, continuing on a program of Kegel strengthening is vital for health of the pelvic floor muscle structure.

Were you ever referred to a physical therapist throughout your POP repair path? I have to wonder if that might be more beneficial to you at this point rather than thinking along the lines of more surgery. A PT will be able to assess your pelvic floor fitness level and will have many options for treatment. Some treatment modems utilized by PTs are biofeedback, electrical stimulus, they can instruct you in proper Kegel exercises. Core strength classes such as pilates or Pfilates are of great benefit; having some structural strength in your core muscles to help support the organs/tissues in the pelvic cavity could truly impact your heal curve. I have recently been exploring the John Barnes method of myofascial release therapy; I am finding it to be extremely beneficial for releasing surgical adhesions and restrictions within the vaginal canal and pelvic cavity.

Don’t give up, there has to be something you can to do  to help with the pain; I’d recommend you question your urogynecologist about referring you to a PT to see if they can guide you on a treatment path to  help treat the cause of the pain. I also have to ask if you are using any kind of estrogen replacement therapy; replacing estrogen lost in menopause will help build the tissue strength and integrity in your PC muscle. Once you get that PC built back up, it should relieve some of the pressure causing pain because it will create support for the organs better.

Good luck Betsey, I hope you find some answers and get relief soon!
Sher
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Thank you for this information.
I have also had 2 failed bladder lifts and 2 bladder repairs from the same urologist. I believe my first problem was not going to a urogynecologist, which at the time of the first one, the doctor I had, did not recommend me to one, nor did this urologist recommend me to a urogynecologist the 2nd time.
I go into to see him to have a cystoscopy in his office in a few days.
I'm sure he will recommend another bladder lift.
I have a new and wonderful family doctor that has told me about a Urogynecologist  in another town. My family doctor told me to come see him as soon as I see this Urologist so that he can get me into the Urogynecologist.
Again, thank you for all this information. I just learned a lot.
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I forgot to tell you, that I am 60 years old, only had 1 child, now 41 years old and had a hysterectomy when I was 29 for Endometriosis.
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Sherrie is no longer on this forum, however, we are here to support you.  
Great to hear you are seeing a Urogynecologist.  I hope your appt is soon so you can make progress with a diagnosis and treatment plan.
Do you know if you had the top of your vagina suspended when you had your hysterectomy?  It may be worth talking to your Urogynecologist about how your hysterectomy is affecting your bladder etc.,  

Endometriosis brings with it other challenges also and I wonder if this played a part at all in terms of your bladder.  
Good luck with your appt and let us know how you get on
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