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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