upcoming surgery

[cscnursegina]

I'm so happy I came across this forum.  I am a 26 year old nurse g1,p1 that is going to be having (take a deep breath here....) a vaginal hysterectomy, bilat salpingectomy with ovarian preservation with enterocele repair, mayo-mcCall Cudoplasty, anterior colporrhophy , posterior colpoperneurrhophy, pubovaginal sling, cystoscopy with placement of temporary suprapubic tube. (phew.. that's a long list!)  And i'm nervous as can be.  I have great trust in my surgeon and he has a great reputation... How do I know- ask the nurses that work with him!   Now GYN isn't my favorite area- i'm a heart transplant nurse so anything related to the female anatomy goes in one ear and out the other one.  
The surgeon said that his biggest "complaint" after surgery is that women feel too tight and that could be fixed with a dilator.
So two questions here; am I truely only looking at being out of work for 2 months? Or will it be longer because of the intense job I have.  And secondly do you think it's unreasonable to ask if a clitoral hood reduction could be done during this procedure?   Just thought i'd throw it out there before I email him and ask.  

Thanks!

[Lennox Hoyte, M.D.]

That's an awful lot of surgery for a 26 year old. Think of getting  a second opinion from a fellowship trained urogynecologist or pelvic surgeon?  If your problem is prolapse, consider a laparoscopic uterosacral suspension and anterior repair. That should be able to restore your uterus and vagina to its rightful position and prevent the prolapse. FOr aqny urinary incontinence, assuming you had urodynamic testing and it showed stress incontinence, you could add a sling procedure to the laparoscopy to good effect.

If the problem is cervical cancer, then you should be evaluated by a gyn oncologist to see if you can get by with a lesser procedure like a cold knife conization of the cervix.

Clitoral hood surgery could cause painful scarring which would make intercourse a problem in the future.   Either way, I would recommend you first get a second opinion on this.

Dr. Hoyte

[cscnursegina]

Thanks for the response.
This is the second opinion at the Mayo Clinic by a urogyn surgeon.  I have a total prolapse- uterine, rectocele, enterocele, and cystocele.  Grade 3-4.  With urinary incontience and some residual as you can imagine with the prolapse.  
Feeling is that this runs in the family.  Mom and sisters have had to have the same type of surgery at a young age as well (20's).   I was seen in the GI motility clinic and found to have an abnormal rectal tone which probably added to the issue over the years.  They did a balloon expulsion test and I failed it miserably.  With biofeedback I was able to regain some of the muscle tone.  
I am happy with the preservation of the ovaries as I dont want to go into a menopause just yet.
I know it's very unusual to see a 20 something with these type of problems- bad genetics or just bad luck.  Not sure.  Just hoping that it wont take longer than 2 months to recover so that I can slowly move back into picking my daughter back up.

Thanks for your reponse....

-The Nervous Nurse.

[DiDi1]

A related discussion, pain after bowel movement, using dilator from cystocele surgery was started.