How will recoup be after DaVinci robotic sx for sacrocolpopexy w/sling and rectocele?

[Meldoy]

I am 56, married and have had 5 vaginal births and had a hysterectomy w/bladder tuck 11 years ago. I have rheumatoid arthritis and take a considerable amount of medication for this condition. I now have surgery scheduled for February 4th for sacrocolpopexy w/sling and rectocele repair via Da Vinci robotic by a urogynocoligist. I have a grade 3 prolapse.  What can I expect post surgery? Very Painful? Will sex be better (alot of discomfort now)? I know I need to have this surgery (I have alot of constipation problems, and urinary incontinence), alot of abdominal and low back pain. I have been doing PT for a few weeks now. It has helped somewhat.

[sherrieP]

Although the heal curve takes a bit of time, once you get past the 12 week point (for some women it is less, for me it was the full 12, depends on degree of severity of individual POP issues) you should be able to resume sexual relations without any pain and will slowly regain sensation (as nerve endings heal up) to the point you will find sex enjoyable again. I found the location of key sensation areas were a bit different  but the sensation was more intense-I'm guessing because pressure that probably had been placed on nerve areas was gone. The first week is a bit difficult but you will have narcotics to ease pain. It is very important that you eat fruit for fiber (works better than grain) and use a stool softner to ease constipation related to narcotics. Once you are off of narcs constipation related to POP s/b gone. Icing is key to comfort post surgery as well, I iced 24/7 the first week-I can give you more info on this if you are interested in this path. (Out of town on wifi so just giving the condensced version right now).
I also recommend you continue to do maintenance post surgery, I look at maint for POP like I look at maint for my teeth and other body balance. (Kegels or other techniques you learned from PT.)

Go into surgery knowing that things should improve for you radically after post-surgical heal curve. I'm so glad a urogyn is doing the surgery, they can guide the best with these procedures.

Good luck! Keep us posted how things go for you!
Sher

[vol_coord]

What is the name of your book

[Meldoy]

Thanks so much for the info. I welcome any and all advice, gladly. I do intend to resume PT post sx. I had never heard or thought of icing post sx, please tell me more about that - when you can. I will keep you posted as things progress. I am sched for urodynamics January 12th. I am having the sx at UMMC - Baltimore, Md- Dr Leslie Rickey. If you know anything about her, let me know. I feel comfortable w/her, and am confident she knows what she is doing. Please keep in touch. Mel

[sherrieP]

If I haven't gotten back to you in a few days, please send me a PM to remind me, I'll dig on dr and want to send the icing info. I'm out of town and the wifi here is iffy so will answer this in detail when I get home-the poke is in case I overlook in!

Hang in there Mel, I'll get back to you soon!
Sher

[sherrieP]

Having a comfort zone with your dr is so vital, especially with a procedure as complex as pelvic floor procedures. A urogyn is always the best bet and  you want to know your physician is available to answer questions post-surgery as well as prior to. I'll send you a PM on dr insights (+).
On the icing, it can  have a HUGE impact to swelling (which rolls to pain level) post surgery. I bought baby preemie diapers, ripped one end open, filled them with ice, and used them both in my crotch and across my abdomen. I used them round the clock for first several days, as first week went on I continued to use them but not 24 hours a day. I made a few up b/4 I went to bed so in the middle of the night I could swap them out easily. The soft inner lining is comfortable on your skin (put them on top of your undies or tshirt) and the absorbant diapers retain the water from the melted ice. The curve of the small diapers makes them fit well in the crotch area and stay on top of abdomen well.

I had to go off of narcotics on the third day post surgery (my body hates narcs) and was comfortable with ibuporfen because the ice worked so well.

Hope this helps!
S

[MCFOR]

Sorry I did not see your msg earlier.  We are in similar situations.  I'm 60 and just had a stage III POP surgery.  My procedure was a laparoscopic sacral colpopexy, rectocele  repair  and mid-urethral sling procedures.  I'm "pasting" a copy of what I sent to SherrieP following my 2 week follow-up.  She has been a Godsend to me because she calmed my serious anxieties about POP.  Here is what I sent on the main Urogynecolgy Community Blog:  

I had my 2 week checkup on Feb 7th.  My urogynecologist said everything seems to be healing very well. I had posted this earlier, but I guess I did not submit it correctly because I did not see my comment when I returned to this site today.  I had a stage III cystocele, rectocele and mid-urethral sling POP repair.  The day of surgery was painful, but durable because they had me on a morphine drip.  I went home with a catheter the day after surgery, but it was removed a couple of days later, thankfully.  I was a "lounge lizard" except for bathroom breaks and walks up and down my hallway every couple of hours for the first week.  I was amazed at how well I felt.  My pain was very manageable with the meds I had. Thanks to your book (which I've read at least 3 times), I was well prepared for the "before" and "after" surgery.  I had everything I needed in place when I returned home.  I used a walker/chair with wheels that locked in placed that had a basket under the seat. I used it to carry all of my "necessities" including my cell phone and reading materials wherever I roamed in my house.  It, also came in handy to move stuff I could not/should not lift.  This week (my third week) I'm up and about without my walker/chair but I still use it to move stuff that I could/should not lift yet.  I have my 8  week follow-up mid-march and will let you know how that goes.  I'm, also, participating in a clinical trial with the Washington Hospital Center using vaginal dilator massage which may help prevent scar tissue bands from forming in the vagina.  Hopefully, it will be beneficial to help decrease the risk of pain with sexual intercourse after surgery.   God bless and keep up the good work keeping us ladies informed and bringing POP to the forefront.  I hope Dr. Oz does a follow-up on his earlier show addressing the surgical aspects of POP.

[vol_coord]

what is the name of the book you mentioned

[sherrieP]

Thanks for posting your info here too to assist Meldoy, women helping other women is what it's all about!
:)

[MCFOR]

You are absolutely right!  We did it with breast cancer and heart disease and we MUST do it with POP.  I always ask myself, "How can it be such a COMMON thing that most women never heard of it?"  

[sherrieP]

I say that every single day; it still blows me away that this has been on medical record since Hippocrates and is still so in the closet-makes me crazy! I'll  keep shouting from the rooftops, things are now starting to shift. If every woman who becomes aware of POP shares what she learns with at least 2 other women, the movement shifts forward!

[MCFOR]

I had a reaction to the silver nitrate my urogynecologist swab my vagina with on my 2 week post op visit.  Broke out in a rash a couple days after that treatment.  Every time I urinated the outer area of my vagina would itch.  I took benadryl and used vagisil cream which soothed the area and stopped the itching.  I used the vagisil cream every time I urinated after I cleaned the area with a moist wipe. I had a followup with my urogynecologist a couple of days later and she agreed that silver nitrate and I should never meet again!  She said I was healing exceptionally well and she would see me for my 8 week post op.  I'm driving, doing laundry, cooking and VERY LIGHT housekeeping (no vacuuming or mopping floors yet).  I use my handy walker/chair to move things that I'm not suppose to lift, i.e. laundry basket.  My husband and I went grocery shopping TOGETHER so he could carry/lift the grocery bags.  I grocery shop once a month and pickup staples like milk, bread and juice in between if we run out.  So I'm trying to be a good girl and not do stuff that might send me back to the hospital because I do feel that I am capable of doing all the stuff I use to do.  But, I've read too many horror stories of women doing stuff to early and having bad results.  I'm very independent and have difficulty seeing something that needs to be done and not do it.  So, I'm catching up on my reading to keep me occupied and out of trouble.  (I'm posting this to the main Urogynecology Community blog as well.)

[sherrieP]

I'm really glad you recognized that the combo of benadryl/vagisil would help get those tissues back in balance!

[Meldoy]

Hi!!! I just wanted to let you know... My surgery took place on 2/4, I was actually in sx for 8 1/2 hours. All repairs were done. Dr says I had ALOT of scar tissue to work through (that was alot of reason sx took so long). She had to patch/repair a place on my lower bowel, as well as two cuts on my bladder. I also have a urethra sling in place. I have to say thank you for all the pre & post sx advice. I followed and believe me it all helped. The first week was rough, but I kept telling myself to rest and made myself get up and walk, every few hours, to prevent any other problems. I went to see my dr last friday (1 week post sx), she removed the Foley cath, did a void trial, and examined me. ALL WENT WELL, she said I am healing very well, that she was impressed that I am doing so well, with all that was done. I was very happy to hear that!!! Tomorrow will be 2 wk post sx. I am doing much better. Somewhat painful still (lower R abdominal, mostly), tired easily- when this happens- I rest, Which is sometimes hard for me to do, I am also one who sees things to be done and I want to do it. I have had alot of help/support from hubby and family, so I know I need to let them do it, and how important it is to listen. All in all. I am satified. Glad it is over, glad I had it done, I can so feel a difference already. I am extremely impressed w/my doctor and the UMMC- awesome. And SherrieP your support, advice- EVERYTHING is right on! Thank You so so much!

[sherrieP]

Holy moley, that's a long procedure, must have been a mess in there. I'm so happy when you ladies get back to me with positive feedback on your situations and how you did and do all the right stuff to help yourselves. I have a project I am working on that I would like to get feedback from both of you on; am swamped today but will be sending each of you a PM to touch base soon.
Thanks for all your input!! You ladies make my road much easier!
Sher

[MCFOR]

Meldoy, so glad to hear your surgery went well.  Mine was 5 hours.  I believe the baby diaper ice packs Sherrie P recommends were a big factor in relieving my swelling.  If you don't have a copy of her book, please get it.  I ordered my from Amazon.com.  You will be amazed at the knowledge she has compiled and the "hands on" advice she gives is superb for the "before and after" surgery care because she has lived through it.  Reading her book was like having one of Oprah's "AHA MOMENTS."  I've marked, highlighted, and made comments in the margins of most of the pages as it related to me.

I've been doing very well except for the continuing issue of vaginal itching.  I have a call into my urogynecologist to discuss further treatment since the benadryll and vagisil are not doing a very good job of controlling the itching.   God speed to a quick recovery!

[vol_coord]

what is the name of the book?

[sherrieP]

I have an idea what might help with the vaginal itching, I won't be able to get it to you until tomorrow because I am in the north woods on a writing sabbatical and my laptop will be going dead soon (I'm in a local cafe). I'll be at the library tomorrow and can plug in there, hang in there and I'll send you a PM tomorrow with that info! Also, are you  using any estriol cream, with vaginal tissues getting dried out as we get older, applying some may help with the irritation. (Mine feel  icky without my cream...you could apply it to external tissues or internal and extrenal. Since you've had breast cancer I know you have to be careful with estrogen, estriol is the safe one of the three estrogens. Of course you'll need to run it past your dr. Bio-identical path. More info to come on other product as soon as I can access the info at library.)

I'll be back soon!
Sher

[Patoisw]

What is the name of your book and I can't get my Obgyn to give me bio identical estriol- she will only prescribe estrace- what can I say to change her Rx?

[truredhead]

Hi there! Meldoy, we have a few things in common. I am 57 and have had 5 kids. I have had a hysterectomy in aug 09, then 2 months later I had to have a bladder tuck due to stage 3 cystocele, then in 2 months I had a rectocele and a vag vault prolapse. I have been making due with a pessary for a year now and am looking forward to having it all fixed, I had a gynecologist for the first 2 surgeries and now I am trying to find an urogynecologist to do the sacroligament fixation. I want to use mesh or something permanent. It makes me mad with dr. not doing it all in the first place, I had a horrible prolapse and he should have known the rest would fall too probably. I am using vagifem, but have estrace cream too, Which is the best? And Sherri do you have a book or do you recommend one for us? Thks Girls! Brenda

[truredhead]

I just found your book and order it from Amazon, Will be looking forward to getting it soon! Thks!

[Meldoy]

I can understand your frustration in that your Gyn didn't see and recommend fixing all at one time. I, too was upset that I was never explained at the time of my Hysterectomy that their was a possibility of POP, I had no idea of any such thing until my recent routine exam w/her. It is SOOO important to have a Urogynecologist do your next sx. Like SherriP has said, they specialize in all of these pelvic floor issues. My doctor has me on Vivelle patch, and she feels this is working well for me. I am so glad I found this site, SherriP is such a godsend. So helpful, informative, and compassionate. It is truly amazing that this condition has been -hidden?- for so long. Women need to be informed!!! When I found this site, and read SherriP's info about POP coming out of the closet, I printed it out and gave copies to my girls as well as my female coworkers! They WILL be informed! I hope you find a doctor soon. Hang in there. Mel

[sherrieP]

Every time I hear women say they are passing info on to daughters & other women it makes me thrilled-that is the best outcome I could wish for. That is exactly how grassroots movements take hold. It takes an army and we will all do this together! The more we dialogue with other women, the more the word spreads!

Thanks to all of you for all you are doing!
Sher

[sherrieP]

I agree on the mesh, I had an extensive conversation with my urogyn about this because I am very active, a bit of an exercise nut-wanted to make sure the fix was a one time shot. Gotta say I'm thrilled with the results. Do discuss with your urogyn type of mesh he/she will use, some kinds have risk factors-the type in me is an older tried and true type, good track record. Good luck, keep us in the loop!

Sher

[truredhead]

Sherrie, what is the mesh you used? My doc referred me to an urogynecology clinic in a large city. I would like to mention it at my meeting.

[sherrieP]

I am out of town right now and want to double check b/4 I give you the type, hang in there until tomorrow night and I'll get back to you with a PM to confirm type used.

[armymama]

Hi, My situation was I was getting not much action except delay from GYN and I felt there must be significant things wrong, so I researched for years on the internet.  

This info is for all suffering women out there who do not know where to start to get the right doc and DO NOT USE ANY GYN.  FIND A UROGYNECOLOGIST.  

I finally heard the term urogynecologist.  Then I researched with the American Urogynecology Association (or similar title), for urogyn's in my state.  Starting with that list, which was about 15 - 30 docs, I did in depth research on each one and researched professional records on each doc plus patient comments on each one.  There are free medical websites that will give you all this for free.  Also read everything you can find on their own ofc website.  Narrow your choice to a top 3 or top 5, then call to see if they will take your insurance.  

I found a magical, caring doctor this way and am now 2 weeks post op.  I had cystocele repair, rectocele repair, urethra sling and uterus sling as well as sacro spinal something.  I am requesting copy of the surgical rpt from the doc so I will have the name of the exact slings he used.  I didn't even know I had so much going on and no GYN ever took the time or interest or had enough knowledge to help.  When I asked the doc how others could just leave me in the pain and in the dark so long, he replied that many GYN's just are not knowledgeable enough about the overall complexities of the needs many of us have deep inside our pelvic area, esp with stress incontinence.  I have been spreading the word about urogynecologists.  None of the ladies at my senior center ever heard of these guys!

I never found this web site until today.  For me, the 2 weeks post op are VERY ROUGH.  Wish I had known about the book  -  I could have been better prepared for coming home after surgery.  Using the walker to hold and transport your cel, book, meds, med schedule, etc would have been a huge help!

Thank you for this web site and for all your info!  
armymama

[javatime3]

What book are you suggesting? I'm having my surgery in less than 1 month

[sherrieP]

That is absolutely correct, urogyns are the specialist in pelvic floor health. I'm glad you took it  step further and researched the individual physicians, this is what all women should do-not all urogyns use mesh so important to ask lots of questions. A good urogyn will answer all questions and guide you with both surgical and nonsurgical treatment options. As we get the media on board with talking about POP, more women will know where to go to find info they need. Sorry you weren't aware of info in my book prior to surgery but the important thing is you did the right stuff to find the right physician! If you have any questions while in the heal curve, please send them over!

Sher

[MCFOR]

I like your post.  I call Sherrie's book the POP Bible.  It should be on every women's bookshelf for ready reference because at some point in their life (20's and beyond) they will be glad they had read it.