It is great that your urologist is so up front with you, and it sounds as though he has learned considerably from the procedures he has done. (and it's a good sign that he acknowledges the issues with mesh irritating sciatic nerve pathway).I feel it is important to hover on surgical repair until you are sure it is the right fit for you (also whether or not to go mesh). There are multiple treatment options, but generally once you are grade 3, they can only keep it in check, not reverse POP. It might be a good idea for you to explore some of those options until you are more comfortable moving forward. Physical therapy can sometimes be beneficial, Kegel8 is a beneficial device, myofascial release therapy may help. Typically when women utilize treatments, more than one is used. It is also vital to recognize the significance of doing daily maintenance and pay close attention to signs and signals your body gives you.
Sher
Sher
Thank you Sherri P. Your info. was quite helpful. Interesting that you mentioned a gut feeling because I have a gut feeling that the gynecologist is not the person that should perform the surgery yet have an unsure feeling on the placement of mesh. I trust the urologist however. I saw the urologist for 2nd time the other day to discuss sched. surgery.He said he previously did all of the cystocele repairs where he came from in a smaller town as the other docs did not want to perform them. Currently he states he does half a dozen a yr. and many sling urethral repairs. The # of cystocele repairs doesn't seem like many. He is confident that the mesh is the strongest hold of any repair although his # 1 complication concern would be erosion of mesh through most likely site vaginal wall. He stated a few wks ago he performed a cystocele repair on someone that refused to allow him to put mesh in so he states unsure whether it will hold up. If he used my tissue states it would fail.He had to patients a long time ago that had sciatic pain up the leg into hip area which resulted because he placed mesh too close to a certain ligament which touched a nerve. He states he avoids that area now.Thank you for your input as I await surgery. I am afraid of the mesh however. I could live with this stage 3 cystocele although it is annoying however the unknown is whether it will progress to stage 4.
Since you can't access a urogyn, the urologist is absolutely your best option. It is important to have a urologist fellowship trained in pelvic floor and it sounds as though this one is based on the answers he gave you. Yes mesh complications are for the most part the result of physicians with little training or experience doing them. What most gyns don't tell you is w/o mesh, you will most likely need additional surgery down the road.
To check the urologist for backdrop, go to watchdog sites like ratemds.com, vitals.com, and healthgrades.com. Of particular interest is the feedback from patients. It is important to trust your gut feelings as well, if you are not comfortable with a dr, that is a flag.
I had repairs for 3 types of POP, grade 3, mesh was used to repair 2 of them. I did my homework and am very happy with the results. I wanted a one time fix.
Sher
Away from desk today, hang in a day more-I'll respond in AM.
:)
Sher