The new mesh surgery for pelvic organ prolapse

Dear Karen,

If it rings a bell what can we say? Most of the women here who are seriously doing this work understand that it is a decades-old, medical-male myth that you don’t need your uterus after childbearing. We ALL need our uterus, as I worked so hard to explain in my book. My best advice to you is to do a survey on your own. Look at your friends, friends of friends, mothers and sisters of friends, and relatives who you know have been hysterectomized. See if you can get an understanding of the toll not having a functioning uterus takes on women. Those women look and function differently – they do! – and Wholewoman is the first public resource pointing out that not-so-easy-for-our-society-to-deal-with-fact. Whether or not you “opt not to take out” your uterus is beside the point, since putting it in that kind of harm’s way is tantamount to hysterectomy.

The pelvic surgeon makes it sound so easy – like a child’s erector set. How amazing that even after reading Saving the Whole Woman you could conceive of such an operation as minimally invasive! Your vagina will be completely splayed open from top to bottom and side to side. More tunneling and dissection will mobilize your lower bowel, which will be lifted out and moved to one side, and mesh permanently attached to the connective tissue layers covering your lower spine. This surgery is not new!! What is new is that the wind has shifted and this year vaginal surgeries are an easier sell. Rectopexies and colpopexies have been performed for decades with the same litany of associated complications. If you are talking about the new transobturator approach you’d better hope your surgeon is up the very steep learning curve and that the mesh stays where it’s supposed to for the remainder of your life, since the obturator nerve that traverses the same foramen the surgical trocar tunnels through controls the functioning of your lower extremities.

These surgeries are not like abdominal hernia repairs due to the very complex way intraabdominal pressure moves through the female body.

Christine

Dear Karen,

I don't want to come off sounding sarcastic or nasty, but I gotta tell ya I think these surgeons or gyne's who are telling ya that the surgery is non-invasive are full of crap. It really infuriates me that they can actually say something like that to a woman these days with a straight-face. NON-Invasive -- for WHO? When I read Christine's intricate descriptions of the various types of pelvic organ prolapse surgeries they perform on women I almost puked! My doctor (OB-GYN) also tried to somewhat sell me on the "new procedure" he had just learned. Because ya know -- it's right down there (my bladder). I'm thinking to myself "Oh yeh I should have the surgery especially since YOU JUST LEARNED IT" ... what do I look like anyway an idiot?" Besides, I don't know if it's really all that NEW anyway. I remember my mom had a similar procedure 28 years ago and all I can remember is her complaining afterwards about how her hip & back hurt (for over a year) and how she felt like she had to pee all the time or couldn't empty her bladder completely (which hasn't changed in all these years). Give me a break -- they haven't come a long way since then! I think I'd pass "GO" if I were you and go straight to the sea sponge site (www.pandorapads.com) I have been using the sea sponges for over a year now for primary cystocele and have having great success with them. If I eat well, take good care of myself, be mindful to empty my bladder completely -- I am just fine. Even though I am done with childbearing -- I STILL WANT my uterus!!!! Do these guys have any idea about what role a woman's uterus plays in her life? I think NOT. Nor do I think they contemplate beyond what they learned in medical school. The uterus produces hormones for the length of our lives regardless of the fact that you aren't having any ore children. It will certainly send you directly into menopause if you're not already there, or make your current meno symptoms worsen. The body knows to shut down production in the ovaries once the uterus is missing.... It certainly happened to my mom. She went directly from having periods (albeit the heavy bleeding & cramping), etc., to menopause in a matter of weeks. These doctors need to learn more about what they prescribe for women with POP. I told mine about the Whole Woman website and showed him the website that sells sea sponges and told him that I wasn't interested in surgery. By the way, the sea sponges will stay PUT if you place them up an over the pelivs. Take care cleaning them each night. I have written about them in other posts too. Take good care, :) April

Dear Karen 1

Oh my goodness, please don't rush into surgery until you have given the non-surgical methods of posture, whole body exercise, bowel-lightening eating, pessaries, etc a go for several months at least.

I am several months down the line with this and have experienced significant improvement in cystocele, rectocele and uterine prolapse. I am not fixed, and never will be, but now hardly feel that lump at the entrance to my vagina, and when I do, I know that it will improve again in a short time. I cannot say how bad it is for you now, but you certainly seem to need some encouragement to try these things first.

The really bad thing about any pelvic surgery is that you cannot go back easily and undo it (and mesh surgery in particular is very difficult to undo) and the results of undoing it may be as bad or worse than the results of the initial surgery. With the non-surgical methods you can *always* change your mind and opt for surgery at any time in the future.

You and only you can assess for yourself the risks that accompany any of the surgeries mentioned. I have checked all the surgical references in Saving the Wholewoman. They are all from well-respected peer-reviewed scientific journals, ie the peers of the authors of the articles agree that all the contents of the articles are accurate and good quality. The figures for things that can go wrong are also accurate, and if you look at them carefully you will see that the risks are very variable for most surgeries, eg in some sources a particular operation may have 10% complications, but in other studies 40%. If you are one of the unlucky ones to experience complications you may be stuck with a damaged body for life. This damage may incapacitate or negatively affect normal living in a significant way. That is very scary to me.

If a surgical method is new, I would be waiting until your potential surgeon has personally done lots and lots of them successfully, and worked out how to avoid complications for *your* body. He will walk away from the Theatre and your body when he finishes your operation. You will be living with it for the rest of your life.

By the way, my reading tells me that vaginal surgery leaves a smaller scar, and you would have a shorter hospital stay, and post-surgery recovery is quicker, but on the other hand vaginal surgery will leave your vagina (!)<:-o scarred="" and="" the="" surgeon="" has="" to="" dodge="" a="" whole="" lot="" more="" vulnerable="" tissue="" nerves="" than="" they="" do="" with="" low="" abdominal="" incision="" ie="" it="" looks="" better="" from="" cosmetic="" point="" of="" view.="" tissues="" inside="" you="" will="" still="" take="" same="" amount="" time="" heal="" be="" unable="" resume="" normal="" activities="" for="" period="" time.="" don="" know="" about="" but="" at="" age="" i="" am="" not="" start="" wearing="" bikinis="" again="">

Please, please don't opt for surgery until you have given the non-surgical methods a chance to stabilise your body and improve your life. Please, please be patient and careful with your body. It is the one that will carry you to the end of your life.

Best wishes

Louise

the urogyno I was referred to told me about the same surgery, the second time I went to him(I went a year earlier) Ask how many pounds you will be able to lift after surgery, for how long? I was told I could never lift 20 lbs again, to me the "cure" was worse than the problem, especially now that I have discovered Christine's stabalizing techniques. I realized after going to several surgeons and getting different stories, that they REALLY didn't know what they were doing in these cases.

Did your doctor prescribe a pessary? This has really helped me, even though I can tell it doesn't really fit right.

Good luck in your decision.