3 weeks pre-op: Could pelvic floor issues get WORSE, not better?

I am pre-op 3 weeks, with pre-op appointment with OB-GYN doc in 10 days. I am at that stage where I am trying to process what involved and come to term with my decisions.

Since the major motivation for the surgery for me is the movement of my bladder, bowel and uterus and regular vaginal bulging with the above (...not to mention the fact that I am incapable of having an unassisted bowel movement 90% of the time) I just want to feel assured that surgery will fix my issues rather than leave me with additional ones. I began having issues 16 years ago after 1st delivery and 4 deliveries later my supportive tissues are just 'gone'.

I am feeling further pressured by the fact that circumstances have lined-up (husband having paid time off of work all though he is recovering from illness, mother being able to come help for several weeks and 13 and 16 yr old being off of school to help with sibs )would allow be to have surgery in 3 weeks and If I don't proceed then I would have to wait a minimum of a year to attempt it again...

*Any advise on what ?s I need to ask... I would be having vaginal surgery without removal of ovaries.
-Planning to ask if cervix removed in process, would prefer not. How will bladder, bowel, vagina be supported, if at all....etc.
*Trying to find a specialist in pelvic floor issues for 2nd opinion...I just don't want to rush the surgery because I CAN do it now and have serious regrets, further major issues down the road.
*non-surgical options for bladder & bowel, bulging issues to be sure to have tried as first choices.

I feel like I have about a 10 day window to get as much information as possible to allow myself to reconsider if need be, OR go into surgery knowing the risk and feeling like the rewards will likely out way the risks.

I know my experience would be individual (good or bad) but please feel free to tell me the things you wish you had known or asked or how things became better or worse, particularly if you entered into surgery for similar reasons.

Hello MAGGIE74,

I can certainly understand and respect your need to explore your options and not rush into surgery. What is the level of expertise of your gyn who is doing your surgery? Is there a urologist assisting him? If so have you met with the urologist? If you can, I would definitely get a second opinion from a pelvic floor specialist/urogynecologist who is very experienced in pelvic floor repairs.

Question I would ask:

1. How many of these surgeries does he do per year?
2. What is the method of repair for the prolapses (mesh, sling, sutures)
3. What is the success rate for his patients with prolapses?
4. What is the percentage of patients who end up with further prolapses?
5. What method of hysterectomy does he use?
6. How long will your recovery be and what will your post op limits be and for how long?
7. What if any lifetime restrictions will he recommend?

Now, chances are he will do a LAVH (laparoscopic assisted vaginal hysterectomy) http://www.hystersisters.com/vb2/article_474868.htm so he can get a better view while doing the repairs. A vaginal hysterectomy includes taking the cervix. This is where my doctor then did extensive repairs to my vaginal walls to ensure they were strong enough to support the repairs. Also my prolapses had caved in areas of the vagina so he had to fix that as well. With these surgeries they usual tighten up the vagina so you will feel some difference when you finally get released for intercourse.

It is vitally important that you follow your post op instructions and give those repairs a chance to take so it is good you have lined up so much help.

	Quote:
I know my experience would be individual (good or bad) but please feel free to tell me the things you wish you had known or asked or how things became better or worse, particularly if you entered into surgery for similar reasons

The questions I listed are mostly what I had wished I had known to ask prior to going into this surgery. I did have a prior prolapse repair via abdominal surgery in 2003 so I am not unfamiliar with being careful after surgery. I also knew my surgeon was very, very well respected and came highly recommended but that being said I wish I asked more questions especially when I made the decision to have my ovaries removed. I am glad you are keeping your ovaries so you don't have to deal with surgical menopause as well.

My reasons for the surgery were painful intercourse, painful periods (I had adenomyosis), badly tipped uterus, couldn't even keep tampons in, frequent UTI's and leakage of urine during intercourse. The repairs so far are holding up beautifully. Most of my post op issues are hormone related. Keep asking questions and be sure you are ready for this surgery. If you can live with the way things are for another year then it is up to you to decide instead of being pushed into it.