Looking for the Best Technique

Aloha

I am a newbie who has several things that need to be treated.
Cystocele (bladder prolapse)
Rectocele

my physician notes read almost full uterine prolapse
I have been wearing a pessary and would continue to do this but have just got the results back from my hysteroscopy which showed complex hyperplasia atypia. so now I will have a full hysterectomy with vaginal vault suspension. I am trying to decide wether to have the abdominal Burch suspension method (which stitches the bladder up to the pubic bone or not. i do not want any mesh and am also afraid of the TVT sling which uses synthetic tape. I have been reading terrible things about the mesh eroding and the tape also being rejected.
I know the recovery time would be longer if I did the abdominal Burch suspension method but I don't want to go back for additional surgery if I have problems with the tape and too much tension etc.,
All comments are appreciated.
Mahalo (thank you)

Wow I'm sorry you have to deal with all this. Which way does your Dr recommend? It sounds like either way you will want to plan for a lot of recovery time. I know thinking about so much time off is hard, but it seems like this will be a big investment in your health and quality of life in the long run... I hope a decision comes clear to you and that you can be at peace with it.

Hi,

Ask your doctor which procedure will give you the best long term results. I had the Burch done in '01, and was told it would last 10 years. Sure enough, 10 years and 2 months later I am recovering from robotically asst tlh (fibroids) with lynx mesh mid uretheral sling, posterior repair & robotic uterosacral ligament suspension. The sling & ligament suspension were for my returned UIC. I was also really worried after reading about all the awful complications so many had from mesh. My doctor took lots of time answering all my questions about it, and yours should too. I believe the majority of the problems were with the larger mesh 'kits' that were used. I asked them why they couldn't just do the Burch again, and they felt I would have a much longer term result this way. I asked about the human tissue method, and they said that breaks down over time as well.
My advice 9 days post-op is once you have had all your questions answered, and feel you have the best surgeons available to you, preferably a urogynecologist, go for it! You can do this! In many ways I already feel better than I did dealing with all of the prolapse issues.
I will pray for you as you pursue this. There is so much to take in.
Hugs

I can't contribute to the method discussion, but this sounds...rough! Hope you heal quickly and that you and your doctor as a team choose the best options for you!

Dee

Many thanks to all of you for your replies

cw--

I'm sorry you are having these problems.

I am one who had anterior bladder mesh for a cystocele that eroded. I wish I'd NEVER had it. I'd also never recommend it for anyone I knew or cared about. It ranks among the worst experiences of my life. Truly. I had 3 surgeries to remove the polypropylene mesh along with several in-office 'clippings' that were horrible. If I had it to do over again, I'd get a doctor that would use my own tissues (also called an 'autologous' or fascial sling). I just wouldn't risk any other type.

As for the woman who had the Burch procedure that lasted 10 years: wow! That's a good long time for one of these things to last.
Since I've had the erosion, I've read a lot about the methods available--yes, hindsight is 20/20 isn't it?--and it seems the literature says that the abdominal approach lends itself to less chances for erosion overall. [See pubmed.gov for references on 'vaginal mesh erosion'].

Of course, it's best to study it out for yourself, get a 2nd & maybe even a 3rd opinion, and make the best decision for you with the best knowledge you and your doctors have.

I also recommend a highly skilled UroGYN or URO (urologist--a practice that focuses on women, that is) to do the surgery, too.

I just had surgery a week ago, and my first dr wanted to use mesh EVERYWHERE. He did not like me questioning him at all, so I got a second opinion and we worked very well together. I felt the same way as you about mesh. That's some scary stuff. I had a severe rectocele and my dr (a urogynocologist) used a porcine graft and also stitched it up really well. For the cystocele he found that when he suspended my vaginal vault that the cystocele corrected itself and was strong enough to not need any further repairs. He used only stitches for this and did not call it the Burch procedure, but basically, I think that is what it was.
He did end up using a bladder sling and I felt comfortable enough with his knowledge that if something went wrong he would be able to remove it.
Good for you for doing your homework on this- I think it is important to know what your options are!

Mahalo
It seems as though my post was edited.

The Dr. I am seeing wants to use the mesh sling and thinks that would give me the best result. I want him to use biological material. I will be having another consultation. It seems as though the two Dr.'s I have consulted are into the mesh. However, the FDA results on using the mesh for slings is still out and they will be continuing to investigate it when they have a panel of experts meet in September.