Rectocele and Cystocele repair

My OBGYN said she has been doing prolapse repair for the past year a different way than she used to before. She gave me a brochure and I looked it up on the internet. It's from AMS and is call Apogee and Perigee. Has anyone ever had repair work done this way? I'd be interested in hearing how it's going. My OBGYN said I could return to work after one week (I have a desk job) but have to be careful not to lift anything heavy for 8 weeks. I was really happy to hear about this because of the short time I would have to be out of work.

It looks like the same type of procedure as the prolift system I had put in. It uses mesh. I am having a problem with mesh erosion with it, and the urogyne I consulted at the Mayo Clinic told me he is seeing a lot of problems with these kind of mesh procedures--and these problems are hard to fix, because the mesh becomes embedded in your tissue.If it starts to erode through your vagina, its really hard get out without a lot of cutting.

There is a website:www.pelvicfloor.com, that is run by a uro-gyne from Canada. Not long ago he posted a warning about how the mesh eroision rate for this stuff is much too high, and that sexually active, younger women should not have this stuff put in. I wish I had known that before I had this done! I would highly recommend that you go to that web site and look for that warning. It is posted in the discussion section.

I think the manufacturer's do a good sell job to the doctors, and make money on these systems. Your doctor may be very good, but I would ask her directly what the erosion percentage on this procedure is. Also ask how many systems she has implanted. I would also ask if she could recommend an alternative surgery to repair your prolapse problems. If she isn't willing to give you alternatives, I would get a second opinion.

The Mayo doctor is waiting to see if my tissue covers the mesh, because removing it would be so messy. I'm going in to see him in August, and I'm very nervous because my husband feels something sharp poking him when we have sex. It also doesn't stretch so sex can be painful. (The vagina expands during sex--the mesh doesn't.)

Good luck!

Yes, I have been afraid of the mesh too, sometimes
they don't know the consequence for quite a while
after something new had comes out, and too, they
don't really listen and make a connection when they hear it. I do feel like I need something to hold all that
up, though.

I recently had cystocele repair using Avaulta, which is mesh but it is coated in collegen. It is suppose to have a much lower erosion rate. My surgery was June 20th, and so far so good. I have a 10# weight restriction for 8 weeks, no sex for 6 weeks, off work for 6 weeks ( I can work from home starting week 3 if I wanted).
Since this was my 3rd repair for cystocele, DR said I needed mesh since my own body did not seem to want to hold up.

Please look up that mesh warning on the Pelvicfloor.com website the warning is written by a uro/gyn from Canada and he believes that absorbable material is the only sure way to prevent rejection. Good Luck with your decision. Hugs.

I looked at pelvicfloor.com but, if you read under laparoscopy, this DR states he uses polypropylene mesh also. I think it depends on the individual. Only you can make the decision. I personally have had 3 repairs that did not hold, and I am a very active person that could not function as I wanted to with the prolapse problem. My DR could have done the Perigee/Apogee or Prolift or Avaulta. He choose Avaulta due to lower erosion rates.

If you read in the discussion group on Pelvicfloor.com the doctor says he only uses synthetic mesh for small repairs such as the tot/tvt and not for vaginal repairs. Look up the message about 'Mesh warnings'.

My Dr. also wants to use Prolift mesh for my posterior repair. I asked him about the erosion rates and warnings and he said that for women with healthy vaginal linings and good estrogen levels the erosion rates are very low. He said the problem comes in when you've gone through menopause (either naturally or surgically) and the vaginal walls have thinned, which is the case with most rectoceles. He said he wouldn't dream of using mesh in those instances. In my case, most of my problems are in my perineal area, which is very difficult to repair without some kind of graft material.

What he says makes sense, but I'm still researching and looking at options.

Good luck to you with your decision!

I've had posterior twice and was told that Dr did not use mesh either time.

I will always believe the first repair prolapsed or entire rectocele was not fixed in first surgery. Dr said it was a different place, but stitches were certainly in the same place. Quite costly and dangerous to require 2nd surgery.

And, now the area where 2nd repair was done feels uneven instead of smooth like the tissue should be. I thought I still had stitches in cause of the roughness.

See Dr next week for 6wk postop, so wondering if this can be fixed w/o having to have surgery again??

Renewal
I had a rectocele and enterocele repaired in Jan 05. My Gyn used pelvicol, which is pig material. It has held up good. I continue with constipation issues, so I went to a colon rectal dr. I had a defecograph done, which shows a enterocele and 4cm anterior trapped rectocele. I went to the uro/gyn who did my cystocele surgery in Sept 05. He said it is still in very good shape anatomically. He thinks he will need to use mesh to lift up my entire rectum. I guess I have lost support in those muscles and things that hold the rectum in place, so it bulges into the posterior wall when I try to go. I will know on the 8th if I am in for a abdominal repair surgery. I think I had this rectocele even after my gyn fixed it 1 1/2 years ago. I never felt like it was fixed.
Maybe this is a similar situation to you.
Good luck on getting it fixed right.

I don't trust these new repair surgeries using mesh until it has been proven to be safe. I will have to really talk to my dr about the repair and how it will be done. I don't want anything used that is still being tested.
Peggy