To have surgery or not?

How do you know? I am suffering from a leaky bladder after 2 children. I know I am a good candidate for the repair surgery for cystocele and rectocele too I think. I had damage after our first child and always figured I would get this surgery to repair the bladder after we were "done" having kids, but I never researched it. I have done physical therapy and it helps, but it's not a fix for me. I finally sat down and talked to my OB about getting my bladder repair and he recommended a vaginal hysterectomy and retain my ovaries. This was a shock to me and I made an appointment with a urogyn for this Friday. I will see what he says.

I know this is a major decision and major surgery, but I am pretty scared. Right now, I can not exercise the way I want, but I am not in a lot of pain. I do not have pain with intercourse. I am so worried my surgery will result in complications and I will be worse off. Anyone else in a similar situation?

Any advice? And what would you ask the specialist this Friday. I am new to all of this and grateful to have found this site.

Hi SCA,
Well, I'm sorry to say it's a decision only you can make, and I know that doesn't help. Why did your doc recommend a hysterectomy? How is he sure that will solve your bladder problems? Those are two of the questions I would ask. I had a slight leakage problem before my surgery, and it's still there. Time will tell if that's just a result of my bladder recovering from the trauma of surgery, and my doc has me keeping a log for the next few weeks to help diagnose the issue. This IS major surgery, so I would try to get as much assurance from your doctors as you can that going through it will solve your current problems.

Only you can decide. The one thing I would say (having just had a second repair in less than 18months) is find a surgeon who does site specific repairs and doesn't use polypropylene mesh (I have just had a surgisis porcine graft to complete my repairs). After a 6 hour surgery, my surgeon is confident that he has achieved a lifelong cure.

Both of these replies are helpful in preparing me to see the specialist, thank you

As far as why my OB recommended removing the uterus, he says taking it out will help the bladder repair's success but he didn't say why really. Just the pressure of the uterus being gone was all I gathered. I was not at all prepared with questions at that appointment because I wasn't expecting a VH to be recommended.

Originally I feel like I am young enough, that I would like to have this repair done rather than live with the bladder issues, but I am beginning to be so scared of complications. I hope my appointment with the uroGyno leaves me feeling more confident in what I should do.

that is the question i asked myself. elective surgery?? why, I can live with this, i thought. i had a level 2+ cycstocele. and had it repaired 2 1/2 weeks ago by a very fine specialist in the dfw area. he just does 'self skin' repairs, no mesh.

i have had NO complicaitons from the surgery. i can tell it worked, and could tell with in a few days. so yes, i am glad i did it. i have had other complictions...migraines and a horrible cough, which worries me about stitches ripping. at a recent chech up with pa, she said it looks good.

as to the hysterectomy? i asked my ob, went to get an exam, and unless there are REASONS to do it, such as IT has dropped, or a history of uterine cancer, or other issues with it...she saw no reason to do it. someTIMES it will put more pressure on that area and the pelvic floor, and cause the surgery to weaken, but at this point, mine has not dropped.

so, i would ask if your uterus/etc has dropped. if you have any reason for it to be removed.

you are young, you should handle the surgery fine. i am 52 and fit, and other than really non related issues, the surgery was easy. no pain ' down there' other than when they removed the packing. ouchie. like a reallly bad bandaid pull in a really bad place. but no pain for me. just a nasty cold and headaches.

so, as my dr. said, he doesn't this all day long, NOT to save lives, but to make the quality of life better.

yes, the recovery (only in that you can't do anything) is slow, but for me, only do to that restriction. i am a bit slow. and feel a bit heavy down there as I think the coughing has aggravated a rectocele i did not have fixed, and i would say staying off your feet afterwards is key to recovery. horizontal feels best due to swelling i presume. but, i would think you would do fine.

good luck, and make sure the doctor is really good. ask around and don't be afraid to change to a real specialist if you need. pm me if in the area and i'll share names.

I had major repairs done back in Nov. and feel great! Just as every person is different doctors are different as well. My urogyno would not do the repairs without a hysterectomy as my uterus was prolapsing and just too much stuff falling out!

I had mesh A & P repairs as my doc has great success rates with that and wanted to give me a strong repair as i teach tap dancing for a living. My surgery was a vaginal hyster, robotic sacral colpopexy, and laproscopic for some of the other repairs and bladder sling. 5 1/2 hours in surgery and a long recovery but so good to be normal!

Hi,
I am having surgery on Aug 20 and have been poking around this site. Your message made me think of where I was a few months back. This is such an individual decision and there is no single answer for everyone.

I have been told I have a 3rd degree cystocele, 2nd degree uterine prolapse and 1st degree rectocele. I was very active (running, biking, yoga) prior to the birth of my first child (March 2011). The damage was all due to a very difficult vaginal delivery ("sunny side up" baby). Although I have no pain, I do have a large bulge and have been using a pessary since 4 months postpartum. I retain about 170 ml of urine in my bladder and have frequent urinary incontinence.

I too was shocked when my urogyn suggested a hysterectomy along with the cystocele, rectocele and bladder sling repair. I thought is was drastic, but being that my uterus is already prolapsing, she convinced me that it was the right thing to do for the best chance of a permanent fix. I had a long discussion with my GP and she also seemed to think it was the best way to secure a good and permanent outcome. After much deliberation, I am going forward with the hysterectomy as I want the best chance at long term improvement. I so want to return to my active self without dealing with the incontinence and extreme bulging that I feeling during exertion.

Good luck with your decision!

Thank you for the thoughtful replies, I will update after my specialist appointment. I appreciate the various replies that have given me some question to ask myself and the doctor on Friday.

Hi,
I had my hysterectomy done when I had my BMX back in Mar 1. The hysterectomy was the easy part, in fact, I wish i had done it sooner!!
My pain and issues came from my BMX and the stupid drains (appendeges I called them last time I had them with my last surgery). Now I am looking at a rectocele, cystocele & a TVT. I am just wondering what the recovery periods is and what I can prepare for.