Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be next) | HysterSisters
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Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be next) Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be next)

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  #1  
Unread 11-25-2017, 10:50 AM
Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be next)

I first went to my doctor, for incontinence issues. They found out that I had bladder and rectal prolapse. I am going to get a mesh sling for the bladder and they recommended doing prolapse surgery, since I will already be under anesthesia and they are already in there. My doctor has done over 2,000 robotic surgeries, and is well-known all over the country. But I just found out that he would like to do a hysterectomy also for the prolapse surgery. He says it is an inferior surgery with not as great results if you don't take out the uterus while you do it. As far as I know, my uterus is not prolapsed, but he says there is a chance it will prolapsed after the surgery if we leave it in since, since I already have weak connective tissues. I am done having kids, and not having to worry about periods and birth control sounds nice. He says since we are already doing the prolapse surgery, that the healing time will be similar. I was thinking a long-term IUD, but he thinks it's kind of pointless at this point. The other issue is, I have a 4 month old. I had a high risk pregnancy with him, so I have met my maximum with my insurance, so this surgery would be totally covered. It is horrible timing with a baby, but if I don't do it now I probably will never do it because I won't be able to afford it. Would you go ahead and do the prolapse surgery, with a hysterectomy, if it were you in my situation? I am starting to question it because I read so many of you on here have these huge bleeding issues fibroids Etc. The only thing I've had is pmdd, incontinence, some sexual pain, and prolapse. I know you are not doctors I'm not looking for medical advice, just your own opinions. If I do just the mesh sling it is only like a 20 to 30-minute procedure and easier recovery time. But then I wonder if I will regret down the road not doing the prolapse surgery, with or without the hysterectomy. Just not sure how to decide
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  #2  
Unread 11-25-2017, 12:57 PM
Re: Would you get a hysterectomy if...

My hysterectomy was for cancer, and I've often thought of myself as blessed that it wasn't for something really complicated like prolapse!

What is your doctor telling you for a recovery time on the surgery and for weight limits during your recovery? How is adding a hysterectomy going to change that? I know for my hysterectomy, I was limited to lifting/pushing/pulling 10 lbs for the first four weeks, 30 lbs for the next two. I've read that women who've had hysterectomies for prolapse may have longer and/or more restrictive limits, in some cases lifetime limits. Where you have a four-month-old, this is something you might want to consider.

The other thing you should be aware of is that a hysterectomy (removal of your uterus) is not going to resolve your PMDD. PMDD is caused by the hormonal cycles of your ovaries, which will continue once your uterus is gone. Removing the ovaries (oophorectomy) will stop the cycles, of course, but it will also toss you into surgical menopause, which brings a host of its own issues.

I'd definitely suggest getting a second opinion from another doctor, even if you end up sticking with the first one to do the surgery.
  #3  
Unread 11-28-2017, 07:15 PM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

Hi Winter100 to HysterSisters!

I am sorry your are going through all of this but I am so glad you found this site.

I cannot answer your questions, but hopefully the ladies in this forum can give you some insight. It is a good idea to get alternate opinions on your surgery as you may have other options. Here is an article: Do I Need a Second Opinion for My Hysterectomy?.

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  #4  
Unread 11-30-2017, 10:05 AM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

Hi Winter100. You asked for our opinions so mine is yes, I would have the uerus removed if you are finished with having kids. You have prolapse issues because your pelvic floor tissue is already weakened. Once the prolapse/s are repaired, you will have a heavy uterus sitting on top of freshly repaired prolapses. Keeping the uterus in will put pressure on these areas. There is a chance that eventually, your uterus will prolapse in the future and then you will need surgery all over again. That being said, yes the recovery can be worse and yes, it does have weight limits. However, so does a bladder sling and prolapse repair. There are weight restrictions (keep that in mind since you have a baby), no pushing, no pulling, no bending for quite some time...and the weight limit restrictions are usually for a very long time regardless of prolapse or hyst. Might as well get them both done if you're going to have surgery now. The big question for you is, can you do this surgery and still take care of your baby? Remember, no lifting, no pushing, no pulling and no bending. If you do these things before the recommended time frame, you risk failure of your entire surgery, which would be unfortunate.
  #5  
Unread 11-30-2017, 03:19 PM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

I agree with everything cat98037 said. If you can keep one or both ovaries, that'd be ideal so you still have the benefit of the hormones they produce. I would also add that whatever you decide, once you are healed, you should go through pelvic floor physical therapy to ensure your repairs hold and your pelvic floor remains strong.

Best wishes ~
  #6  
Unread 12-01-2017, 09:01 AM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

Hi
I would definitely get a second and even third opinion. If you are considering hysterectomy I would keep your ovaries. Surgical menopause causes a host of other problems and is not easy to deal with. I would also not get mesh sling I would use your own tissue for sling. I had hyst with ovaries removed A Tvt sling and A&p repair. I asked my dr prior to surgery was tvt sling mesh that is all over the news people are suing over. He stated no this is a new mesh. There is no new mesh! Putting mesh in is a crap shoot. You have no way of knowing if your body will have foreign body reaction or if it will erode etc. My incontinence became worse after surgery. Previous to surgery I had no pain with sex. My urogyno told me if I had no pain before surgery I wouldn't after but if I did the sling could make it worse. I now have pain and didn't previously. I have been having pelvic PT but that has not helped. I wasn't offered that prior to surgery. You may want to try that prior to having any surgery. Sorry to sound so negative but I wish I knew prior to surgery what I know now. There are thousands and thousands of women that lives have been ruined by mesh and the statistics are higher than what the surgeons seem to be telling patients.research foreign body reaction to mesh and read some stories on this website on road less traveled. I don't mean to scare you but know the risks before surgery. I wish you the best in whatever you decide.
  #7  
Unread 12-01-2017, 09:24 AM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

  Quote:
Originally Posted by Cyn0619 View Post
Hi
I would definitely get a second and even third opinion. If you are considering hysterectomy I would keep your ovaries. Surgical menopause causes a host of other problems and is not easy to deal with. I would also not get mesh sling I would use your own tissue for sling. I had hyst with ovaries removed A Tvt sling and A&p repair. I asked my dr prior to surgery was tvt sling mesh that is all over the news people are suing over. He stated no this is a new mesh. There is no new mesh! Putting mesh in is a crap shoot. You have no way of knowing if your body will have foreign body reaction or if it will erode etc. My incontinence became worse after surgery. Previous to surgery I had no pain with sex. My urogyno told me if I had no pain before surgery I wouldn't after but if I did the sling could make it worse. I now have pain and didn't previously. I have been having pelvic PT but that has not helped. I wasn't offered that prior to surgery. You may want to try that prior to having any surgery. Sorry to sound so negative but I wish I knew prior to surgery what I know now. There are thousands and thousands of women that lives have been ruined by mesh and the statistics are higher than what the surgeons seem to be telling patients.research foreign body reaction to mesh and read some stories on this website on road less traveled. I don't mean to scare you but know the risks before surgery. I wish you the best in whatever you decide.
What kind of mesh did you get and where was it placed? There are new synthetic slings.....mine will be a small plastic type device with a string on it so that the surgeon can tighten it as much as she wants. This sling can even be applied in the office under local. There are many types of slings and mostly what I hear on this forum is "mesh". It is not mentioned where the meshes are placed, which makes a huge difference. I agree with getting a second opinion....and asking specific questions, as well. OP is already having SUI and painful sex, which is difficult to deal with emotionally, especially when you are young.already having SUI and painful sex. My urogyn explained to me that using your own fascia carries a greater risk of failure down the road and that the site of where the tissue was removed can be extremely painful.My coworker used her own ascia and she said it was horrible and very painful. I do hope the OP is seeing a urogyn, not a gyn. She might find different options. Google Altis sling if you get a chance. They have come a long way for mesh issues. And as mentioned, a lot of erosion depends on where it is placed. If using for A&P repair, mesh is frowned upon but for bladder slings, they have advanced the options available to women.
  #8  
Unread 12-01-2017, 01:25 PM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

I went with the fascia sling because I didn't want mesh or any foreign object in my body. I am hyper-sensitive to a host of things and allergic reactions to odd ball items are very common for me. I also didn't like all of the very real and high volume of stories of complications, erosions, etc. I found them heart breaking and scary. My thought was, why take the risk with mesh if there is a safer alternative?

I did a ton of research and everything I read (and I really looked at it from all sides) showed that the fascia sling is as or more effective long term than a mesh sling. I have heard doctors say things that aren't exactly accurate or they put a spin on something and it is misleading. For instance, I had one doctor say in such a way that the fascia sling has a 50% chance of needing to be loosened - as if to shy me away from it. All the research I read and and at least one other doctor all said it's a 50% chance of a mesh sling needed to be adjusted - so the risk was exactly the same.

I can't compare the fascia approach to a mesh w/r/t recovery b/c I only did the fascia but from what I hear, yes, it is more recovery. However, barring any complications, I can tell you the fascia sling really isn't bad at all. I had two c sections and the discomfort was no different with the fascia incision - in fact, I barely felt my incision. I kept wondering where it was. I had two unfortunate complications that made it a more difficult recovery overall but those two are extremely rare. The problems I had after the surgery weren't because of the process or idea of the sling - it was because of human error.

Yes, get more opinions but also do your own research as many doctors are ignorant, brain washed or biased. I personally am so glad I used my own tissue. I can't reject it and it won't erode. As far as everything I've read and heard, it will last just as long (compared to a functioning mesh with no complications) or longer.

As far as the ovaries, I think I already mentioned it's best to keep them if you can. If you can't or only get to keep one, consider bio-identical hormone replacement when it is warranted. It took me a few years before my body started to show signs of needing any supplementing and then several years after that before any doctor would listen to me but eventually, when I did start them, I was fortunate to find the bio-id kind.

In the end, what matters is that YOU feel comfortable and at peace with your decision. Not your doctors, not any of us but you.

Best wishes!
  #9  
Unread 12-01-2017, 07:49 PM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

I had a hysterectomy, sacrocolpopexy, and a TOT urethral sling all for proplapses. My uterus was also prolapsed, but my surgeon explained that they usually all fall together. The uterosacral ligament holds the uterus, pulling it up, and attaching to the sacrum. This can be torn during vaginal childbirth. At your age, your tissues are probably weak from trauma. So, in your case, your uterus will probably prolapse (my totally not an MD opinion). I agree with taking it out, if you are done having children, to give you the best chance for successful repair.

As others have mentioned, the recovery is longer for prolapse repair than it is for hysterectomy alone. I am currently under a 3 month 10 lb weight limit. I have to have my six year old push the shopping cart and carry the groceries for me. For another two months! If you live somewhere that gets snow, that means no shoveling.This is a big deal and you will need help. If you get the help, you can just snuggle that 4 month old in bed all day, which would be fine. I can’t imagine being a primary caretaker though. If you don’t follow the restrictions, you run the risk of ruining the repair. I would not do it if you don’t think you can follow the restrictions right now. I put off my surgery for years. I don’t know if that made it all worse and made my repairs more extensive or not. Initially I got bad advice from my ob/gyn. When I realized how bad it was, i sought out the best uro-gyn I could find.

As far as mesh vs. your own tissue, there are strong opinions on that one. Yes, many women have had terrible experiences and it’s a scary decision. But Cat is right, the rates of mesh problems vary with the procedure and how it is inserted. The experience of the surgeon also influences the rate of issues. For sacrocolpopexy, which I had, the average rate of rejection of mesh is about 3%, and it is much lower when performed by an experienced uro-gynecologist. I chose to take the chance, knowing that my surgeon has an amazing reputation. I addressed my mesh concerns with my surgeon and she had good answers. In the end, I decided that if I trust her to do this surgery, I would trust her expertise completely. On the other hand, I respect Ciganka’s choice. She researched her options and made the best choice for her. With her sensitivities, that was probably a wise choice. I do not doubt that many women have had horrible experiences, but the data suggests that is not the norm.

Good luck deciding what to do. You will find support here in whatever you decide.
  #10  
Unread 12-02-2017, 12:54 AM
Re: Would you get a hysterectomy if having bladder and rectal prolapse surgery, doctor says prolapse of uterus may be ne

I agree with MtnD. She raises some good options for you.....snuggling in the bed with the baby would be nice! She is right in also saying that if you are the only caretaker, you might want to hold off on any of this surgery until you can get the help you need. I would've never thought of shoveling snow (I live in Houston, where it's HOT) but I have shoveled snow and it ain't fun....at all. My doctor, whom I trust, is a urogyn. If your doctor is a gyn, find a urogyn for a second opinion, especially since you have questions that remain unanswered. My urogyn said that my cystocele and rectocele is at a Grade 2. They are graded 1-4, with 4 being the worst. She explained to me that repairing these prolapses at a Grade 2 is perfect and greatly reduces the chance of future prolapses. So, you want to ask the grade of your prolapse and see where you are at. If you are a grade 3 or 4, I wouldn't wait. I would ask a friend or family member to move in with me for 6 months to help out and go ahead with the surgery. Like you, I understand the timing. I have met my out of pocket maximum, as well. It makes sense to have everything done before end of year. My surgery is scheduled for Dec 28, by my choice. Regarding bladder slings, I agree with MtnD, everyone has their opinion and their concerns are very valid. I will mention to you that you will not find much info about the Altis sling as I think it is a newer one and yes, it has had very successful clinical trials and uses less mesh. Again, as MtnD says, it usually is just the choice of the surgeon as to what they use. For me, I am glad my surgeon uses the Altis vs TOT, ect...

I have learned so much on this forum and I think I know what to expect post-op. I am a nurse, as well. I am not looking forward to my post-op time because I'm having a perineorrhaphy as well as A&P repair and bladder sling. AND.....I'm determined to return to return to work 3 weeks post-op. I figure my "sisters" will get me thru this. Like you, I have incontinence and painful intercourse. I also can see that "bulge". It is embarrassing to me. I am single....I don't want a man to see that blge. I get waxed...I don't even want the person doing the waxing to see the bulge, so I refrain from waxing now. That being said, I will be very glad after the surgery and healing in hopes that I might feel confident again.

Please keep us all posted and let us decide what your course of action will be. We all like to see each others progress. And if you end up deciding to have the surgery, you and I will be close in our post op recovery periods. I'm sure with all the info you have received thus far, you will be able to go back to your doctor or second opinion and make the best choice for yourself.
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