scheduling sacrocolpopexy and cystocele repair...more than a little scared

I am 62 years old and have had stage 3 cystocele (bladder prolapse) for over 10 years and it has not bothered me much until the last year. I had a bout of bleeding due to some rubbing but it finally quit and I got checked out for uterine cancer (which I did not have). I think the bleeding was brought on by rubbing from a pessary that I finally tried due to urologist's urging. Recently was told that my prolapse is now stage 4. Went to a urogynecologist who is highly recommended and he said the best procedure for me is sacrocolpopexy. I was a bit surprised that he wanted to do a hysterectomy and so questioned him quite extensively. He described it as a "once and done" procedure saying it would allow me to have a better quality of life and I wouldn't have to think about it anymore. Since my mom is 96 and never had a hysterectomy I guess I thought this might be overkill. In order to get out of his high-pressure office I scheduled a follow-up. I just felt like he was way too anxious to get me into surgery. When I cancelled my follow-up with him I was questioned aggressively by the receptionist and received multiple follow-up phone calls trying to get me to come in and discuss "my surgery." My gynecologist thought he might be a bit aggressive in what he had recommended and so she sent me to another urogynechologist in town who is highly regarded. I liked him much better and after examination he recommended the sacrocolpopexy as well. He said he did not think that a simple anterior ligament repair would hold because my ligaments are so weak. He said the sacrocolpopexy done robotically with hysterectomy is the state of the art procedure for my situation at this time. He was very willing to explain things and answer all of my questions and was not as pushy as the first urogynecologist I went to. He even said if I wanted to, I might come and work with his nurse on another pessary fitting to see if I had better luck. He even told me that he could see from my examination that my previous bleeding was likely coming from a small area at the base of my cervix that looked to have healed recently. He said it could have been caused by the previous pessary or just by rubbing on the tissue which was a bit atrophic. He also emphasized that using estrace and/or vitamin E gel or any type of cream or gel would add to my comfort level.

This was a couple of months ago and I decided just to take a break from going to doctors. I have been using the cream and it has helped. However, in the past couple of weeks it seems that the cystocele is causing me more discomfort. It is very difficult for me to empty my bladder and I have had a couple of nights where I am up and down all night trying to empty it and as soon as I get back in bed I feel like I have to go again. I am planning on making an appointment to go back in to the second urogynecologist and work with the nurse that does the pessary fittings. I had told him I was extremely afraid of the mesh and he said it is not the same mesh or the same surgery that you see on all of the class action lawsuit commercials. I just don't know who to believe. I am so confused and feel that the situation is not getting better, in fact, it is really getting worse.

I would like to know if there are any doctors at the Mayo Clinic that perform sacrocolpopexy or who do any type surgery on cystoceles. I would be willing to come and consult one of them but I just don't know where to begin. I would also like to hear from anyone who has had such surgery and how their recovery has been. I have some issues with my back as well and I feel like the prolapse is adding to a heavy feeling in my back and pelvic area. I apparently don't have UTI which is surprising given that my bladder seldom empties. I just need to take the next step but don't know what that is. Help? Direction? I really appreciate it.

@gailg That is me, I’m suppose to have the same surgery January 25 but I still haven’t decided if I’m going to or not. My biggest fear is having incontinence afterwards. They give you all the possible outcomes and this one scares me terribly. Right now I have a level 3 prolapse, bladder, bowel, uterus, but no incontinence other than an occasional dribble from coughing with a full bladder. I went through PT and retrained my bladder so my urge issues are pretty much gone. I’ve also figured out how much fiber I need daily to keep me regular with my rectocele. I’m 59 years old, in good health and am having minimal issues with the prolapse right now. If I do have the surgery I want it in January so it’s now or wait a year. I just keep going back and forth, I haven’t been able to decide. Anyone else have incotinence develop after surgery? If it happens I can do the sling but they said the urge may never go away. I don’t want more issues to develop from surgery.

So sorry you have had these issues? When did you start having problems with this? I have not heard about the belly button problem but did this occur as a result of the laparoscopic surgery? I am unclear as to the order of things. You had bladder prolapse surgery with hysterectomy in May and then because of problems you had revision surgery? Is your doctor a urogynecologist? I am so sorry you are going through this. I am sure you have done so but have you gotten a second opinion as to what exactly you need at this point? I would be hesitant to let the same doctor operate on me again if I had these kinds of complications. If you are in a small town, have you considered going elsewhere for treatment? I had a similar long protracted outcome from an ankle surgery many years ago so I know how frustrating it can be to think you are fixing something and then have these other things happen. I will keep you in my thoughts and am still very curious about exactly what occurred.

Hi Gail, will be so nice to know how you doing after you pelvic prolapse surgery. Did you had any problems with the mesh so far?
I am considering to have surgery too and traveling to US for that reason. Thanks

Good Morning, I am sorry to hear of your experience with the first dr....I had my repair surgery done in March and it was successful it was done without mesh and I did not have to have a hysterectomy. My uro. told me that my muscle spasms may return like a fire storm but would settle down...well they did and I am back in p/t...I am glad I had the surgery I was stage 2 and was very uncomfortable when I went into surgery I was pain free thanks to the p/t....now I have swelling du2 to the spasms it is better but I am still not myself the p/t dose help another thing that has happened since the surgery is I had what I thought was a uti and it turns out the dr. thinks I have ic (no testing has been done) acidy foods cause painful bladder issues so in a nut shell yes I am glad that my insides don't feel like they are falling out and that I am not going thru the hell of one pessery fitting after another that only left me sore and sometimes infected...I did not get the sling I hear a lot of women had problems with that so I am lucky there but I am still in pain and have a dr. that will not prescribe valium (which helped with the spasms) he did order eruogics blu for the bladder pain but it upset my stomach so I am dealing only with the p/t .... I wish I could find another dr. but the practice I go to is the only one in my state and doesn't allow you to see other dr.s... I wish you luck

Hi, is it ok to ask who is the doctor who performed your surgery without mesh. I am looking for a good urogynecologist to do this surgery without mesh. I have hear that Micky Karan in LA is good. Anyone has experience with him?

The doctor’s name is HUDSON, MEMORIAL HERMANN IN HOUSTON, TX. SHE IS VERY GOOD.

Good Morning, I am sorry to hear of your experience with the first dr....I had my repair surgery done in March and it was successful it was done without mesh and I did not have to have a hysterectomy. My uro. told me that my muscle spasms may return like a fire storm but would settle down...well they did and I am back in p/t...I am glad I had the surgery I was stage 2 and was very uncomfortable when I went into surgery I was pain free thanks to the p/t....now I have swelling du2 to the spasms it is better but I am still not myself the p/t dose help another thing that has happened since the surgery is I had what I thought was a uti and it turns out the dr. thinks I have ic (no testing has been done) acidy foods cause painful bladder issues so in a nut shell yes I am glad that my insides don't feel like they are falling out and that I am not going thru the hell of one pessery fitting after another that only left me sore and sometimes infected...I did not get the sling I hear a lot of women had problems with that so I am lucky there but I am still in pain and have a dr. that will not prescribe valium (which helped with the spasms) he did order eruogics blu for the bladder pain but it upset my stomach so I am dealing only with the p/t .... I wish I could find another dr. but the practice I go to is the only one in my state and doesn't allow you to see other dr.s... I wish you luck