The most difficult thing about what I do has nothing to do with my own complications to do with my mesh bladder sling. It has to do with women who contact me searching for other methods due to prolapse or urinary incontinence. I am NOT a doctor or a nurse and everything I have learned about my own situation comes from searching, reading and getting myself educated. Plus listening to women who are going through excruciating complications of the various mesh sling surgeries offered by doctors around this country. My foremost concern has been to listening to women who are so ill from mesh slings without anyone listening to them, and helping them through to a hopeful, better life.
I am still trying to do this myself and in October I will have mesh removal. To understand my choice of surgeon, you can go to this link and read for yourself. http://teapapers.com/bladdersling/2012/06/mesh-dr-raz-u-c-l-a/
So I have been reluctant to take on anything else until my surgery and recovery is completed and yet these questions about non mesh surgical procedures keep coming in. When they do, I truly do not know what to tell women other than you have to get educated. You cannot sit back and let someone else take over and hope they know what they are doing. You have to find a good surgeon WITH EXPERIENCE in the technique you choose to have done and UNDERSTAND IT YOURSELF. Then you will have to INTERVIEW the doctor you THINK can do a good job and make SURE he can. There are no guarantees with any surgery. There are risks. You need to understand the risks and complications and choose wisely BEFORE you have any procedure done.
Rarely when a woman reaches the point of needing any prolapse surgery is she dying or close to it or she would not be contacting me. She is already researching to find out about what a sling is and what she can do as an alternative. This is because of all the TV advertisements from lawyers to do with taking cases of mesh related complications. So this is what I would tell any women. You have to think logically. Would you rather take a couple of months to research and choose the procedure and the doctor, or would you rather take on even a slight chance that you will wind up like me and the many thousands of women with serious complications from mesh and get the job done quickly? Once you have answered that question, more questions will arise.
Do not read the first paragraph about any procedure and decide “Oh yes, that’s the one I’ll choose”. You have a huge amount of work ahead of you to try to keep the life you have now. No one is going to hand everything over to you on a plate. No one, not me or any doctor. You are it. For perhaps the first time in your life you have to take control of it. No excuses! None of ‘I am so busy’, ‘I work full time and juggle kids’ , I don’t have time’. Make the time. If this is the first time in your life you choose you, do it! Your decision can affect the rest of your life. Remember if you choose quickly you may have all the time in the world where you cannot do very much at all because you are in pain. You may not be able to play with your children any more. You may lose your partner because you can no longer have sex. You may wind up living in so much terrible pain, than you may possibly contemplate suicide. You may wind up alone and everyone leaves you to suffer without help. MAKE THE TIME!
So what do you need to know? I can only give you what I have learned and believe me it isn’t a lot on this subject. So I am going to provide you with the quick information I have gathered and a few links. The rest is up to you. Now read on. Do not be bullied by anyone you think has power over you. They don’t. Not doctors, not friends nor family members. This is YOUR life.
I am giving you a mixed bag of information and procedures. You should understand that sometimes a doctor could be swayed by medical device manufacturers and their products. A doctor may also not be trained in non product procedures or even if he/she is, you have to ask how many they have done not just twenty years ago, but every day on a regular basis. Also understand that ALL PROCEDURES HAVE RISKS AND COMPLICATIONS. MAKE SURE YOU REALLY NEED IT BEFORE YOU DO IT.
Lesson #1. PLEASE NOTE; You also have to understand what these sutures are made of and then research the name of them and IF there are complications. Certain sutures have been recalled in the past due to how they work against body tissues. Retropubic suspension uses surgical threads called sutures to support the bladder neck. In this operation, the surgeon makes an incision in the abdomen a few inches below the navel and then secures the threads to strong ligaments within the pelvis to support the urethral sphincter. This common procedure is often done at the time of an abdominal procedure, such as a hysterectomy.
Lesson #2. Traditional non mesh sling procedures. Sling procedures are performed through a vaginal incision. The traditional sling procedure uses a strip of your own tissue called fascia to cradle the bladder neck. Other slings may consist of donor natural tissue or synthetic material. The surgeon ties both ends of the sling to the pubic bone or ties them in front of the abdomen just above the pubic bone. I took this latter excerpt from this link http://www.voicesforpfd.org/p/cm/ld/fid=90
Lesson #3. Making bladder sling using pig skin. Though there has been a great deal of success using human (cadaver) or porcine (pig) fascia (connective tissue) to create biomesh, there is a slight risk of tissue rejection. Therefore, instead of synthetic mesh or biomesh from outside sources, some surgeons will propose using the patient’s own fascia to fashion an organ sling to reinforce stitching. The fascia can be harvested from a thigh or the abdomen during the POP repair surgery. The surgeon removes a narrow strip of tissue several inches long from which to create a sling for the bladder. The surgeon anchors the sling to strong tissues in the patient’s pelvis at either end, forming a tension-free “hammock” to help hold up the bladder. Since the sling is made of the patient’s own tissue, there is no risk of rejection. And since it is not a synthetic material, erosion into the vagina is unlikely as well. Other doctors will opt to perform POP repairs with stitches only, using no slings or reinforcing materials at all. Though this method carries the risk of stitches failing to sufficiently support the healing pelvic structures or from the reoccurrence of prolapse years later, it has fewer overall complications than sling and mesh methods as a general rule. I took this excerpt from this article. http://www.hystersisters.com/vb2/article_453678.htm
Lesson #4. Understanding the Burch procedure. This method uses sutures to hold the bladder to stop leaking. I do know two women who had this done 36 and 40 years ago without any complications. That being said, all procedures can have complications, many due to the skill of the surgeon. Read, ask and make an informed decision. I took this from this article. http://emedicine.medscape.com/article/1893728-overview You can watch a video of a doctor describing this procedure here. http://www.empowher.com/urinary-incontinence/content/what-burch-procedure-dr-alinsod-video
Lesson #5. A newer method of the surgical procedure. http://www.reproductivecenter.com/stressincontinence.html explanation of laparoscopic Burch procedure.
Lesson #6. What is a pessary? If you have decided with all the problems you do not want any surgery right now and want to take the time to understand all these methods, you may want to look into a pessary as a temporary method of prolaspe care or as a permanent solution. Sometimes we also have to face the fact that as we age, so do our tissues. I have had women contact me because their aging mother was given mesh sling surgery and they are in agony. I could never do this to anyone too old to understand and I hope you won’t too. I took this paragraph and have included the link so that you can read more. ‘With the aging population in the United States, there has been a renewed interest in pessaries as a conservative alternative to surgical repair for pelvic organ prolapse (POP). They present a good option for patients who have not completed childbearing, do not desire surgery, or are poor surgical candidates. Long-term pessary use is a safe and effective option for patients with POP and stress urinary incontinence. Although serious side effects are infrequent, insertion and removal of most pessary types still pose a challenge for many patients. Pessary design should continue to improve, making its use a more attractive option’. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2876320
This is part of an email I received from a wonderful lady who has been through mesh removal now and is still recovering. She was a lady who led an active life. “I wore a pessary successfully for about 5 years prior to mesh sling surgery, winning my age group in many triathlons and being extremely active and healthy. A pessary works great for most, if not all women with prolapse. It’s a non surgical remedy as easy as putting in birth control or dentures. I never slept with mine and it came in and out in a manner of seconds. In retrospect I would have continued using it and would have avoided all of this misery. I don’t know why it isn’t used more commonly. There’s a size, shape, and type for everyone and most prolapse cases. I honestly don’t know why surgery is listed as the only remedy. I have 2 pessary’s in my medicine cabinet that I tried to keep me comfortable awaiting this last surgery but I was unable to use them because the mesh was making it impossible to have them inside me. After the surgery in October scar tissue help up my bladder. Going in for this last surgery June 29th it had fallen again and Dr. Raz said he used permanent sutures to hold it back up as it was pressing on my urethra making it impossible to void except a few drops so I felt like I always had to pee. If this falls again I’m not sure what will work because of all the work, but my first choice would be a pessary.”
I am sure that once you read this blog, you will be overwhelmed and cannot make any decision for awhile, but that is okay. Take it one step at a time.
Let me get something straight once again. I am NOT a medical professional. I am a woman who has serious complications from a mesh bladder sling. What you choose to do is up to you. How you choose to live your life is up to you. I wish you luck.