questions to ask if you're considering surgery for prolapse

[Chamsia]

My very scientific friend came up with these questions, off the top of her head, for me to ask a surgeon as I consider whether to pursue an operation for my POP.

This list is so good that I have to share!

Please forgive the sloppy formatting.  It started with numbers, then we added thoughts and more questions.  And I'm too tired to edit!

Best wishes to all of you mamas who need to decide how to proceed with this stuff...

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1.  Draw me a diagram of where my organs should be...and where they are now...and where they will be in a year from now without any other intervention besides occasional pessary use. 2.  How many of these surgeries do you do in a year? 3.  What is the chance (in %) that I will become incontinent due to surgery? 4. What is the chance (in %) that I will become incontinent within X years WiTHOUT surgery? 5.  Ditto both questions for painful intercourse. 6.  What is my increased risk of infection now...with surgery....in X years without surgery? 7.  What exactly is the surgery going to do?  What kind of synthetic material will be used?  8.  Are there alternative ways to do the surgery?  New types of surgery? 9.  Is the surgery full open abdominal surgery?  Is there a laproscopic way to do it?  Where exactly will incisions be made? 10.  How long will the surgery take? 10b. How long will I be in the hospital?  If I'm not feeling well (two young children and a Laura Ingalls Lifestyle :-) can I stay an extra day? 11.  How long will recovery take?  When will I be able to function normally again? (Keeping in mind two active children). 12.  What are the risks of NOT doing the surgery? 13.  If I were going to seek a second opinion (purely for due diligence sake) who would you suggest I talk to? 14.  How much pain do you expect me to be in immediately after surgery?  After two days?  After two weeks? 15.  What kind of pain management will I be given? Is that compatible with breastfeeding? (prob not!) 16.  Cornell is a teaching hospital.  Who EXACTLY will be doing the surgery?  If it isn't you then are you going to be standing next to that person the entire time?  (I am personally OK with this approach, but you might not be.  His answer may vary depending on the degree of difficulty of the surgery and perhaps they can't determine that until they are inside?)  For IVF at Cornell you see residents for the routine daily monitoring but egg retrieval and transfer is always done by one of the REs.  And during daily monitoring as you get closer to retrieval you stop seeing residents and start seeing the full REs...so it seems to be a conservative approach to teaching but of course that may vary wildly from department to department.   17.  Same thing for your anesthesiologist.  18.  What kind of follow up appointments will be necessary? Will they be with him or with a resident?

What if I accidentally got pg after the surgery? How long do you recommend abstinence post surgery?  Will a diaphragm be OK to use then? My local gyn said she would do surgery. What's the difference b/w her doing it and you doing it? Experience I assume but also equipment differences?  Do you do any special technique or is it a fairly standard surgery? Any other post op meds? (routine to give antibiotics?) or post op instructions or restrictions?

Tampons?

Would it make sense to get my tubes tied at the same time?

[cinderella08]

Excellent list!!

[Turquesa]

I would add....."By percentage, what is the chance that the surgery will/will not be effective?  In other words, what is the chance that I will need to do it again?" 

I'm not sure if questions 3 and 4 were getting to that....

I read somewhere that there is a high failure rate on surgery for cystocele, but it's more effective for rectocele.

[Chamsia]

And what about the class action lawsuit against the surgical mesh manufacturers?  Would you use surgical mesh?