A lot of controversy regarding surgical mesh exists, especially when surgical mesh is used to treat vaginal and/or uterine prolapse or urinary incontinence. The truth is, there are many different surgical mesh products used for many different pelvic floor disorders, and they are not all created equally. Some are considered to be “gold standards,” or “the best things out there” for prolapse or incontinence; whereas other mesh products tend to have higher complication rates and are not considered the gold standards. When it comes to surgical implants of any kind, there are always known complication rates that come along with these implants. A risk-free surgical implant does not exist. Implants are used when traditional surgical methods do not provide optimal success rates or if there are no other means of correcting the dysfunction. For example, a total knee arthroplasty (knee replacement) is a surgical implant used very commonly. Its use provides an improvement in the quality of life of patients with knee pain that other treatment methods cannot provide. It has a known complication rate and sometimes the implant must be removed due to these complications. Mesh used in the pelvic floor for prolapse or urinary incontinence is no different. Some pelvic floor mesh products have higher complication rates than others.
Prior to the use of mesh for pelvic floor disorders, the surgical options were very limited, with less than ideal long-term success rates. Mesh was incorporated into the pelvic floor surgical regime in order to provide higher long-term success rates, which it has done, to an amazing degree, in fact. Many studies have been done looking at these success rates, comparing surgical procedures with the use of mesh versus procedures without the use of mesh. For several pelvic floor disorders, the surgical mesh procedure provides a longer lasting surgical correction, with a low complication rate. Mesh however, is not indicated for every type of pelvic floor disorder. So when discussing surgical options, ask your urogynecologist to clarify if a mesh product will be used and if so, what the associated complications are. As stated earlier, some mesh products tend to have higher complication rates; whereas other mesh products do not. Ask your surgeon to clarify what types he/she uses.
This is where we thought we would put “How to Take Care of Her When She Gets Home,” but let’s face it. The guys want to know…
The answer to that question can vary depending on the situation, including what surgery or surgeries are done. Usually, it is something like six weeks, but may be longer, depending on the woman’s comfort. Another major factor affecting this answer is whether or not she had other procedures done along with lifting her pelvic organs, especially the Anterior and/or Posterior Colporrhaphy (Anterior and/or Posterior Repair). You will have to ask her doctor this question to know for sure.
Improved sexual intercourse is not guaranteed, but is often reported by patients and partners. It only makes sense that if the vagina is held firmly back inside the pelvis instead of falling out, vaginal intercourse would be easier and more gratifying for all parties involved.
When the patient comes home, she will need some help. The most important thing is for her to not lift heavy items. The action of lifting heavy items will cause an increase in pressure in her abdomen (belly), which will then cause an increase in force downward on her vagina, thus increasing the risk of the repair failing. So, someone else should do all the household chores she usually does, for at least six weeks. Any chores that require lifting more than ten pounds should be done by someone else for at least six weeks.
That depends on the type of work she does and what type of procedure she had. If she sits at a desk, she may be able to return to work in as little as two weeks. If she does heavy construction, it could be as long as ten weeks. You would need to discuss this with your doctor.
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At UGYN, we’re cultivating a community where members feel safe sharing deeply personal experiences, photos, reviews, and opinions without fear of judgment. We also want you to be able to trust that the information you find here has been posted without bias or a hidden agenda.
The Code of Conduct outlines what we expect from you, and what you should expect from others. Still not sure if you’re following the rules? Check the UGYN Terms of Service or ask us. Also, we reserve the right to modify these guidelines at any time without notification.
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UGYN does not discriminate based on positive or negative views, or on the basis of race, gender, sexual orientation, gender orientation, disability or status.
UGYN hosts diverse discussions. We give community members space to share their opinions, debate issues, and support each other. Even when things get heated, we expect you to show respect for all members of the community.
Negative opinions and disagreements are fine, but it’s not appropriate to use UGYN to bully, name-call or insult other community members. Follow the rules of good debating and address the issue, not the person.
Report any of the above using our Contact Form
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Unless otherwise directed, you may only use UGYN as a consumer. (Using UGYN as a Health Care Provider requires profile approval.)
Do not use UGYN to promote your own interests or those of anyone you know, including family, friends, affiliates or employers. This includes both:
In addition to the Code of Conduct above, these additional guidelines apply to Health Care Providers on UGYN:
Health Care Providers are expected to maintain professionalism at all times on UGYN. Do not bully or post disparaging comments about community members, other Health Care Providers, or UGYN.
Do not post any content that violates HIPAA or other applicable health-privacy laws. Consider the privacy and safety of all community members before posting.
Follow Our Photo & Video Guidelines
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Clearly explain any conflicts of interest, including products, brands and research funded by third parties. For example, if you are receiving money from a brand whose product you endorse, clearly define this relationship in all relevant posts.
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The mission of UGYN is to help consumers make confident decisions about urogynecology and urogynecologic procedures.
Health Care Providers who violate UGYN Terms of Service, Health Care Provider Code of Conduct, the Code of Conduct or the Photo & Video Guidelines may have their profiles suspended, limited or removed, temporarily or permanently, in UGYN’s sole discretion.
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UGYN, Inc. Attn: Legal, P.O. Box 18268, Oklahoma City, OK - 73154
Urogynecology is a relatively new subspecialty of obstetrics and gynecology. It has grown out of need. Urogynecologists focus on the care of women with bladder issues and symptomatic pelvic floor relaxation.
For time immortal, there has been a need for therapies to treat the problems women face that are related to childbirth, aging, and the forces of gravity. When women go through pregnancy and vaginal delivery, the organs of the pelvis are stretched and rarely return to their pre-baby state. These effects are amplified by age, a genetic predisposition, and other medical conditions such as diabetes. When the uterus and vagina lose their normal support, they begin to fall. They can even fall outside of the vaginal opening. This phenomenon is called pelvic floor relaxation or prolapse. There are several different types of prolapse. [link to types of prolapse] For years, the best treatments doctors had to offer for these issues were exercises, open abdominal surgeries with large incisions and difficult recoveries, or the use of pessaries. Pessaries are devices that must be worn constantly to physically push the organs back up into the vagina and hold them in place.
Surgical robots were originally developed by the military with the idea that a surgeon could operate on a wounded soldier from a remote location, sort of like flying a drone. What has evolved is totally different. The robots are now used by surgeons sitting at a console in the same operating room where the patient is. The advantage the robots offer is that surgeons can do very delicate surgeries inside the abdomen through very small poke holes rather than through large incisions. The result of all that is that the patients can have less blood loss, less post-operative pain, and require fewer days in the hospital. In fact, the surgical robot actually makes some surgeries much more practical than their open counterparts have always been. Specifically speaking, the gold-standard surgery for uterine prolapse is the sacrocolpopexy, which has traditionally been performed through a large incision in the abdomen.
The Robotic Sacrocolpopexy is performed mostly by urogynecologists. It is done in conjunction with a robotic hysterectomy in women with utero-vaginal prolapse. It is also done alone in women who have previously had a hysterectomy and now have vaginal vault prolapse. [link to types of prolapse] In a Robotic Sacrocolpopexy, from inside the abdomen, a Y-shaped piece of flat surgical mesh is used. The arms of the “Y” are sewn to the front and back of the vagina respectively and the stem of the “Y” is sewn to a ligament on the inside of the sacrum (lower part of the spine attached to the pelvic bones.) This procedure lifts the vagina back into the pelvis and securely holds it there. This surgery has a high success rate, higher than most other prolapse surgeries, making it the gold standard surgery for the treatment of uterovaginal or vaginal vault prolapse. When indicated, a procedure for urinary incontinence can be done at the time of a sacrocolpopexy. [link to types of urinary incontinence]
The primary benefit of this surgery is obvious. It is that the patient’s pelvic organs are no longer falling out of the vaginal opening.
The women who have had these procedures report that they are more comfortable both mentally and physically when not having to deal with the constant vaginal pressure and discomfort.
This obviously goes with the above topic, but women are happier after these surgeries, because they no longer have the anguish that goes along with constant worry about feeling less feminine, poor sexual performance, and embarrassment.
Another less obvious benefit is improvement in urination. By pulling the vagina back into the pelvis, the urethra (the tube from the bladder to the outside) is pulled back into a more normal alignment allowing more normal urine flow, without obstruction. This can improve the bladder’s ability to empty and reduce the risk of urinary tract infection.
Improved sexual intercourse is not guaranteed, but is often reported by patients. It only makes sense that if the vagina is held firmly back inside the pelvis instead of falling out, vaginal intercourse would be easier and more gratifying for all parties involved. Many patients report this sort of result. However, in a small percentage of cases, the implanted mesh can erode through the vaginal wall making intercourse uncomfortable for male sex partners. Also, any prolapse repair procedure, not just sacrocolpopexies, can lead to discomfort with intercourse, but fortunately, these problems are the exception rather than the rule.
Another surgical option for uterovaginal prolapse that can be done robotically is a uterosacral ligament suspension. In this surgery, the surgeon ties the upper part of the vagina to a pair of ligaments in the pelvis called the uterosacral ligaments. These ligaments lie on either side of the lower part of the sacrum and are in part responsible for suspension of the top of the vagina. This is done with suture. No surgical mesh is used. It has the same goals and benefits as the Sacrocolpopexy. The main difference is that many studies have found the Uterosacral Ligament Suspension has a slightly lower long-term success rate when compared to the sacrocolpopexy. One of the benefits of this procedure is that since there is no mesh used, mesh erosion is never an issue.
Other surgeries are often performed together with one of the above procedures. If the patient has a weak front vaginal wall and her bladder is bulging into her vagina, this is called a Cystocele. The surgery for this is called an Anterior Colporrhaphy (commonly known as an Anterior Repair). If her back/posterior vaginal wall is weak and the rectum is bulging into her vagina, this is called a rectocele. For this, the patient might need a Posterior Colporrhaphy (Posterior Repair). If the woman leaks urine when she coughs or laughs, it is called Stress Urinary Incontinence. The most common surgery for that is a Urethral Sling procedure to help prevent urine leakage.
The sub-specialty of Urogynecology has grown rapidly since the introduction of the surgical robot, but not all Urogynecologists are firm believers in robotic surgery. Some of these doctors still prefer open procedures because that is what they have experience doing.