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Incontinence

If I have surgery will it be a success?

06/18/2007

Question:

I have had a protrubence down my vagina for 22years. I am now 63. This lump appeared after moving heavy furniture in 1985. I may add I have also bronchiectases which causes me to cough violently.

In the early 90`s I saw 3 gynecologists privately. The 1st one said yes he could do something for me, but it was a catch 22 situation due to my chest condition, and that all his work could be undone by my bad coughing. The 2nd one said he could stitch me up, and just leave me with a hole to wee through. The 3rd, which was the top gynecologist said, as I have had various procedures including repairs etc: there wasn`t anything he could do for me.

In 1999 I returned to my GP who sent me to see someone not a gynecologist, but someone who specialised more in the bowel aspect of surgery, it was this fellow, who correctly diagnosed me as having a rectocele. He said I should wait a year or two before going back.

I have now been back and seen a general surgeon, who has refered me back to gynecologist. I am puzzled about the whole affair. I don`t know if I should be seeing a gynecologist, or should be seeing someone who deals with the other end.

I really would appreciate some advice, as I feel I have been pushed around. Things are really bad at the moment, but I am also worried, if I have surgery I may further damage myself, due to my violent coughing, which is a nessecity.

Thank you.

Answer:

Although, you did not mentioned any voiding problem with your condition but a assume you do not have any dysfunction in that area. This is good for, having urinary condition complicate your treatment.

All the options you have been offered are reasonable. However, you should choose procedure which is more suitable for you and your life style. Repair of rectocele is simply done by a gynecologist. Cystocele and rectocele or vault prolapse can be corrected by vaginal approach or colpopexy. These corrective procedures should be tried by an expert urologist or gynecologist. There are also urogynecologist who have the expertise as well.

The last and simplest treatment without surgery is placement of pessary which as an appliance fitted to your vaginal canal to lift the prolapse. With you severe cough it would not be the best option. This also can be offered by your gynecologist.

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Response by:

Ahmad  Hamidinia, MD Ahmad Hamidinia, MD
Formerly, Professor of Clinical Surgery
College of Medicine
University of Cincinnati