A couple of days ago I told you that I am going to undergo pelvic reconstruction surgery. Today I’m going to discuss this decision with you, indepth and personal. I’m going to talk about things that you might not want or need to know. That’s okay. Come back another time.
It is estimated that 30-40% of women in the US suffer from some form of pelvic floor dysfunction. As our population ages, the problem is projected to only get worse.
Many, many women suffer in silence, not seeking treatment, due to unnecessary shame and embarrassment.
It is my sincerest hope that my openly talking about my problem, and what I’m doing about it, will help more women seek treatment so they can live more glorious and joyful lives.
When I think about the female pelvic floor several thoughts come to mind, not necessarily in this order:
1. There is no God. How could a presumably smart God create such a hot mess?
2. There is a God. And He’s a man.
3. There is no God, because no loving God would make the curse of childbirth last a lifetime.
3. There is a God. And He’s a sadist.
4. Neither God nor Natural Selection gives a shit what happens to a woman’s vagina once it is done procreating.
5. The burden of reproduction falls so completely on the woman. When I think about the fact that the very same sex act results entirely in pleasure for the man, and–many months later–possible death or lifelong pain, disfigurement, and suffering for the woman, my blood begins to boil. It challenges me to my deepest core.
A few days ago, I talked about urinary incontinence and the importance of pelvic floor rehabilitation.
I strongly suggest if you are having urinary incontinence problems (even a little dribble now and then) that you seek out the services of a Physical Therapist who specializes in pelvic floor rehabilitation. I do not think a woman should consider surgery until she’s had physical therapy for six months to a year.
Surgery will not repair lax muscles.
If your pelvic floor problems are due to weak or lax muscles you need to address that problem first.
Years ago, when I was working as a post-surgical gynecological nurse, I knew two nurses who both had hysterectomies and vaginal reconstructive surgery within days of each other.
Both women were the same age, both were healthy, and both went to the same excellent surgeon. This doctor didn’t have a fellowship in the subspeciality of Female Pelvic Medicine and Reconstructive Surgery, which is what I’m recommending my readers seek out, but he was a meticulous gynecological surgeon and a caring man. Post-operatively, His patients did well. I even sought him out for a consult at one time, but I wasn’t ready to give up my uterus.
One woman was THRILLED with her results. She couldn’t say enough good about it.
The other woman never had pleasurable sex again. Last I heard she was going in for her third or fourth surgery to try to repair what was left of her vagina.
The above story illustrates the challenge facing me. Many women undergo pelvic reconstruction surgeries every year, but not every woman achieves satisfactory results.
After surgery, many women continue to suffer from the same symptoms that led them to surgery in the first place. Nearly one-third of the women who undergo surgery for urinary incontinence return for additional surgeries later.
But the worst part is that many women end up with additional sexual problems as a result of surgery.
I remember when my mother was going through menopause.
While other women her age that I knew were complaining about dryness and a loss of libido, my mother reassured me that when I hit these years I’d go the other way. Dammit if my mother wasn’t right again. I cannot believe how good sex has gotten for me.
So I must confess that I am facing pelvic reconstructive surgery with extreme trepidation. It seems that just when my sex life has gotten truly excellent, I’m about to put it all on the line.
So the first question I am asking myself is: What can I do to help ensure the best results possible for myself?
To say that I’m scared is an understatement. Losing my ability to have pleasurable sex is about the worst thing I can imagine happening to me.
In fact, if I were being totally honest, I’m flat-out freaking terrified.
Considering what’s at risk and how frightened I am, one of my close friends asked me why I would have this surgery since I’m not having many of the most troublesome symptoms right this very instant.
She’s asked a good question that I want to answer today:
Why am I having pelvic floor reconstructive surgery?
The fact is that I do need a hysterectomy. I have an enlarged uterus with uterine fibroids that bleed. And when they bleed they bleed like you wouldn’t believe. Luckily, they don’t bleed all the time. I have months and months of normal periods punctuated by days where I can’t leave the bathroom because I’m bleeding so badly. These periodic episodes have been happening more and more frequently and my physician says that they are only likely to increase with menopause.
I had an endometrial ablation two and a half years ago which helped a lot, but didn’t cure my problem. When I returned to my OB/GYN to tell her the bleeding had returned, she presented me with my three options: 1) birth control pills, 2) another endometrial ablation, or 3) hysterectomy.
I’ve dismissed birth control pills because I do not like their effect on my libido. It ought to tell you something that I’d rather bleed to death than give up sex.
I initially considered another attempt at endometrial ablation, but during the routine hysteroscopy to make sure I don’t have other problems, i.e. cancer, it was determined that I am not a candidate.
That leaves hysterectomy. Now or later.
I could wait until the bleeding returns; I could wait until I absolutely need a hysterectomy, but emergency surgeries aren’t the best surgeries to have. The best surgical scenario is a scheduled surgery where everyone is calm and collected and prepared, not a running down the hall to save somebody’s life. Trust me on this one.
So, reason #1: I do not want to end up having to have an emergency hysterectomy due to sudden hemorrhage.
Bleeding is not my only problem. I have had two nearly 10-lb babies and have some damage from both of those deliveries (one c/section, one vaginal). A hysterectomy alone will not solve all my problems.
In fact, hysterectomy alone may result in vaginal vault prolapse. Definitely not groovy.
I knew that if I was going to have a hysterectomy, I would also need vaginal reconstruction if I was going to avoid a worsening of my other troubling symptoms.
Because my regular OB/GYN is a rural physician who doesn’t perform vaginal reconstruction surgeries very often, I knew going in that I wanted a referral to a surgeon who does this surgery day in and day out.
A good physician knows her limitations and isn’t threatened when a patient asks for a second (or third) opinion. Because I was ruthlessly honest with her, my physician understood my concerns. She referred me to the same Urogynocologist with a Fellowship in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) who performed her own surgery.
A urogynocologist is an obstetrician/gynecologist who specializes in the care of women with pelvic floor dysfunction. A physician who has a Fellowship in Female Pelvic Medicine and Reconstructive Surgery is a urogynecologist who has received 2-3 years of additional training in pelvic floor reconstruction.
Over the next few days or weeks, I’ll be talking about my process preparing for, having, and recovering from pelvic reconstructive surgery.
I hope you will share this series with any other women you know who might be suffering from this problem.