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.

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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.

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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.

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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.

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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.

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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.

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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.

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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? 

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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?

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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.

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So, reason #1: I do not want to end up having to have an emergency hysterectomy due to sudden hemorrhage.

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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.

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{ 22 comments… read them below or add one }

Carol Dias December 29, 2016 at 11:25 am

Thanks for sharing your story with us, you made me very inspired!

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Karen Zaghiyan November 10, 2016 at 11:03 pm

Hi,

First of all hat’s of to you that you have suffered from this really very dangerous and uncomfortable disease. Many women shy to talking about their pelvic problem. But you are the one who have shared all your story with us & I hope that those women will some inspired from you and they will share their problem with their doctor. So that they can live a happy and stress free life.

You are really very brave.

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Brandy September 9, 2014 at 9:04 am

Remarkable things here. I am very happy to see your post.

Thanks so much and I am looking ahead to touch you.
Will you please drop me a mail?
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PK Fields September 18, 2012 at 8:52 pm

Chloe,

You are so awesome for sharing something so personal yet so helpful to other women.

XXOO P.K.

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Chloe September 19, 2012 at 8:45 am

I hope it helps, PK. There is a lot of bad information and women are getting screwed over because of it. Our vaginas are sacred and important and deserve the best. I hope to continue writing about this topic as I continue to recover from my surgery. I’ve learned so much that I want to share.

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Birthblessed December 12, 2011 at 6:53 pm

Honestly, good bowel care is directly related to the amount of urinary incontinence I experience. Some of the things I eat stop me up. That leads to incontinence. And tummyaches. It’s an absolute must to eat plenty of fiber and drink plenty of water.

But I still find the urge incontinence is cyclical. The week before my period starts, I will wet my pants at least once. For two weeks after my period I will never wet my pants.
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Chloe December 13, 2011 at 6:09 pm

If women are shy about talking about their bladders, they are shier to the umpteenth degree talking about their bowels.

I really appreciate you talking about this part of a woman’s issues. Many, many, many woman suffer for these problems in shameful silence. We have nothing to be ashamed about. These problems by and large come about as a result of our life-giving capacity. We haven’t done anything wrong; it is what it is.

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Kat December 8, 2011 at 7:10 pm

Chloe,
I really appreciate you sharing this with us, and I am looking forward to reading more. I just went through endometrial ablation a couple months ago. Still kind of waiting to see if it “took.”
We toyed with bypassing the ablation and just going for the hysterectomy..but just could not go there, for the same reasons you mention here!
Hoping and praying this all goes well for you!

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Margaret H. December 8, 2011 at 4:33 pm

Keep preaching it, sister.

It’s normal to be scared, but you know that, though knowing that doesn’t really help. Just hear this: if you have trouble post-op you will work it out. Your surgeon will help just as much post op as he/she is pre-op, and during op. Because sex is important to you, because you have a healthy, happy marriage – working out your new parts will work, ya know? I’m fully confident in that.

You know far more about this stuff than I do, but fwiw, here are a few tips from the BTDT crowd: Fiber up. My FPMRS recommended Konsyl twice daily. It’s some amazing stuff. Better than anything else I’ve ever used. Get it moving smoothly for at least the last few weeks before surgery. As you know, surgery and pain meds stop things up. You.do.not.want.to.be.stopped.up.post.op. Hear me on that.

D-mannose powder twice daily in a full glass of water does wonders on an irritated bladdar/urethra post op.

Vast amounts of non-sticky lubrication is your friend early on…..just sayin’.

Praying for you. ((hugs))

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Chloe December 8, 2011 at 6:07 pm

Thank you for the heads up on the bowel care. I was thinking about afterwards, but you’re right about wanting to have things moving smoothly beforehand too.

I have a theory that women who have more sex do better from these surgeries than women who have sex infrequently. It’s sort of like a rubberband. Leave it in the bottom of a drawer and it gets all gummy and hard. Now there’s a visual.

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jenfromfaraway December 8, 2011 at 10:03 am

my husband and i play a game where we list all of the things that were caused by the fall (we’re theologically geeky that way).
unproductive pain in child birth–>the fall
menopause–>definitely the fall
pelvic floor issues–>definitely the fall.

when jesus comes back….it will all be made right, like it was intended. i just keep telling myself that….so i will remember and believe it.

praying for you.

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Chloe December 8, 2011 at 11:02 am

I’d like to see more things fall off of men.

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Robin December 8, 2011 at 9:54 am

Agreeing that this is an important topic that is worth discussing.

Surgery is almost always a scary option.

Wish I could offer more than just a *hug* – but that’s about all I’ve got and even THAT is not much because it isn’t even real!! But still – *HUG*
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Sally December 8, 2011 at 8:36 am

This is an interesting topic. Even though I have not yet faced the prospect of a hysterectomy, I am in your same age demographic, so I personally know more women who are needing to make decisions regarding gynecological surgery.

What other factors – besides the skill of the surgeon – affect the outcome of surgery? I’m wondering about basic fitness level (abdominal and other muscle support), scarring, whether the surgery is vaginal or abdominal, how much of the cervix is left, etc. That may be too much to answer here, but can you point us to good articles about these questions?

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Chloe December 8, 2011 at 9:34 am

Salty,

I’m going to be writing about these very things as I prepare for my own surgery. I have done some research and I have some ideas that I think will improve outcomes.

After choosing a skillful surgeon, I believe that seeking out the services of a physical therapist trained in pelvic floor rehabilitation is the most important thing a woman can do.

Many women may find that they don’t even need surgery after physical therapy for several months.

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Brenda December 8, 2011 at 8:22 am

I so get your hesitation to lose an excellent sex life. Coming up to 40 and now passing it has been the best of my 20 years. I’ll be praying for calm and skillful professionals to help you and for peace at your decision to overcome you. Thanks for the info, I’ll know where to come if I have symptoms.

But I must say that I thought you’d be talking about Roger Waters when I saw the blog title. 😉

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Chloe December 8, 2011 at 9:22 am

Roger Waters has issues.

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Susan in the Boonies December 7, 2011 at 9:31 pm

Excellent information in this post. I appreciate the research you have done. I know you do your homework, and especially when it comes to something so potentially life-altering.
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Tomekha December 7, 2011 at 8:41 pm

Oh dear…I’m so sorry ur faced with all of this tsk – ” There is a God. And He’s a sadist.” I sometimes think that too.

All the best with everything.
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Chloe December 7, 2011 at 10:05 pm

It is hard not to think this when I think about the female pelvic floor.
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Anne (@notasupermom) December 7, 2011 at 8:15 pm

I hope it goes well for you. Totally normal to be nervous before a surgery.
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Chloe December 9, 2011 at 1:13 pm

Thank you my friend. I feel better knowing you all have my back.
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