If you are considering prolapse or urinary incontinence surgery, ask your doctor about all the treatment options available to you, your doctor’s level of expertise and complications’ rate, and particulars about your case.
Treatment Options
You want a surgeon who can repair your problem with or without mesh -- then talk with you about which one is best for you. So, if your doctor is recommending using transvaginal mesh, ask:
- Please describe all the options available to me specifically and review the pros and cons of each choice.
- Is surgery my only option?
- What surgery is recommended? Why was this chosen?
- Will mesh placement (or another biologic graft) be used? Why will this material be used instead of another option?
- Can you provide written information about the surgery and the exact name of the material that would be used?
- Why are you recommending using mesh for my surgery instead of using my own tissues for the repair?
- Is this permanent or dissolvable mesh?
- Is there a non-mesh surgery that would work for me instead?
- What are the pros/cons of these different surgeries?
- Please provide written information about the product including the package insert of the product that will be placed or a patient information handout.
The Surgeon’s Experience
If mesh is going to be used in your surgery, choose a surgeon who has done at least 50 of these surgeries and who can manage any postoperative complications. You also want a doctor who is up-to-date on the latest on the surgery and specific products to be used. Find a specialist online.
Ask your doctor:
- What is your experience using this specific mesh product and treating complications associated with mesh placement?
- Do you attend national meetings to stay current on the most up-to-date research? If so, what was the last meeting you attended?
- Do you perform research?
- Find out about the surgeon’s complication rate with this particular surgery. Other than simple problems like urinary tract infections (UTIs), the complication rate should be less than 10 percent.
- What is your personal complication rate after this surgery?
- What complications are possible?
- Will you be able to help me with the complications, or will I need to see another doctor?
- What is the recovery time?
- How likely is it that the surgical mesh could be removed if there is a complication and what could be the consequences?
- If I need future surgery for one of these problems, how would mesh placement affect that?
- What will be done if the surgery doesn’t work – for example, if I still have urine leakage or you develop another vaginal bulge?
- Are you board-certified in prolapse and incontinence surgery (called Female Pelvic Medicine and Reconstructive Surgery?
The Experience and Opinions of Others
Ask your doctor if you can speak with another one of their patients who had the same surgery you are considering. You could also ask for your records and then get a second opinion. Neither of these requests should pose a problem.
Also ask your doctor what the FDA says about the specific surgery being recommended. The FDA is investigating some mesh implants used to fix prolapsed bladders with further research studies. Understand if you would be participating in one of these studies.
Mesh slings for incontinence are not under investigation. Print out the following from the FDA website and bring it with you to your doctor’s appointment:
Expectations after Surgery
Pick a surgeon who is willing to address your concerns. So, before the operation, ask your doctor what to expect after surgery:
- What things should I look out for after the operation and for how long will they last?
- What are my restrictions after surgery and for how long?
- Will we know right away if the problem is resolved? If not, how long will it be until we know that problem is taken care of?
- Can I expect everything to be like it was before I developed the problem? If not, what might be different?
- How soon will I see you after surgery?
- How do I reach you (by phone or email) with any concerns?
- When will the follow-up appointment be scheduled?
- When can I expect to resume my normal routine?
If after you have surgery, you have concerns, see your original surgeon or seek another opinion. Find a specialist online.