Q: Do I need surgery?

A: No, not necessarily. For most gynaecological conditions there are conservative (eg physiotherapy) and medical treatments.

Q: How do I know if my consultant is the right person to operate on me?

A: This is very important. Most good consultants will limit their own practice to a few areas within their specialty so that they become highly skilled at what they do. Within gynaecology I no longer deal with gynaecological cancers, IVF or colposcopy. If your consultant covers everything within their specialty, they are probably do not have the same level of expertise as someone focussing on specific areas. Ask your consultant how many of these operations he does per year. For some commonly performed procedures it is recommended that at least 20 such procedures should be done per year to maintain operative skills (MHRA, NICE). Can your consultant tell what his/her person outcomes of surgery are?? If not, go elsewhere.
Other resources: RCOG, BSUG

What is the controversy with mesh surgery for incontinence or prolapse?

Mesh was introduced approximately 18 years ago in TVTs for stress incontinence. TVTs had some advantages over the current operations performed at the time such as colposuspension or fascial sling, in that they could be done as a day case. The meshes used in TVT, TOT and prolpase operations can result in some fibres from the mesh protruding into the vaginal cavity (an exposure) and this can occur many years after surgery. In addition, as with many operations, pain can occur around the operation site, and this can sometimes be difficult to treat. Even removal of parts of the mesh may not relieve the pain but this is an infrequent problem.

  • Abnormal periods / Vaginal bleeding
  • Pelvic, vaginal and bladder pain
  • Vaginal laxity and prolapse
  • Urinary incontinence, infections and other bladder problems
  • Vaginal lumps and bumps
  • Abnormal vaginal anatomy
  • Hormonal and menopausal problems: PMT, hot sweats, vaginal itch and soreness, HRT problems
  • Post-surgical complications eg removal of vaginal mesh, wound problems
  • Post childbirth problems
  • Advice about general health and wellbeing (diet, dieting, exercise etc)
  • Mesh-free continence and prolapse surgery