Help! My Doctor Says I Need Surgery

Has your doctor recommended surgery to treat your pelvic prolapse or incontinence?

Your first step: take a deep breath. Really, right now, take one — a nice, slow breath, in and out. I’ll wait. There’s time.

Now that you’ve had a breath…

Having prolapse, or leaking pee, can be many things: embarrassing, upsetting, disturbing, uncomfortable, frightening. It can make it hard to do the things you want to do. It can make you feel out of control, or that you’re not the woman you want to be.

These pelvic health problems are real problems!

But there’s something prolapse and incontinence are not…

They are not an emergency. There’s no reason to rush into surgery.

I can’t give you medical advice. Only your doctor can do that. I can’t decide for you about surgery. Only you can do that. (You decide about surgery. Not your doctor — you!) Everything on this page is simply my opinion, shared here with you in an effort to help you get the information you need. You can see my full medical disclaimer here.

After helping over 3,584 women with their pelvic health, I’ve heard women say a lot of things about this type of surgery that just aren’t true. Let’s set the record straight.

Myth: Surgery will make my problems go away.
Fact: There’s a good chance your problems could get worse.

Prolapse and incontinence procedures fail up to 50% of the time. And up to one in six women have complications.

I regularly hear from women who regret having had the surgery. For example, Liz wrote:

“I read all the stuff and foolishly had rectocele and enterocele repair in 2009 — oh the regret!! No incontinence but just horrendous bladder urethra sensitivity/pulling/rectal pain etc etc! HELP! I can never stand, sit, or drive without pain and discomfort.”

And here’s Betty. Betty said,

“I had prolapse surgery 6 months ago. Now I pee all over myself. Last week, there was poop in my panties, it was awful. What’s happening to me?!! I wish I never had this surgery.”

And if you google “vaginal mesh lawyers,” you know that surgery is a huge problem.

Russian roulette gives you better odds than prolapse or incontinence surgery.

Myth: If I have prolapse, it has to be “fixed.”
Fact: Many women partially or completely reverse prolapse by doing the Kegel Queen Program and other techniques. Even if the prolapse isn’t completely gone, you may improve your prolapse enough that you can be active and comfortable. Many women choose to live with a manageable degree of prolapse rather than risk surgery. (By the way, sometimes doctors recommend surgery for prolapse even if the prolapse isn’t bothering you. That’s just plain crazy!)

Myth: A hysterectomy is no big deal if I’m done having kids.
Fact: A hysterectomy puts you at risk for bladder prolapse, vaginal vault prolapse, and a frightening list of other problems. Even if you eventually choose surgery, there are procedures that keep the uterus in place.

Myth: My gynecologist is the right person to do my surgery.
Fact: You are gambling with your health when you have prolapse or incontinence surgery, no matter who your surgeon is. But if you choose surgery, a surgeon who holds a fellowship in urogynecology will give you better odds than a garden-variety OB/GYN.

Myth: If my doctor says I need surgery, I have to do it.
Fact: You get to choose. Prolapse and incontinence are not life-threatening conditions. This type of surgery is elective surgery: your choice.

Again, I can’t give you medical advice, and your health care decisions are 100% yours to make! But if you were my sister, this is what I would say to you:

1. Breathe. You have time to figure this out.
2. If you have a surgery date, cancel it. You can always schedule a new date later if you choose to, but once you have the surgery, you can never go back and undo it.
3. Get the facts about surgery. Exactly what are the percent odds of recurrence and complications with the procedure you’re considering? What percent of surgeries fail at one year, five years, ten years? One Cleveland Clinic study found that just one year after prolapse surgery, 58% of women had the prolapse recur (Whiteside JL, Weber AM, Meyn LA, Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004 Nov;191(5):1533-8. doi: 10.1016/j.ajog.2004.06.109. PMID: 15547521.)
4. Do absolutely everything you can to get better without surgery. Kegel exercises are an excellent option. But they’re only one of many ways to get help without surgery. Don’t just try one thing. Use absolutely every other option available to you, and recognize that some techniques take time.

After that, you may see enough improvement that surgery is the furthest thing from your mind. If you have given your all to every other option, and your problem is still so bad that you just can’t stand it, it’s still not time to rush into surgery. It’s never the right time to rush into this type of surgery!

If you’re still considering surgery after you have truly given your 100 percent effort to safer options, then do your homework. Don’t say yes to the first doctor who wants to operate, or the first procedure they suggest. Find out what the different procedures are, and what the risks are for each one. Find out which surgeons, and which hospitals, have the best results. Ask hard questions about the odds of success, how long the procedure typically holds before it fails, and the frequency of specific complications. You may need to travel to find a surgeon who meets your standards. You need to be your own advocate. Nobody said dealing with the risk of surgery would be easy!

The Good News

The good news is that there are safe, simple alternatives that really work — beginning with kegels. But watch out: literally 99.99% of women are doing kegels wrong. Find out how to do one perfect kegel, and get started today!