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Is surgery good option for 78 yr. old woman?

By Anonymous June 1, 2020 - 7:36pm
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I'm will be 78 this yr. Had total hysterectomy at 50. Have cystocele? (dropped bladder) for a number of years. Pessary painful and don't think I can live with it. Smaller size doesn't work (falls out with pressure). Health is good, only take BP med. Was told problem will get worse in time.
More scared of this procedure than my hysterectomy. (General anesthesia, mesh used, 2 days in hosp. 8 weeks recovery.)
Thank you so much, Jane

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HERWriter Guide

Hello Anon

Thank you for writing!

Are you enquiring as to if a second bladder lift surgery is a good idea for you?

We can't offer a 'yes' or a 'no' but there are certainly things to consider and questions to ask-

Who has a more successful outcome from her bladder lift surgery? Is it the woman who is undergoing it for the first time, or is it the woman who is undergoing it for the second time? Reason would dictate that if a woman needs a corrective surgery for the second time because the first failed, the likelihood of success the second time would be lower.

A paper from Cleveland Clinic-Florida was published looking at the success rates of cystocele repair in women undergoing it for the first time, vs. those undergoing it for the second time. The “in-between-the lines” question to be asked from reading this research is how to try to prevent women from having a recurrence after their first surgery so there is potentially no subsequent surgery.

The results from the study showed that after one year, the group of women undergoing surgery for the second time (group I) and the group of women undergoing surgery for the first time (group II), had the following success rates at one year:

Group I: 18/23 or 78.2 percent (“second timers”)

Group II: 17/21 or 81 percent (“first timers”)

You may say to yourself, these groups are nearly the same, without significant difference. That’s good, right? The real story here is why are 20 percent of women developing recurrence in either group just one year after reconstructive bladder surgery?

Here are their results at two years:

Group I (“second timers”) 9/21 (2 lost to follow up) or 42.8 percent

Group II (“first timers”) 15/21 or 71.4 percent

What are we to make of these worsening results?

These results are actually in line and consistent with published data about how bladder surgery commonly fails within the first one to four years post-operatively. In fact, failure rates are actually between 40-70 percent.

The authors of the study (rightly) conclude that if a woman has recurrence of her bladder drop and requires another surgery, then just “fixing it” again using the same technique that failed the first time will not give good results. A different technique would be required and is logical to prevent a second recurrence.

So if you are considered a second same surgery, it's really important to discuss the pros, con and alternatives.

I hope this information helps!


June 2, 2020 - 10:37am
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