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How is stage 3 rectocele and a stage 1 cystocele treated ?

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Practicing since : 1998
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6 mos. ago I was diagnosed with a Stage 3 rectocele and a Stage 1 cystocele. My doctor has recommended surgery "when I am ready". I work as a floor nurse, and have to frequently lift patients. I NEED to work at least 1 more year to pay off my mortgage. Is there the potential to create "unreparable" damage during that time? Will I need to quit floor nursing due to the lifting requirements of my job? I love my gynecologist, but I am reading that a urogynecologist is suggested for this procedure -- there is one that works at my hospital, but I do not know him and I would prefer to use the hospital and my gynecologist in my home town. Is a urogynecologist necessary? My trust lies in my gyn . . .

Please respond -- I am scared about the implications that this stupid betrayal of my body will have on my career. I am only 48 and worked very hard for my BSN.
Posted Fri, 20 Apr 2012 in Women's Health
Answered by Dr. Rajiv goel 3 hours later
Dear MH,

Thank you for using "Ask a Doctor" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

You read two queries in your post here.

First one is whether there is an increased risk of complications associated with rectocele and cystocele with your current job and delayed surgery.

Do you have symptoms associated with the above problems? If you do not have symptoms at all, then you may delay the surgery and go for it when required. Till then you should consider pelvic muscle strengthening exercises and pessaries under the guidance of Gynecologist here at current hospital. There are certain postures that can be avoided or restricted with your Gynecologist can guide you.

During your work which is largely associated with shifting of patients, serving the patients you go into different positions and postures where there is increased abdominal pressure which can further increase the symptoms that you may currently have. There are hardly any measures to adopt to nullify the risk. We generally advise rest for people who suffer from incontinence. Having said that the continuation of your current job should not cause unrepairable damage. The surgery will certainly improve the quality of life any time.

Second query is, who should treat or repair such problems. A cystocele as well as rectocele repair can be ably done by Gynecologist. If you have trust in your Gynecologist and if he/she is experienced in handling such cases earlier then you should go ahead and get it done by him/her. The procedure is usually not associated with any major complications and you shall be able to return back to your previous work soon. You should prefer the surgeon whom you are comfortable with and the trust. So my suggestion is to opt your regular Gynecologist.

In developed countries there is a fragmented branch called Urogynecology who are specially trained for such repairs, however it should not stop you going ahead with the surgery with your well known Gynecologist.

Hope that this information helps and hope that you will get better soon.

Dr. Rajiv Goel.
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