Implications for my Nursing career

[pookatunie]

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.  

[Rajiv Goel, MD]

Dear,

Thank you for using MedHelp's "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.

I can 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, then you may delay the surgery and go for it when you are ready. Till then you should consider pelvic muscle strengthening exercises and pessaries under the guidance of a gynecologist at your current hospital. There are certain postures that should be avoided or restricted which your Gynecologist can guide you.

During your work, which is largely associated with shifting of patients, there is an increased abdominal pressure which can increase the symptoms. There are hardly any measures to adopt to nullify the risk. We generally advise rest but you can wait till the time you are ready for surgery. Surgery will certainly improve the quality of life.

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 she is experienced in handling such cases earlier then you should go ahead and get it done by her. The procedure is usually not associated with any major complications and you shall be able to return to your work soon. You should prefer the doctor with whom you are comfortable. So my suggestion is to opt for your regular gynecologist.

In many countries there is a fragmented branch called Urogynecology, where the specialists are trained for such repairs. However, it should not stop you going ahead with the gynecologist you trust.

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

Regards,
Dr. Rajiv Goel

[cricket3991]

I had this surgery in Jan. after having a rectocele for 10-12 years.  I now have a uteris that has fallen and now my cervix is in the same place the rectocele was in.  Did I gain anything, not much.  It also trigered Overactive bladder which I can't take medication for so I would not have done it.  I am 70 so I could have lived iwth it another 10 years and maybe I wouldn't have gotten any worse.    Now I have to have surgery again for uteris or live with this!  My Uro/Gyn did not bother to look at my record and see that I could not take estrogen, because of breast cancer, so I did not heal as well.  My advice is to read alot on line and make your Dr. explain all the complications before you decide what to do.  I think there are more complications with this surgery than they want to admit.  Or at least that is what happened to me.  I was told not to lift anything over a gallon of milk for several weeks.  You are younger so you may heal better.  Good luck, go with the Dr. that you can talk to and will tell you all the options.