Which surgeon is the best for your operation?

Vaginal repair surgery has traditionally been the preserve of the general gynaecologist but the last few years has seen dramatic changes in how this type of surgery is performed with many surgeons adopting new techniques and taking part in the renaissance of pelvic reconstruction.

Surgeons like to characterise themselves in craft groups and often present themselves as being part of an "expert craft group" best suited to performing your surgery.

General gynaecologists usually are involved in a number of areas of practice and may also deliver babies and treat infertility or cancer patients. Urogynaecologists are trained in performing specialised urodynamic bladder testing techniques. Female Urologists are not necessarily female but are urologists that treat women's problems. Colorectal surgeons with an interest in pelvic medicine have traditionally used different techniques to treat rectal prolapse.  Laparoscopic surgeons are specialised surgeons who perform procedures through small keyhole incisions in the abdomen. 

In recent years slings have become the gold standard treatment for stress incontinence and mesh is becoming more popular in the treatment of prolapse.

There is still considerable controversy with regard to the use of mesh in the pelvis and most surgeons are not advocating vaginal repair with mesh as primary or routine treatment for prolapse. However, there has been a dramatic increase in surgeons from all of these groups adopting or starting to adopt these techniques.

When considering surgery in this area of medicine, especially when it is proposed to use mesh,  ask your surgeon to outline his experience and outcomes in the particular type of surgery he is recommending. All of the craft groups described above contain a number of specialised surgeons who have made their reputation as Pelvic Reconstructive Surgeons but there are others in each of these groups who have recently decided to diversify into this type of surgery and have very little experience.

AAVIS is a multidisciplinary pelvic floor society made up of surgeons who share an interest in pelvic medicine and cross discipline training, education and research.

Click here to visit the AAVIS Website

Questions to ask your surgeon 

It is a good idea to ask your surgeon to give you this information in writing.

What technique are you recommending ?

When did you first perform this technique ?

Where were you trained in this technique ?

How many of these operations have you performed ?

What are the results of your operations in this type of surgery?

How many of these operations are done at your hospital ?

Remember, prolapse and incontinence surgery is elective surgery and should be undertaken after a thorough consideration of risks and potential benefits.

If you are unsure seek a second opinion and if possible choose a surgeon from a different craft group to that of your original surgeon so as to obtain a balanced view. You may need to see a number of surgeons for an opinion before deciding to undertake surgery.