10 weeks post pelvic floor surgery:
The last blog I wrote was in the thick of my battle with urinary incontinence. Not long after writing that, I made the call to book in my pelvic floor surgery and find a permanent solution to this debilitating condition once and for all.
I sought the advice of Dr Salwan Al-Salihi , the Head of Unit of the Urogynaecology Department at the Royal Women’s Hospital.
Dr Salwan was not only incredibly experienced and well-researched but he exuded compassion and empathy like no other specialist I have ever come across.
Dr Salwan compared my clinical findings with those done in November 2022, when I had my initial consultation with him. Despite extensive conservative input, my clinical findings had worsened significantly in 18 months. He discussed my options for surgery including the risks, likelihood of success and limitations of all the options.
No need to convince me at this point:
I booked my surgery on the spot – 31st of May 2024. Locked in the diary, no going back now. The pelvic floor surgery involved three main parts:
1) The urethral sling to prevent stress urinary incontinence.
2) The prolapse repair (anterior and posterior vaginal walls).
3) Sacral hysteropexy – suspending the uterus to the front surface of the sacrum.
3 hours of general anaesthetic later, I woke up a brand new woman. Groggy, nauseous and sore but delighted to be out the other side of this long journey.
Why bedside manner is so crucial in this space:
Ultimately, I wanted the best surgeon in Melbourne. I needed my pelvic dysfunction to be cured for good. A bedside manner, at the time of choosing my surgeon, felt rather unimportant. Fast forward to my post-operative period, Dr Salwan’s empathy was not only a bonus but rather, quite crucial. He helped me to understand just how bad my pelvic floor dysfunction was (something he only discovered while operating) and reiterated that I had, indeed, made the best decision. He gave me step by step recovery guidelines and his reception team were amazing with any questions I had during this time.
I was limited to walking around the house and, later, around the block. No lifting, no reaching, no housework and plenty of horizontal rest. This was the ultimate challenge for a busy type A!
Back to what I love:
I went for my first run last week and, much to my amazement and delight, had no incontinence at all! I still cannot believe I can say that. I’ve been for a few runs now and I am confident now that the surgery has worked. I even did some sprints and star jumps to really test the urethral sling. After that first run, I emailed Dr Salwan to tell him that he was a magician. I genuinely thought I would be that minority for whom surgery is ineffective.
From a prolapse repair standpoint, I have had no symptoms at all since my surgery (vaginal heaviness, bulging and dragging). While this wasn’t as debilitating as the incontinence, it did still bother me every waking moment.
Running has always been an important part of my self care. I am a better Mum, Physio, wife, friend and general human when I get those running-fuelled endorphins.
One happy patient:
I will be forever grateful to Dr Salwan and his expertise. Surgery is certainly not the answer for every woman suffering from incontinence and prolapse symptoms, but it was for me. My advice? Seek help, get second (and third) opinions if you’re not happy and, above all, be your own advocate. Pelvic health is essential for our wellbeing and should be treated as such.
Dr Al-Salihi: https://dralsalihi.
~ Ali Minichiello
Pelvic Health Physiotherapist