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Sacrocolpopexy not a top 10 dinner conversation. In fact, you were probably here because your doctor brought it up and you have questions, stay tuned and we’ll review everything you need to know about Sacrocolpopexy.
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Hi, I’m Dr. Rich and my passion is to provide every woman with practical knowledge about the world of women’s health. Today. My good friend and esteem colleague will be joining us via zoom to discuss Sacrocolpopexy. Sacrocolpopexy, chances are, you don’t know what that is, unless your doctor said you need one, or you’re just into weird medical terms either way, come join us and check it out. Welcome back. Uh, I want to thank everybody for tuning in today. Uh, we have our esteemed colleague, Dr. Erin Meyers, joining us via zoom from Charlotte, North Carolina. Uh, Aaron is a urogynecologist and we’re very delighted for you to be here today. Thanks for joining us.
Dr. Erin Meyers (01:13):
Thank you for having me. I’m very excited to be here.
Dr. Rich (01:17):
So today we’re going to talk about a procedure, a surgical procedure. The term is sacred. Colpopexy now it’s a mouthful and most patients probably haven’t heard of that, but there are definitely a number of patients that have, and they want more information. So in terms of cyclical bull Pepsi, or we could call it synchro, what is that? What is it for? And how does that relate to prolapse?
Dr. Erin Meyers (01:44):
I love this question. I talk about this every day with my patients. So Sacrocolpopexy is a mouthful, and it’s really made of three smaller words. So sacro stands for sacrum. So that’s the lower back area. Culpo stands for vagina. And I think we all know that area. And then Pexy means, you know, kind of putting them together. So sacrocolpopexy means sacrum, vagina putting together. So essentially we’re using some support of the lower back to help. When the vagina falls down, we can support that vaginal prolapse with the lower back.
Dr. Rich (02:23):
How might a patient present to your office if they have prolapse, what symptoms would they have?
Dr. Erin Meyers (02:30):
You know, a lot of times, um, patients will present with just a feeling of heaviness or pressure may be feeling a bulge, or sometimes they’ll say they’re sitting on an egg or feeling uncomfortable. Um, usually it’s no pain. Interestingly. So women who present with pain as a primary symptom that tends to not be prolapse, uh, but mostly just heaviness pressure, a bulge. And when it’s really advanced, some ladies will complain of prolapse coming all the way outside the vaginal opening, and they can see or feel that.
Dr. Rich (03:03):
Okay. And, uh, patients will often ask what is prolapsing? So what, what organs or what, what is it actually, what is the egg that they’re sitting on? Right.
Dr. Erin Meyers (03:16):
That’s a great question. They’re always so nervous about what is prolapsing. Everyone wants to know “what is this?” And what I always tell them is don’t worry. It’s just vagina skin. The vagina’s kind of coming inside out on itself. Uh, what’s behind the vaginal wall is really what kind of tells us about the symptoms of what’s going on. So sometimes it can be the bladder and if the bladder is behind the vaginal wall, then we have problems with emptying our bladder urination, things like that. Sometimes it can be the rectum. And if the rectum is behind the vaginal wall prolapsing, it can be more difficult to have a bowel movement. And sometimes it’s just the uterus. And so in those cases, it’s more just heaviness or pressure as the main symptom. Uh, sometimes it’s all three. Um, and so really an exam helps to understand, you know, for the physician and patient both to understand what’s going on. Um, but in no way, shape or form, uh, is it really going to be dangerous to touch or anything like that? It’s not, Oh my goodness, don’t touch my bladder. No of it is just the vagina, skin prolapsing.
Dr. Rich (04:19):
I see. And a lot of patients will come in, um, particularly elderly patients who have many urinary tract infections, and sometimes they’re not, um, suspected to have prolapsed by their care providers. And yet after years of infections and even hospital admissions, we find out that that’s the actual cause is prolapsed behind these infections.
Dr. Erin Meyers (04:49):
That’s absolutely right. When the prolapse is predominantly related to the bladder, it can be very difficult for ladies to empty their bladder. And when you’re in stays inside over time, as you, as you mentioned, it can get infected.
Dr. Rich (05:02):
And I have a number of patients ask, um, is this just a normal part of aging? Because you know, my mom or my grandma had a similar thing and they just, they were uncomfortable, but they never did anything about it.
Dr. Erin Meyers (05:18):
Well, I would say to that will, yes, it’s a, it’s more common in women who are in the menopausal years or post-menopausal years, but that doesn’t mean it has to be normal. And so we can address that and, and help them achieve a better quality of life by, by eliminating some of those discomforts
Dr. Rich (05:39):
And for the surgery itself. Uh, and you know, I’m gonna, uh, go ahead and offer that you and I both liked to use the robot for the surgery, although it can also be done through an open type of an incision, how has it actually done? So, so you had that, there’s the COPUS, which is, uh, you know, the vagina and then, uh, the sacro, which, uh, truly is a, is a ligament on the sacrum. Um, so how does that actually work? How do we attach those two? And how does that provide support?
Dr. Erin Meyers (06:14):
Well, actually we used a mesh graft. So part of the mesh is attached to the vagina. And the other part of the mesh is attached to the sacrum because as you might imagine, there’s no way the vagina can reach the sacrum. So we need a little graph to attach the two together. Um, and so that helps provide the support.
Dr. Rich (06:34):
So in wake of, um, some of the vaginal mesh issues that came to light through the F D a and then became kind of, um, publicized on television and radio and patients had this awareness of what they typically refer to at least in my office as a bad mesh. So is this different and how is it different?
Dr. Erin Meyers (07:03):
I think that’s a great question and something I talk about all day long every day. Um, so I’ll try to explain that not all meshes are bad and some mesh is very, very good and can help women with both incontinence and prolapse. So for prolapse, I try to explain the couple Pepsi procedure or sacrocolpopexy procedure has been around since about the 1960s. So this is not something new that we’re doing. We’re not experimenting, we’re not trying a new product out. We’re not, you know, figuring things out as we go. This is a tried and true gold standard treatment option. That is really good for women. Um, some of the other options that have come and gone, uh, along this time may not have been as good. And so there are different than vaginal mesh products and those products came on the market in the early two-thousands.
Dr. Erin Meyers (07:58):
And, um, you know, based on the route of entry is what I try to explain. So vaginal mesh is placed vaginally. So if you place a sterile graft through maybe a non-sterile area, uh, you know, it might get infected or you might have pain. And so the vaginal mesh products came on the market, like I said, in 2000 early two-thousands, and they’re now off the market. Uh, but a couple of vaccine mesh is completely different because it goes through a sterile area, meaning the abdomen. So we take the mesh through the abdomen through little tiny holes that we placed for our ports, for our robotic ports. And that mesh goes right through those tiny holes about a size of a pencil, and then that mesh stays sterile the whole time. So much less risk of infection, much less risk of pain, and really just completely different procedures.
Dr. Rich (08:50):
That’s, I think that’s going to be great news for, for people to hear and, um, probably some peace of mind knowing that the thing they’re worried about the vaginal mesh product, nobody could use it if they want it to, it’s not currently on the market and the CID or Coldwell vaccine procedure has a six-decade track record of, of good outcomes.
Dr. Erin Meyers (09:18):
Absolutely. And, and it’s, you know, stood the test of time. It’s not been pulled for the market. So I think that should help them feel safe. And I think that it does, you know, when I talk to patients about the differences in Coldwell Pepsi mesh and vaginal mesh points, they understand the differences, they feel very safe going forward.
Dr. Rich (09:36):
Sometimes I find it helpful as well to kind of explain it. Its basic level net is really just, um, a series of interwoven, permanent suture. So somebody might fix a hernia for example, with a permanent suture. So this is just kind of an interwoven matrix. It’s the same thing that, you know, we would use. It’s just a piece of suture material, um, by itself is actually very inert. Um, complications can happen, but they’re nowhere near the risk that happened with vaginal mesh, um, which is why this is safe and that’s off the market.
Dr. Erin Meyers (10:15):
Yes, absolutely. I agree.
Dr. Rich (10:17):
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