While medical care has become increasingly safe, some procedures still carry risks that are important for women to understand. As with any medical decision, being an informed patient is key to weighing options and providing fully informed consent.
This article explores several procedures that can pose particular health concerns for women so that readers have the information needed to discuss risks and benefits knowledgeably with their doctors.
Transvaginal Mesh Implantation
Transvaginal mesh was developed as a synthetic material intended to provide extra support when repairing weakened or damaged pelvic tissues. The mesh implant contains tiny openings, allowing a woman’s body tissues to grow into it, making it designed as a permanent solution. However, removal of the mesh may not always be possible should complications arise.
While many women experience no difficulties after receiving this implant, some do encounter problems. Issues can surface immediately following surgery or develop years later. The range of complications varies from mild discomfort to debilitating pain.
Potential side effects involve irregular bleeding, pelvic swelling or pain, discomfort during intimacy, and bladder or bowel problems like infections or incontinence. Other reported issues include stinging, prickling, or stabbing vaginal sensations, especially with exercise. Abdominal, hip, or leg pain has also been reported in some cases.
So, what can be used instead of mesh for prolapse? Fortunately, there are alternatives to mesh that have benefited many women.
According to TruLaw, pelvic floor exercises conducted under the guidance of a physical therapist aim to strengthen these muscles through targeted tightening. Bladder training and medications also provide options.
Vaginal pessaries internally support the pelvis, helping to reduce prolapse symptoms or stress urinary incontinence. Lifestyle modifications such as weight loss, limiting heavy lifting, and treating constipation or chronic coughs further decrease risks. Absorbent products can effectively manage incontinence for some.
These non-surgical approaches have improved prolapse symptoms and bladder and bowel function for significant numbers of women.
Coronary Artery Bypass Surgery
A recent extensive study conducted by researchers at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center revealed that women face a significantly higher risk of mortality following coronary artery bypass surgery compared to men.
The study, based on data from over 1.3 million bypass surgeries in the United States spanning from 2011 to 2020, indicated that women had a mortality rate of 2.8 percent during or shortly after surgery. In contrast, men had a lower rate of 1.7 percent. Even after adjusting for variables such as age and other health factors that influence risk, women still experienced a 30-40 percent higher risk of death than men.
Published in JAMA Surgery, the findings of this study echo those of previous research conducted over several decades. Dr. Mario Gaudino, the lead investigator of the study and a cardiothoracic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, emphasized the importance of these results, stating that they should serve as a “wake-up call” for cardiothoracic surgeons.
Despite advancements in medical practices, the trend of women facing a higher risk of adverse outcomes following coronary artery bypass surgery has persisted without significant improvement over the past decade.
As an alternative to traditional CABG, various approaches such as thoracotomy, off-pump, total endoscopic, and robotic-assisted CABG have gained traction to mitigate the increased early risk associated with CABG.
Minimally Invasive Surgery for Endometriosis
Minimally invasive surgery refers to a surgical technique where small incisions, typically less than an inch in size, are made, and specialized tools are used to carry out the procedure. This approach offers several advantages over traditional surgery. Some common procedures include hysteroscopy and laparoscopy.
Hysteroscopy involves using a slender instrument called a hysteroscope to examine the inside of the uterus without the need for any incisions. It’s commonly used to investigate abnormal uterine bleeding.
Laparoscopy utilizes a small telescope inserted through tiny incisions in the abdominal skin to assess the pelvic organs. By sending real-time images to a video monitor, the laparoscope allows the surgeon to see within the patient’s body and perform complex procedures with less stress on the patient. In some cases, laparoscopic procedures may involve the use of the da Vinci Robot, particularly for complex surgeries.
A recent study examined the incidence and risk factors associated with short-term postoperative complications among patients in the United States who underwent minimally invasive surgery (MIS) for endometriosis. The findings revealed that certain factors increase the likelihood of major complications following MIS for endometriosis.
These factors include African American ethnicity, hypertension, bleeding disorders, as well as previous bowel surgery or hysterectomy. Additionally, among women undergoing surgery, regardless of whether it involves bowel procedures or hysterectomy, African American ethnicity remains a significant risk factor for major complications.
Non Hormonal alternatives, such as TNF-α blockers, may modulate inflammation and offer an alternative medical approach to endometriosis treatment.
In summary, it’s essential for women to understand the potential risks associated with certain surgical procedures. This knowledge enables informed discussions with healthcare providers and facilitates decision-making regarding treatment options.