From 'Hardly Walking' to Gardening Again: A Perkins Woman's Journey with VNOTES Surgery

At 78 years old, Linda Shingleton of Perkins, Oklahoma, is an avid gardener who loves to stay active. She wasn’t afraid to get into the dirt with her shovel, care for her plants, and enjoy time outdoors.

"I'm still very much a gardener, and I’m outside a lot,” she said. “I do a lot of lifting, a lot of work. I love to shovel and all that kind of stuff."

But when a pelvic organ prolapse began affecting her quality of life, she knew she needed help. Like many women, Shingleton had lived with the condition for several years before seeking treatment.

"I knew I had a prolapsed uterus for several years," she said. "It was uncomfortable, but not totally out. I knew I had something wrong."

When her symptoms worsened in the summer of 2024, affecting her bladder and bowel function, Shingleton was referred to urogynecologist Dr. Adam Hare, M.D., assistant professor in the Department of Obstetrics and Gynecology at the University of Oklahoma College of Medicine. There, she learned about an innovative surgical approach called VNOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) that would change her life.

Understanding Pelvic Organ Prolapse

Pelvic organ prolapse is more common than many women realize.

"We see prolapse in women of all ages," said Dr. Hare. "We can see it as young as in the 30s and 40s. We also take care of women in their 80s and 90s with prolapse."

The condition occurs when the pelvic floor muscles and tissues weaken, causing organs to drop. Dr. Hare notes that several factors can contribute to prolapse, including prior vaginal delivery, chronic medical conditions like constipation or COPD, and genetic predisposition.

“If a woman comes in and says, 'my mom or my sister dealt with prolapse,' that patient is at least two times increased risk," Dr. Hare said.

Symptoms can include feeling pressure or a bulge in the vaginal area, difficulty with bladder or bowel function, and discomfort during physical activities. Many women, like Shingleton, initially try to manage the condition conservatively before seeking surgical options.

A New Surgical Approach

While mesh repairs were common in the past, many women today are hesitant about this option due to potential complications. The VNOTES procedure offers a different approach.

"VNOTES is different because it allows us to get really good visualization," Dr. Hare said. "We have the benefits of laparoscopic surgery, so we can see everything really well. It's minimally invasive, but we're not making incisions on the belly. We're going in just through the vagina."

This approach results in what Dr. Hare calls "scarless surgery" with quick recovery time. Most patients go home the same day and can return to normal activities within two weeks. For Shingleton, this meant she could look forward to returning to her beloved gardening.

Though initially uncertain about the details of the procedure, Shingleton trusted Dr. Hare's expertise.

"I just knew that I needed the surgery at that point in time," she said. The four-hour surgery was performed in August 2024, and while recovery required patience, Shingleton noticed improvements quickly.

"I could hardly walk when I got to Dr. Hare," she said. “Now, I’m walking better and gradually regaining my strength. Hopefully by spring, I will be able to get back into the gardening."

The impact of the surgery was so significant that Shingleton told Dr. Hare it "saved her life." Now, she's encouraging other women to seek help for their symptoms. At a recent community theater event, she shared her experience with another woman considering treatment options.

"I basically said my surgery was extensive, but I am recovering well," she said.

Hope for Other Women

Dr. Hare emphasizes that women shouldn't suffer in silence.

"Conditions like pelvic organ prolapse and urinary incontinence can oftentimes feel like a normal part of aging," he said. "It is common, but it's not normal. Don't feel like you have to suffer with these conditions."

For women experiencing symptoms of prolapse, VNOTES offers a promising solution without the concerns associated with mesh repairs. The procedure is particularly beneficial for active women like Shingleton who want to return to their normal activities as quickly as possible.

"I think a lot of women just suffer in silence," Dr. Hare said. "The first thing to do if you're bothered by pelvic symptoms is give us a call. You don't even need a referral."

Learn more about comprehensive, multidisciplinary women’s health care and about urogynecology services at OU Health or call (405) 271-9493.