Betsy, Anarcha, and Lucy survived multiple attempts to fix their condition, and although Sims was able to close the fistula, small perforations remained after healing, leakage continued, and often the sutures became infected. It was not until after the thirtieth surgery that Sims was successful on Anarcha. During these surgeries, the women were not under anesthesia, only an ineffective opium that resulted in constipation and nausea instead of anesthetic. After the success of Anarcha, many white women came to Sims to have the procedure, yet none of them endured a single operation, noting the intense pain associated with the surgery.