Thread: Prolapse

Hi.

I also tried the excersizes without any result at all. Infact the Physio said it was a waist of time!

So, Im off to the Hospital next month for the OP! They recon I'll be off my feet for a while, upto six weeks!

Did you have pain inside and out, feeling sore at times?

Lyn

What is prolapse??

Hi everyone I'm new here. I'm looking for some women who have had uterine prolapse surgery. I too have uterine prolapse and had a uterine suspension six months ago. I am still experiencing some pain and discomfort and donot know if this is normal. I read on some womens health websites that after this type of surgery there is a sixty percent chance of this happening again and I'm a bit worried. Lifting things is not recommended after this type of surgery and unfortunately I must lift somewhat heavy things at work. How are you after your surgery? I need some support out there and am having a hard time finding anyone to help me. Thanks Mary

Surgery for prolapse

Deciding whether or not to have surgery for your bladder, bowel and/or prolapse problems is an individual decision. The success or failure of someone else's operation should never be the deciding factor for you. Every woman's situation is different.

Work with your urogynecologist to make a plan that works best for you. A lot depends on your individual problems, and more depends on your preferences. A woman should seek treatment whenever her symptoms have negative impact on her life ? you don?t have to wait until your symptoms are 'really bad'. Uncontrollable urine leakage, while common, is not a normal result of childbirth and aging. You do not just have to 'learn to live with it'. Seeking medical help does not mean that you have to have surgery right away. Some women start with more conservative treatment like physical therapy, and go on to surgery only if their urine loss is not well controlled.

It is important to understand that there are several different surgical techniques which are effective depending on the experience and training of your urogynecologist and the exact nature of your problem. There is no single operation that is right for every patient. You and your urogynecologist must decide on the specific surgery together. Some of the surgical options for various types of prolapse are listed below. Remember - to be effective, prolapse surgery must correct all of the support defects that you have. Most of the time, a urogynecologist can identify your defects while examining you in his/her office. That exam determines the type of surgery your urogynecologist will perform. Sometimes, however, the findings in the operating room are slightly different than those observed in the office. In those cases, your urogynecologist may decide to add a procedure during the time of surgery - or possibly not do something he/she had planned to do. It is also important to remember that surgery to correct urine leakage is often performed along with prolapse surgery. Your doctor will determine whether to recommend continence surgery based on your medical history, physical exam, and possibly some specialized testing such as urodynamics, anal manometry and radiology studies of the pelvic floor.

There are two main categories of prolapse surgery - 1) Obliterative & 2) Reconstructive

Obliterative operations actually close vagina completely. The skin of the vagina is removed, and the front and back walls of the vaginal support system are sewn to each other. There are two main types of obliterative surgery - Colpocleisis, and Colpectomy. Both are very effective in getting rid of bulges (prolapse), but there is no possibility of having intercourse after one of these procedures. Therefore it is very important for women to be ABSOLUTELY sure that they no longer want to have intercourse before having one of these operations. The benefit of obliterative surgery is that it tends to be less invasive and quicker than reconstructive surgery.

The goal of all Reconstructive operations is to restore normal anatomy and give the patient her best chance at normal quality of life including sexual intercourse. Most urogynecologists agree that the most important aspect of a prolapse repair is restoration of the support to the vaginal apex (or "tip top" of the vagina). Three common procedures that do this are the sacral colpopexy, uterosacral ligament fixation, and sacrospinous ligament fixation. Fixing an enterocele is often part and parcel to any of these operations.

Operations that correct cystoceles are the paravaginal repair and the anterior repair.

Operations that correct rectoceles are the posterior repair (aka rectocele repair).

Operations for uterine prolapse are the same ones mentioned above for fixing the apex of the vagina. They can all be performed with or without the uterus in place. Your doctor should explain the reasons for and against hysterectomy at the time of prolapse surgery.

If I decide to have surgery, what can I expect during the recovery period?

Depending on the extent of your surgery, the hospital stay usually lasts one to four days. Many women have difficulty urinating immediately after the surgery and have to go home with a catheter in place to drain the bladder. These catheters are usually only necessary for 3 - 7 days. Most patients require at least some prescription strength pain medicine for about one to two weeks after surgery. After any surgery to correct urinary incontinence or prolapse, we ask that patients ?take it easy? for 12 weeks to allow proper healing. This means no lifting more than 8 pounds (the weight of a gallon of milk), no intercourse, and no exercise other than walking.

The amount of time necessary for you to "bounce back" from surgery has a lot to do with the route of surgery. In other words, if an abdominal incision is necessary to perform your operation, you will probably have more pain postoperatively than if your procedure is performed through a laparoscope or throught the vagina. However, some patients are not good candidates for the vaginal or laparoscopic approaches. Your doctor should be able to explain his/her choice regarding the type of surgery you need.

Even if your surgery is performed via a less invasive route, prolapse operations tend to be "major surgery". In other words, all of these operations are a pretty big deal in terms of recovery and shouldn't be taken lightly.

If my surgery is successful, how long will it last?

The goal of continence or pelvic reconstructive surgery is to re-create normal anatomy permanently. However, none of these procedures are successful 100% of the time. According to the medical literature, failures occur in approximately 5 - 15% of women who have prolapse surgery. In these cases, it is usually a partial failure requiring no treatment, pessary use, or surgery that is much less extensive than the original surgery. Patients who follow our recommended restrictions for 12 weeks after surgery give themselves the best chance for permanent success.

I have prolapse, but I don't leak urine. Do I still need bladder testing?

Yes, if you are going to have surgery to correct the prolapse, bladder testing (called urodynamics) must be done first. That's because the prolapsed portion of your vagina may be pushing on your urethra and preventing urine leakage. If that is the case, having the prolapse corrected can give you a new problem - urinary incontinence. The only way to tell whether a continence procedure is needed at the time of prolapse surgery is to perform urodynamics while holding the prolapse up in its normal position.

What will happen if I just ignore this problem? Will it get worse?

Yes. It may not happen quickly, but if left untreated, pelvic organ prolapse almost always gets worse. The one exception to that rule can occur shortly after having a baby. ?New? prolapse (noticed by a patient or doctor in the early postpartum period) will often get better within the first year after the delivery.

However, treatment of prolapse should be based on your symptoms. In rare cases, severe prolapse can cause urinary retention that progresses to kidney damage or infection, When this occurs, prolapse treatment is considered mandatory. In most other cases, patients should be the ones to decide when to have their prolapse treated - based on the symptoms they are having.

Do I have to have a hysterectomy as a part of my surgery?

No. Any or all of the operations for prolapse and incontinence can be performed with or without a hysterectomy. However, hysterectomy is often performed along with these operations for a variety of reasons. In some cases, removing the uterus first makes the rest of the surgery easier to perform. In other cases, there is another reason besides prolapse or incontinence (such as cancer or excessive bleeding) to remove the uterus. Any such decision should be between the patient and her surgeon, and it should be individualized from patient to patient.

Hi, I was recently told I have uterine fibroid tumors and that's what is causing my prolapse, well, my doctors wanted me to have a hysterectomy and I was insisting on a myomectomy instead. Then I read article on a CLinical Trial called MR Focused Ultrasound. The treatment cuts the supply of blood to the tumors WITHOUT SURGERY!!! It takes 3 hours while they blast you with ultrasound waves and then you walk out of the center and go back to living your life. So far it has a 71% success rate. I'm mentioning it because we as women should BUG THE FDA UNMERCIFULLY to allow this procedure to be tested on a larger percentage of the population for safety. I like no incisions and no down time to 2 days hospitalization and then 6 weeks down time. I'm waiting to hear when the study gets underway in my area and if I get accepted as a candidate.

It never use to hurt when I had sex,and now it does. Normally when I'm on top, and now its hurtin ing other positions and I have to stop, its just uncomfortable. I want to continue it just hurts.
I was thinking, it could be my unhealthy habits, like what I eat or how I exercise. The truth is I just dont know what it is.