Urogynecology Expert Forum
Mrs
About This Forum:

Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Mrs

I have been advised to have a hyterectamy for a uterine prolapse. What are the draw backs of this procedure
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Significant uterine prolapse is a descent or "falling down" of the uterus, such that the uterus or upper vagina protrudes past the labia at rest or with straining. Prolapse is usually a nuisance for women with the problem, and usually not a life and death or emergency matter. Problems associated with prolapse can include, an uncomfortable bulge in the vaginal area, urinary frequency/urgency, problems with emptying your bowels, and low back pain, which is usually worse at the end of the day. If you have prolapse past the vaginal opening, and you have one or some of the above symptoms, then correction of the prolapse may help to relieve your symptoms. Correction can be done with pessaries, which are rubber inserts which go into the vagina to help hold the uterus up. Upside is they are non surgical. Downside is they do not work for everyone, and you have to remove them if you are seeking to have intercourse vaginally. Other remedies are surgical. Some prolapse surgeries can be performed without removing the uterus, and others can be done along with hysterectomy. THe procedures can be done throught the vagina or through ann abdominal incision, or with laparoscopy. Most pelvic surgeons agree that the absolute best  approach involves removal of the uterus, however, depending on your anatomy, it may be possible for you to have a good outcome without  uterus removal. My best advise would be for you to consult with a trained urogynecologist, or experienced pelvic surgeon, who can correctly diagnose if you have significant prolapse, and can also offer you an appropriate management or procedure, designed specifically for your particular needs. Google the "society of gynecologic surgeons" or the "american urogynecologi society" and their website will allow you to put in your zip code to locate a urogynecologist or pevic surgeon in your area.

The major drawback to hysterectomy, is that you cannot carry pregnancies after the procedure. This may be a moot point depending on your age or interest in pregnancy. Some people believe also that your sexual experience changes after hysterectomy. If the prolapse repair is done without hysterectomy, your recovery time may be faster, Also, patients tend to recover from transvaginal surgery faster than if it is done through an abdominal incision. Like any pelvic surgery, surgical risks apply, and include bleeding, infection, damage to bowel, bladder, blood vessels, nerves, ligaments. A qualified pelvic surgeon can review these with you in detail.
Dr. Hoyte
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Thank you for the great post! I have all of the symptoms above with no uterus, I had a hysterectomy last year. Could this be with I am experincing all of this at such an early age?
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242593_tn?1313867921
Hysterectomy is indeed one of the risk factors for prolapse. If you have prolapse symptoms, it would be good for you to get them evaluated by a qualified urogynecologist.

Dr.Hoyte
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