I was dx with uterine prolapse grade 3 cystocele and grade 3 rectocele 1 mo ago the OB/GYN I went to wants to do a hysterectomy with a sacrocolpopexy using the da vincible method in Dec. I am hesitant about the mesh-I really do not want it but understand why he discussed this with me. I only have 3 weeks off work. Will this be enough? I do home visits and going to the bathroom will be an issue and of course I will have to drive. Also does weight loss and gain affect this surgery?
Supracervical Hysterectomy with sacrocolpopexy is a good treatment option for pelvic organ prolapse. The addition of the da Vinci Robot has made this procedure easier and less invasive than open procedure or traditional laparoscopic approaches. Mesh used in this fashion does have an erosion or extrusion rate of around 3 to 6 % meaning that further operations may have to be done to remove any mesh that is exposed. This complication is however becoming less common as surgeons do more supracervical hysterectomies vs complete hysterectomies and use better meshes. Three weeks should be fine. Weight loss has been shown to improve incontinence. Lastly, make sure your surgeon has done a reasonable number of these procedures. 15 to 20 would be adequate in most cases. J. Kyle Mathews, MD
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