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PROLAPSE REPAIRS
Aims. To repair the loose or stretched tissues, so that the organs sit where they did originally.
Indications. Women who have symptoms from prolapse of the vaginal walls or uterus.
Symptoms may include a lump, feelings of pressure or dragging, pain, discharge, sexual difficulties, and urinary or bowel problems.
Method. There are different techniques for fixing a prolapse, depending on what is in the wrong place and why. Basically, the operations can include or combine:
• repair of the front or back vaginal wall tissues (anterior or posterior colporrhaphy)
• repair of the perineal (pelvic floor) muscles (perinorrhaphy)
• surgically hitching and securing the uterus in place, rather than relying on stretched ligaments.
Vaginal repair can be performed with hysterectomy, as this will sometimes give a better result than vaginal repair alone.
Complications. The complications common to most surgery (anaesthetic problems, infection, bleeding) could occur, but precautions would be taken to prevent these.
Specific problems which may be encountered include urinary trouble, as the bladder neck (outlet) and the urethra are close to the action when operating. That is why most surgeons would use a urinary catheter to drain the urine away from the bladder for the first few post-operative days.
Because the vaginal skin and surrounding tissues are usually cut and then sewn up again, the sensation to the area may be altered. This may lead to altered sensation during sexual contact. Cut skin usually regains normal sensation within a few months.
One occasional complication of prolapse repair is not really a complication, but the fact that the condition may recur, despite surgery. Removing the potential aggravators, like obesity, straining, coughing, etc., is a way of increasing the likelihood of the operation being successful.
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