What will be done?
This procedure will repair prolapse of the vagina and/or uterus using the vaginal approach, (from below). We will use Mesh (a strong weave of permanent suture material) or individual sutures to re-support the vagina and/or uterus to more solid structures in the pelvis. We can preserve the uterus or remove it (vaginal hysterectomy) at the same operation depending on the type of prolapse, any other problems and your age. Sometimes we may also perform an operation to repair urine leakage.
Why is this done?
Common reasons for performing prolapse surgery are; prolapse causing discomfort or pain, difficulty emptying your bladder or bowel, prolapse not reduced by pessaries, prolapse interfering with sexual activity.
What are the alternatives to this treatment?
A number of other conservative interventions may be appropriate for your particular condition and will normally have been considered prior to your surgery. These include pelvic floor exercises and vaginal pessaries. Pelvic Floor Repair may be performed vaginally, abdominally, laparoscopically or in a combination of the above, each with their specific advantages and risks. Vaginal Pelvic Floor Repair may reduce your recovery period (including hospital stay), reduce postoperative pain, and reduce the need for a general anaesthetic. It may be associated with complications, particularly vaginal shortening and scarring or erosion of mesh.
How is this done?
The procedure is normally performed under a general or spinal anaesthetic. A drip is inserted into your arm. A catheter (a tube for urine drainage) is inserted after you have been anaesthetised. If the uterus is to be removed an incision is made inside the vagina and the uterus and cervix are removed with or without both ovaries and tubes. Incisions are then made in the front and back walls of the vagina and the bladder and bowel that are prolapsing are supported with mesh or sutures. We sometimes remove excess vaginal skin, the cuts are then closed with sutures that will dissolve within six weeks. A pack of cotton is placed in the vagina to stop bleeding. We sometimes put a rubber splint in the vagina that will stay in place for a month. The procedure itself takes approximately one to two hours, but you can expect to be in theatre and recovery for a number of hours.
What should I do before the procedure?
Any investigations or consultations arranged at the preoperative consultation should have been completed. You should have only fluids (soups, jellies, juices or similar drinks) in the 24 hours prior to the surgery. The bowel preparation medication should be taken as ordered. You should continue your regular medications, unless advised otherwise. Stop smoking. Should you develop an illness prior to your surgery or have any questions, please contact our waiting rooms on 07 333 21 999
What should I do on the day of the procedure?
Unless otherwise specified, you should stop eating and drinking on the midnight before your operation.
You should continue all your usual medications, unless otherwise specified.
You should bring:
What should I expect after the procedure?
When you wake from the anaesthetic, you will be in the recovery room. A drip will be maintained for one to two days and the catheter in your bladder will normally be removed the following day. You should expect a stay of one to two days in hospital. You will be given specific discharge medication if required, but you may use paracetamol as required (one to two tablets every four hours up to a maximum of eight tablets per day).
After discharge from hospital, you should:
You should not:
You should expect some vaginal discharge for several days after the procedure. It is normal to experience some depression after this procedure. You should visit the nurse at your GP to have the sutures removed from your abdominal wounds seven days after the operation. You may require up to six weeks off work. You should have returned to normal activity by three months, but full recovery may take longer. Pelvic Floor Repair may result in variable bladder and bowel dysfunction.
Once the vaginal prolapse has been corrected you may develop leakage of urine. This resolves in most women after six months, others may require an operation to correct the leakage. You may have difficulty in emptying your bowel, it is important not to gel constipated or strain on the toilet. A balanced diet with fruit and fibre will reduce this happening. Any prolapse surgery can change how your vagina functions with sexual activity, you may experience reduced sensation or pain, this usually resolves.
What are the complications of this procedure?
Every surgical procedure has associated risks. Complications include, but are not limited to:
What if I have any problems?
You should notify your GP, or the office if you experience the followingproblems:
Inability to empty your bladder or bowels