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Explaining Genitourinary Prolapse

Updated on February 1, 2015

A Feeling of Heaviness

If you’re experiencing heaviness in your vagina, feel a lump in your abdomen, notice abnormal vaginal discharge or feel pain during intercourse, you may be experiencing uterine prolapse complications. In addition to diagnosing your condition, your doctor will need to determine which of the uterine prolapse stages or degrees your case fits in.

Stages of Prolapse Uterus

Uterine prolapse staging indicates how far you’re the uterus has descended into the vagina. In addition to physically checking you and taking x-rays, your physician will ask you about symptoms such as uterine prolapse pain or uterine prolapse bleeding to determine the degree of your condition. To help you identify what your physician writes in your medical file, here is a look at the four uterine prolapse stages:

  • Stage I – In this stage, the uterus is still in the upper half of the vagina.
  • Stage II – The uterus has dropped further, reaching the opening of the vagina.
  • Stage III – At this degree, your condition is bound to be painful as the uterus starts protruding outside the vagina.
  • Stage IV – Also referred to as procidentia, the uterus and cervix is completely out of the vagina.

It is during the latter two stages that you will start experiencing uterine prolapse pain and bleeding. Unfortunately, by then, non-surgical procedures such as pelvic floor muscle exercises may be out of the question. Oestrogen therapies may also be off the list since women diagnosed with third or fourth degree may need other treatments.

The Pelvic Floor

This diagram shows how the pelvic organs are supported by a floor of muscles.
This diagram shows how the pelvic organs are supported by a floor of muscles.

Uterus Pain

Uterine prolapse occurs when the muscles supporting the uterus grow weak, causing it to slip from its original location. This issue can be due to trauma following childbirth, age, obesity, or genetic diseases such as Ehlers-Danlos Syndrome. Regardless of the cause, this is a serious condition that may require a hysterectomy. However, prolapsed uterus pain and other symptoms can be treated with a sacrohysteropexy operation if you do not wish to remove your uterus, risk of losing your sexual drive, or damage to other organs. Your physician will help you decide which course of action is best in your case, but make sure to select a reliable gynaecological surgeon to mitigate any risks related to the procedure.

Is This Describing What You Feel?

Have you suffered some form of prolapse?

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There Is Hope: Surgical Treatments

There are a number of surgical treatments used for countering uterine prolapse complications. Removing the uterus, i.e. getting a hysterectomy, is one of the options for women who are no longer able to bear children or do not want any in the future. However, though it may permanently stop uterine prolapse pain and other scary symptoms, it can put you at the risk of issues such as loss of sexual drive or damage to other organs.

This is where a sacrohysteropexy may be your best option. The operation involves the addition of flexible mesh to lift and hold the uterus in its original position. If you opt for a laparoscopic procedure, you will experience minimal scarring and your abdomen will heal very quickly. As your gynaecological surgeon has a better view, rest assured that you will not suffer any organ damage.

If you suspect that you have developed uterine prolapse, visit your gynaecologist to carry out uterine prolapse staging and receive the treatment you need right away.

Do You Plan More Children?

Unlike hysterectomy, sacrohysteropexy does not entail removing the uterus. Therefore, your fertility will be preserved. Furthermore, opting for laparoscopic sacrohysteropexy will ensure fewer cuts to the vagina itself, limiting the risk of sexual problems and keeping the option of having children open. There have already been women who have had children post sacrohysteropexy with no further prolapse problems.

Before a Sacrohysteropexy Procedure

This shows how the uterus slips down forcing the vagina out.
This shows how the uterus slips down forcing the vagina out. | Source

How Is The Sacrohysteropexy Performed?

A specialist surgeon performs this surgery laparoscopically which is also known as keyhole surgery, rather than having to make a large incision into your abdomen.

So the surgeon will make tiny belly button sized cuts (these are the keyholes) through which the telescope and instruments are passed. One is positioned in your belly button (where the camera is inserted), one along your bikini line and one to the left of the belly button. This method enables the surgeon to look around your pelvis via a screen.

Firstly, the mesh is inserted via the bikini line incision and then using tiny needles, the surgeon attaches one end of the mesh (which is designed to not break down inside your body) to the back of the cervix and then the other end is attached to your tailbone (sacrum) and fixed with metal staples. The mesh is also covered with a thin layer of tissue to prevent scar tissue forming but encourages tissue to grow and make the repair stronger. It can stay indefinitely and does not require a re-do operation at any point in the future.

The Sacrohysteropexy Operation

How Quick Is The Recovery?

The recovery is so much quicker than having a procedure such as a hysterectomy. You will only be in hospital for one to two days:

  • you can drive after two weeks
  • you can resume intercourse after two weeks
  • you need to avoid lifting for around 6 weeks, only because the bruising may cause discomfort.

Many ladies remark on immediate alleviation of symptoms when they come round after surgery.

After the Sacrohysteropexy

This diagram shows how the uterus is pulled back into position after sacrohysteropexy.
This diagram shows how the uterus is pulled back into position after sacrohysteropexy. | Source

In Conclusion

So many women suffer from a prolapse of some kind. Many of their family doctors advise that relief will only be found after a hysterectomy. Understandably, many do not want to proceed with this so suffer continuously. The sacrohysteropexy procedure compared to a hysterectomy will be life changing and prevent or alleviate:

  • injury to other organs
  • pain during intercourse
  • intraoperative complications such as bleeding, pelvic bases and infection
  • infertility
  • 30% re-operation rate for vaut prolapse
  • vaginal shortening
  • vault evisceration

In total, it will transform the quality of life.

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