Explaining Prolapse Post Hysterectomy

Of the 48,500 women who opt for hysterectomy annually in the U.K., thousands suffer from genitourinary prolapse, a condition where one or more pelvic organs slip out of place. Due to the surgery, the ligaments, pelvic floor muscles and pelvic organs’ support structure grow weak. Mr Broome is able carry out tests to determine which of the following types of genitourinary prolapse you suffer from:

  • Anterior Compartment Prolapse – This condition can manifest in three ways: urethrocele, which is the prolapse of the urethra into the vagina; cystocele, or the prolapse of the bladder into the vagina, and cystourethrocele, the prolapse of the urethra and bladder.
  • Middle Compartment Prolapse – There are three conditions listed under this type: uterine prolapse, enterocele, and vaginal vault prolapse. However, only the latter occurs post-hysterectomy. The vaginal vault, which is the blind-end of the vagina closed after a hysterectomy, can prolapse into the vagina causing pain and other symptoms.
  • Posterior Compartment Prolapse – Known as rectocele, this form of prolapse is diagnosed when the rectum falls into the vagina.

Symptoms You Should Be Concerned About

Mild post-hysterectomy prolapse may lack symptoms. However, you many suffer from a range of symptoms, especially the following.

  • Feeling of pressure, fullness or heaviness
  • Feeling of a bulge or noticing a protrusion
  • Inability to retain tampons
  • Spotting

Some women also experience urinary symptoms such as incontinence, frequent urination, urgency, or feeling of a relatively full bladder despite urinating. In addition, some report coital difficulty such as vaginal flatus and loss of sensation in the vagina. Finally, you may face bowel symptoms like constipation, flatus or stool incontinence, and incomplete evacuation.

These symptoms will cause discomfort and disrupt your routine and life. Therefore, you need to consult a medical professional quickly.

Treatment Options 

Often, it is important to wait and see how symptoms develop. However, there are certain lifestyle changes that you can make such as losing weight, treating constipation, quitting smoking, and avoiding heavy lifting which can assist you. Pelvic floor exercises can also be very beneficial.

A vaginal pessary may also be recommended, especially to women who do not wish to have surgery, have to wait for surgery or may have illnesses that prevent them from having surgery. During this procedure, a ring made of silicone is inserted into the vagina to lift the walls of the vagina. However, you need to change the ring every 6-12 months.

For a more permanent cure for genitourinary prolapse, you can opt for surgery. A skilled gynaecological surgeon will perform one of the following depending on your case:

  • Vaginal repair operation, which entail reinforcing and tightening vaginal walls
  • Sacrocolpopexy, where the vagina is elevated and fixed into the sacrum with mesh
  • Sacrospinous fixation, which is similar to sacrocolpopexy except that the vagina is stitched to a ligament inside the pelvis and no cuts into the abdomen are required

Mr Broome is highly skilled at performing these procedures and would be willing to assist you.

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