Female pelvic organ prolapse is a common occurrence especially after childbirth. It can present as;
- A bulge felt vaginally especially when washing
- Loss of urine with coughing, jumping, running etc
- Loss of sensation with intercourse for either partner
- Dragging or back pain especially towards the end of the day
- Need to push inside the vagina to pass urine or stool
A prolapse may manifest as a relaxation in one or many vaginal compartments causing a variation in presenting signs and symptoms noted above. Dr Rosen can assess the pelvic floor to determine where the problem lies and outline what measures can be taken to correct these defects.
- Pelvic floor physiotherapy
- Vaginal oestrogen replacement
- Silicone pessaries to support the pelvic organs
- Surgical correction
Surgical correction depends on many factors;
- The desire for future sexual activity
- Future childbearing desires (generally we try and avoid any prolapse surgery until the family is complete)
- Patients age and state of general health
- The type and nature of prolapse
In this practice, we perform many operations using laparoscopic or keyhole techniques to suspend the vagina, support the bladder neck or correct defects between the vagina and bladder and the vagina and rectum. The gold standard prolapse procedure is the laparoscopic sacrocolpopexy and only a handful of surgeons in Australia are trained in this technique, Dr Rosen being amongst this group with over 10 years experience with this surgery. It involves complex dissection of pelvic structures and insertion of a graft, much like an abdominal hernia repair, to stop any recurrence of the prolapse into the future.
Alternative options are also possible and as each case is individual, full assessment and personalized discussions are conducted with every patient to best suit her needs and expectations.
Risks: all surgery is risky. In general the risks include
- Bleeding problems
- Recurrent prolapse, usually in a different area that was not present at the time of the original operation
- Unintended consequences – eg pain, changes in urinary function, constipation. These are usually transient but can be extremely disappointing in the short term when one is expecting a perfect outcome every time.
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