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Procedures / Operations

Prolapse

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.

Therapies:

  • Pelvic floor physiotherapy
  • Vaginal oestrogen replacement
  • Silicone pessaries to support the pelvic organs
  • Surgical correction

Surgical correction depends on many factors;

  1. The desire for future sexual activity
  2. Future childbearing desires (generally we try and avoid any prolapse surgery until the family is complete)
  3. Patients age and state of general health
  4. 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. In addition, vaginal procedures can be employed to place a polypropolene mesh from the vaginal route, the so-called vaginal mesh kits. Each case is individual and would need to be carefully assessed and discussed.

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
  • Infection
  • Unintended consequences – eg pain, changes in urinary function. These are usually transient but can be extremely disappointing in the short term when one is expecting a perfect outcome every time.

For further information please click here to open the .pdf file on Prolapse written by Dr Rosen.

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