After the uterus is removed, the vagina is held in place by the body's natural support structures. Vaginal prolapse is the condition where the vagina hangs from where it should be towards the vaginal opening as a result of weakening of these support structures.
Weakening of these support structures; It depends on whether the uterus was removed, age, changes in hormone levels, and the number of vaginal deliveries. Vaginal prolapse can affect quality of life. For example, it can cause a feeling of pelvic pressure and discomfort.
Minor sagging can be treated without surgery with pelvic floor exercises and vaginally inserted pessaries (usually a plastic ring). Surgery may be needed if you have more serious sagging symptoms. Current operations for vaginal prolapse; meshed or non-mesh vaginal repair, sacrospinous fixation, and sacrocolpopexy (laparoscopic or open). Sacrospinous fixation (a vaginal procedure where the vagina is attached with sutures to the sacrospinous ligament) and sacrocolpopexy are the most effective surgeries.
Studies have shown us that open abdominal sacrocolpopexy has a success rate of 74-98.8%, and laparoscopic sacrocolpopexy has a success rate of around 92%.
Because laparoscopic surgeries are newer than open abdominal surgeries, less is known about how successful laparoscopy is in the long run.
No procedure is risk-free in surgical procedures, and complications can sometimes occur. These include:
Without preventive measures, the risk of developing a blood clot in the leg (deep vein thrombosis or DVT) in all surgical patients is approximately 15-25%. Please discuss the risks of this operation with your surgeon. Additional information will be provided about the measures we have taken to reduce this risk.
The operation will be performed under general anesthesia. You will sleep and feel nothing. Before the operation, you will meet the anesthetist and have the chance to ask your questions about anesthesia.
A dose of antibiotics will be given during the operation to reduce the risk of infection (prophylactic antibiotics). Other doses of antibiotics may be given before discharge.
When you wake up after surgery, you will have a cannula (small plastic tube in a vein) in your hand or arm. You may have a catheter (draining tube) in your bladder and a gauze pack (like a large tampon) in your vagina. This is more likely if you have had vaginal surgery to correct the prolapse along with laparoscopic sacrocolpopexy. If you have a catheter and/or a vaginal tampon, the tampon is usually removed the day after surgery. There will be dissolving stitches and a dressing on the small incisions in the abdomen.
There may be some discomfort, but not severe. Nurses will give you pain medication. Some women may experience bloating and shoulder pain due to gas under the respiratory muscle (diaphragm). This feeling disappears as the gas is absorbed by the body. You will be discharged 24-48 hours after the surgery.
If you have had vaginal surgery with laparoscopic sacrocolpopexy, you will have some vaginal discharge that can last up to 6 weeks and vary in color and amount. Hygienic towels should be used instead of tampons for discharge. If the discharge turns into bleeding or has a heavy and offensive odor, you should consult your doctor.
The recovery time is usually 3 to 4 weeks. In the beginning, you should avoid strenuous and heavy work and gradually return to your normal life. Swimming is a good exercise after recovery.
Women have a risk of developing constipation after gynecological surgeries. Make sure you drink plenty of fluids and eat a balanced diet, including fruits and vegetables. You may need to be given laxative drugs after constipation.
In the beginning, sexual intercourse can be a little uncomfortable and should be avoided during the recovery period as it can disrupt the healing process. It will be useful to use vaginal lubricant products at first. Post-operative patients often find that sexual intercourse is more enjoyable than before they had prolapse surgery. Most patients can return to work after 4 to 6 weeks, depending on the type of work.
You should avoid driving for 2-4 weeks. When you do not feel pain after emergency braking, you can start driving. Practice stopping and reversing in the car before you start driving.
Pelvic floor muscles; It provides important support for your vaginal walls, bladder and bowels. It is important for controlling bowel and bladder function.
Either lie on your back with your knees bent or sit in a sturdy chair with your knees slightly apart in good posture.
Squeeze the ring of muscle around the anus as if inhibiting bowel movement, and then Squeeze the muscles around your anterior passages, lift them up, HOLD, and then slowly release. Don't forget to relax your hip and thigh muscles. Breathe normally throughout the exercise.
Aim to exercise as described 3 times a day.
Approximately 6-8 weeks after the surgery, you will be given an appointment for control. If you or your doctor think it is necessary in any situation that you see differently or that bothers you, you can apply to the polyclinic before the appointment date.
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