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Prolapse problem

Postby redmaggie on Thu Mar 08, 2018 5:20 pm

I'm a slim and active 60 year old but have had prolapse issues (and ops) over the years after a traumatic 1st delivery. I had a recurrence of large cystocele and uterine prolapse so last August I had an open uterosacropexy with posterior and perineal repair. No cystocele repair was done. Only 6 weeks after the surgery the cystocele returned to the same extent as before. I've told my consultant but he just said to return in 3 month's time. There's been no exam since August either. I had anterior repairs in 1988 and 2013. I'm quite uncomfortable - can this latest cystocele be put right ?
Thank you!
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Re: Prolapse problem

Postby Mr Jonathan Broome on Wed Mar 14, 2018 7:28 pm


Yes it can be put right but I understand your specialists reluctance to undertake a 3rd operation on the vaginal wall. The risk of failure is very high (over 75%) having already had two failed repairs. The mesh sacrohysteropexy works very well as it is a permanent support unlike simply repairing the vaginal walls which relies on your own tissues hence the recurrence as your tissues are obviously very weak.

I think you may need to consider the option of strengthening material being inserted into the anterior vaginal repair, obviously there's a huge issue with vaginal mesh but may be an option in selected patients with experienced surgeons as part of a clinical trial. Degradable meshes and tissue grafts might also help and they don't have the potential long term risks associated with vaginal mesh.

I'd suggest eferral to a tertiary urogynaecological unit for assessment.
Mr Jonathan Broome
Consultant Gynaecological Surgeon - MB ChB, MRCOG
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Mr Jonathan Broome
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