I have a question please ladies.

I have tried to find a site that gives step by step instructions on TVH's so that i can better understand what will be happening while im in the castle asleep in fairy land but i am lost. If anyone could point me to the direction or email me with their views I would so much appreciate it... One of my main questions is if they do an Episionomy (excuse the spelling) just trying to educate myself a lil further and there is no better place then here where i can ask the PRO-PRINCESS'S ....thanks girls!

Hi there,

I had read somewhere prior to my surgery that an episiotomy was a possibility with vaginal surgery. I asked my doctor about it and he said that he has heard of some doctors preforming one and that it was usually because the uterus was *very* enlarged and that he had never heard of one being as drastic as the type done during childbirth. He told me that he would do everything possible to avoid doing one, and lucky for me he did!

Good luck!

If you are having a posterior repair (repair for a rectocele) done vaginally along with a TVH, you will have an incision which resembles an episiotomy. Otherwise, not necessarily... why not ask your DR?

For graphic pictures and explanation of what happens during surgery, check out www.pelvicfloor.com (not for the squeamish, but really helpful if you want to know exactly what is done).

Here is a brief summary of the procedure in a vaginal hysterectomy:

	Quote:
A circumferential incision is made around the cervix, the bladder is dissected away from the cervix and the peritoneal cavity is reached from the anterior and posterior vaginal fornix. The cardinal and uterosacral ligaments are ligated to allow the uterus to descend before cutting the uterine vessels.The upper pedicles are ligated after the uterus has been delivered vaginally. If the ovaries are to be removed, clamps are first placed across the mesosalpinx and then across the infundibulopelvic ligament (Thompson and Warshaw 1996). There are also several techniques to reduce uterine size during the procedure. The uterus may be bisected with a knife in an antero-posterior direction towards the fundus. Wedge morcellation may be performed by amputating the cervix and removing V-shaped pieces of tissue, combined with myomectomy if necessary. In addition, intramyometrial coring decreases the size of the uterus. It is carried out by incising the myometrium parallel to the long axis of the uterine cavity (Kovac 1986 and 1997; Magos et al. 1996). A technique without ligation of the paracervical ligaments is used in Japan. The lower ligaments are cut only with scissors, and the uterine arteries, the upper ligaments and tubes are ligated and divided. At this stage the uterine arteries and cardinal ligaments are sutured together (Kudo et al. 1990). Another modification of vaginal hysterectomy is Döderlein vaginal hysterectomy. After first delivering the fundus of the uterus through the anterior or posterior vaginal wall, the pedicles can then be secured vaginally in the same order as they would be in regular abdominal hysterectomy (Garry 1994a). Subtotal hysterectomy may be also performed in this manner (Pelosi and Pelosi 1997).

Source: http://ethesis.helsinki.fi/julkaisut...n/laparosc.pdf

No photos in that one!

Hope this helps.
s,
-Linda