Laprascopic A & P repair ?

Is it possiable to to get the A & P repairs done Laprascopically ? It just seems logical to me that stitches inside the vagina would create scar tissue and therefore have the potential to make having intercourse painful , later on when the o.k. is given?

i had all my repairs done that way...i feel wonderful...not sure about the scar tissue.. i will cross that road if the time comes... i havent seen any negative posts about it though... we all heal differently.. i am so glad i got this surgery done.. best thing i have done in along time...and the repairs went smoothly...

oops sorry miss read your question...lol... mine were done vaginally.... but they did go well... lol

I'm glad to hear things went well for you. I guess I'm just getting a little scared of the unknown...

Car^go... I'm feeling the same way as you are about my upcoming A&P repairs (and TVH). It just seems like it will never be the same in the sex department after you cut and stitch all that up in there front and back, but I can't continue with everything falling out either, so I have no choice but to believe that they wouldn't do something that would mess someone up like that.

I had my done that way - it's called a sacral colpopexy - research it.. it's the "Gold Standard" to repair prolapses.

*Princess*, Does that mean you have NO stitches inside your vagina !?? I will research that asap. How are you doing after your castle stay?
How's the recovery going ?

Wordwizard, I am really not up to the whole process of being cut and stitched inside my vagina. I've had 4 kids and my body has been telling me about it...with everything prolapsing. We won't even mention that I am a human sprinkler system, haha, I have four automatic settings, cough, laugh, sneeze, and run, then watch out cause everything below the hip is getting wet !!!!
Someone else just posted concerning the gold standard for A & P repairs check it out, I'm going to go research it right now.

(((car^go))) You really need to ask your doctor this question. "A&P repairs" has a specific meaning. By definition, they're done vaginally. They involve slitting the front and rear walls of the vagina, overlapping the edges and re-stitching, the goal being to provide multiple layers of tissue with reinforcing stitches to help resist further prolapses. There would be no point in going in laparascopically to cut the walls of the vagina.

There are also other types of pelvic floor repairs depending on your situation. There is no one "gold standard" repair that is best for everyone. The sacral colpopexy, as well as other pelvic repairs other than the A&P repairs you're scheduled for, have as their objective to tack up the organs (bladder, rectum etc) that *might* prolapse again in the future, whereas the A&P repairs are meant to reinforce the vaginal walls so that if prolapse happens, it can't get very far.

Which is best for you really depends on the particulars of your situation, and only your own doctor can help you understand that. If you don't feel comfortable with the explanation you get, then by all means ask for a second opinion.

I had A&P repairs done with my vaginal hysterectomy. I was one of the very rare ones who did have a complication, called vaginal adhesion, in which the anterior and posterior repair incisions healed together and formed a bridge of scar tissue between them which prevented penetration. Ultimately I had a second vaginal surgery to remove the adhesion, which actually was a piece of cake compared to the hyst.

One thing you can do to minimize the likelihood of problems with healing on those incisions is to use vaginal estrogen. However, since most doctors have a "nothing in the vagina for six weeks" rule, you would need to arrange this with your doctor ahead of time. I would recommend at least asking about it, because it does help the incisions heal faster and results in 'softer', more flexible healed areas.

Even with my complication and further surgery, the end result of the A&P repairs was not a problem. There is no pain, no difference from before the surgery other than that penetration is much easier without the uterus, bladder and rectum all pushing down on the vagina! However, I am more than seven years post op now; I would say that very early on, I probably had more discomfort than others who didn't have A&P repairs.

I hope this helps. Good luck with your surgery!


-Linda

Surferbabe, Thank you the very detailed post! I was just coming to that conclusion about the differences , ie, sacral colpopexy from what I understand is for vaginal vault prolapse. I guess right now I am emotionally grasping for an easier way to get the end result.
I have watched the A & P procedure on OBG Management vidio clips, along with a perineorrhaphy. I cringed watching these clips and I am so sick at heart at the thought of my vagina being pulled out of my body and cut open. It just looks so savage . And I am soooooooo worried that I will not be able to enjoy sex with my husband and/or he will not enjoy sex with me.
It seems as though there's a lump in my throat from trying to choke back crying. In my mind I realize that this is necessary, but emotionally I am a wreck.
On June 3rd I'll have my last Dr. app. with the gyn before surgery, till then I'll try and write up a list of questions. After that maybe it would be a good idea if I try to forget about it for awhile before I drive myself nuts !
Thank you