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Is pelvic organ prolapse common after having a hysterectomy? Is pelvic organ prolapse common after having a hysterectomy?

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  #1  
Unread 03-11-2014, 06:48 PM
Is pelvic organ prolapse common after having a hysterectomy?

Hi there! I am new to the community (just joined) I'm 38 years old, and I had a hysterectomy in November 2013. Now I'm having pelvic organ prolapse. I am scheduled for surgery next month, and I have some concerns. I've shared them with my doctor and got medical answers, but I'd love to hear from women who have gone through the same situation. I had the laproscopic robotic (DaVinci) hysterectomy and was able to keep my ovaries and cervix - I'm 38 years old, so the doc felt it was best to not go through menopause yet if I didn't have to. I had a giant fibroid, and he was able to remove the uterus. Now I'm having the prolapse, and the surgery I will be getting involves the mesh. I was concerned because I've heard bad things about the mesh, and the lawsuit commercials I see on tv are making me nervous. The doc said I'm too young for a pessary, so I really have no other options. Also, the protrusion of tissue is getting worse by the day, and I am not the type of person to sit still. I'm a stay-at-home mom, and I'm also busy running kids and doing things around the house. I'm not in any pain, so I think that's why I'm having a hard time 'taking it easy'. Any advice on the mesh and has anyone heard if this is common after a hysterectomy? Any suggestions on how to be more comfortable while I wait for the lift surgery? Thanks ladies!!!
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  #2  
Unread 03-12-2014, 07:58 AM
Re: Is pelvic organ prolapse common after having a hysterectomy?

Hello traderr,



Glad you found us! I am sorry that you are dealing with pelvic organ prolapse. If you don't mind my asking, what exactly has prolapsed, what grade is the prolapse and what method of repair did your doctor recommend?

Mesh, well you are right to question the use of mesh even though many women have successfully had mesh placed to repair their prolapsed organs. There are definitely risks involved and you don't want to not explore your options first. There are other methods of repair and if your doctor is not willing to consider sutures or using something more natural like your own fascia I would recommend you get a second opinion from a reputable urogynecologist who specializes in pelvic floor repair.

As for prolapse after hysterectomy , yes it happens but most women have their hysterectomy without prolapsing later. In fact, there is a school of thought that keeping your cervix reduces the risk of prolapse and since you still have your cervix you can see that is not necessarily true. I believe from all I have read, it's lifestyle , heredity , childbirth, and strength of tissues or a combination of that create the right circumstances for pelvic organ prolapse. Yes, sometimes hysterectomy can add to the risk but not necessarily the sole cause of prolapse.

Do your research, get second or even third opinions and ask lots of questions. If you are not in pain, have you considered a pessary in the interim? Edited to add: I see your doctor says you are too young for a pessary but I have seen other women who are young try pessaries and there are many different types to try.

  #3  
Unread 03-12-2014, 02:29 PM
Re: Is pelvic organ prolapse common after having a hysterectomy?

Hi Molly50! Thank you so much for responding! It's nice to get some insight from other women on these topics. What the doctor said is prolapsing is unfortunately the cervix gave way, and that is what is protruding, with the bladder on top of it. There is some tissue exposed at the vaginal opening, which looks like a ball. Some days are worse than others where it looks to be coming out further. But for now, it's bearable. The surgery will be sacrocolpopexy, using the DaVinci and the same incisions as the hysterectomy in the abdomen to place the mesh and lift the organs - it will be stitched to a ligament in the sacrum. From what I've read too, in my case I think it is definitely a combination of things - childbirth, lifestyle, the hysterectomy, and heredity, like you said. My grandmother had the same problems! The technology is different today of course, but I guess it's just a streak of bad luck. I'm optimistic though, and taking it all with a grain of salt. I did do some research on the mesh, and I'm reading that the transvaginal mesh that caused so many problems is a different procedure from the laproscopic robotic that I'll be having. The date is scheduled, but I still have time to research and get other opinions. I'll keep you posted about what I find out and what decisions I decide to go through with. For now, I'm taking it easy as much as I can - no heavy lifting, etc. I appreciate your thoughts on this, and I'm so glad I joined to talk to other women about such ugly issues we all go through. Lol. Gotta love being a woman!
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  #4  
Unread 03-12-2014, 02:48 PM
Re: Is pelvic organ prolapse common after having a hysterectomy?

I talked with Dr about this and she said two things to avoid are weight gain and lifting large amounts. I was concerned about this before surg., but having no problems. I also do Kegels and have since I was 18. Hope all goes well for you .
  #5  
Unread 03-12-2014, 03:14 PM
Re: Is pelvic organ prolapse common after having a hysterectomy?



It can depend on what your definition of common is. One study found that 1.3 in 1,000 women required a surgical procedure to correct a pelvic organ prolapse following a hysterectomy. The risks go up if prolapse was present at the time of the hysterectomy. For perspective, 1 in 1,000 women who have a hysterectomy will die, and some stats even indicate the death rate could be as high as 6 in 1,000.

Interestingly enough, vaginal hysterectomy was not found to be a risk factor in the study mentioned above.

Other risk factors for pelvic organ prolapse include menopause, genetics, obesity, frequent heavy lifting, pelvic surgery, childbirth, and age. WebMD states, "30%-40% of women develop some presentation of pelvic organ prolapse in their lifetime, usually following menopause, childbirth, or a hysterectomy." The article does not specify the risks for hysterectomy alone.

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  #6  
Unread 03-13-2014, 08:51 PM
Re: Is pelvic organ prolapse common after having a hysterectomy?

I have a pelvic prolapse that I've had since around Thanksgiving, so about 9 months after my hystererectomy. I had my cervix removed but kept ovaries. I never had any issues with prolapse or the looseness I have felt since then. I am in physical therapy but it doesn't seem to be doing anything. I'm feeling very discouraged. I wish the DR had mentioned this could be a possibility, it really freaked me out when I first discovered the prolapse! I'll be seeing the DR again next month, curious what the next step is. I wish you luck with your surgery & will be anxiously awaiting how you do :-)
  #7  
Unread 03-14-2014, 10:27 AM
Re: Is pelvic organ prolapse common after having a hysterectomy?

Mesh has been used in sacrocolpopexy for years. What if anything are they planning to do about your bladder?
  #8  
Unread 03-25-2014, 10:31 PM
Re: Is pelvic organ prolapse common after having a hysterectomy?

The uterus is the primary support for the vaginal vault. Once removed, your chances for prolapse are greatly increased. Some surgeons fail to attach the vaginal cuff to support when performing a hysterectomy, and this is setting patients up for failure. Even if they do, with out the uterus in place, the vault can begin to cave in (rectocele, cystocele, etc.) without that center of support. With that said, what's done is done, and no, mesh is not a requirement to repair prolapse, but rather a choice. Research and make an educated choice.
  #9  
Unread 03-26-2014, 06:43 AM
Re: Is pelvic organ prolapse common after having a hysterectomy?

I had a TVH and A&P repair in January. Instead of my doc using mesh he was able to "tighten" my walls. I was a 2/3 uterine prolapse with my bowels, bladder, and tissues following right behind it. My doc basically removed my uterus and cervix, cut open the walls to place my bladder and bowels back where they should have been. He basically cut off the excess and stitched me up. I refused to have mesh. For myself I was too scared. (Knocks on wood) things are great so far. And the look and feeling of everything is sooooo incredibly different. I forgot this is how it should look. My husband has also noticed that things are much "tighter" (sorry for tmi). I know everyone is different. For myself I apparently have excellent pelvic floor muscles. So I'm not sure if that's what helped. But if you are questioning, ask your doctor. I too am a stay at home mom, age 34.
  #10  
Unread 03-26-2014, 11:53 AM
Re: Is pelvic organ prolapse common after having a hysterectomy?

  Quote:
Originally Posted by DaisyDukes View Post
The uterus is the primary support for the vaginal vault.
I think there is some confusion going on. Women who have a uterus do not have a vaginal vault, so the uterus cannot be the primary support for it. A vaginal vault is created with the removal of the uterus.

  Quote:
Once [uterus is] removed, your chances for prolapse are greatly increased.
Do you have reputable stats for this that you can share? I didn't find them in my research as I shared above.

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