Uterine prolapse questions ?

I have just been told today by My GYN that I have a uterine prolapse. Its stage one but getting worse. She has recomended a total hysterectomy removing my uterus and cervix. I'm OK with that as I don't anymore children. I've had several painfull cysts on my left ovary but She said She wanted me to try to keep both, because of my age.

I am 28 have had 1 child,1 tubal pregancy, 2 medically necessary abortions and finally my tubes tied. I've been married 6 months and only able to have sex 4 times this is ruining my sex life (painfull and spoting afterward), not to mention its pressing on my bladder and I can't even use a tampon anymore. I was even spotting after My OB giving me a very gentle exam.

My questions are..
1. Is a abdominal hysterectomy better than the Vaginal one ? Is it true the vaginal one will make sex uncomfortable after ?

2. I just started a new job and stand all day, is this safe until surgery?

3. Will 1 ovary work as good as 2 if I have the bad one removed?

I've read all the general info on the web, I'm looking for someone who's been thru it or knows about it to answer my questions, while I'm waiting for my second Dr's appt. (Can't see them till after the Holidays)
Thanks.

I have been in the medical field for 12 years, however I am not qualified to answer your questions directly. I would recommend getting a second opinion, due to the worry inherent in your questions. Most insurance companies will cover a second opinion in the question or surgery. Good luck, and I hope things turn for the better.

It would be wise to ask your DR these questions and maybe even get a second opinion.

reatment Return to top

Uterine prolapse can be treated with a vaginal pessary or surgery.

A vaginal pessary is an object inserted into the vagina to hold the uterus in place. It may be used as a temporary or permanent form of treatment. Vaginal pessaries are fitted for each individual woman.

Pessaries may cause an irritating and abnormal smelling discharge, and they require periodic cleaning, usually done by the physician. In some women they rub on and irritate the vaginal mucosa, and in some cases may erode and cause ulcerations. Some types of pessaries may interfere with normal sexual intercourse by limiting the depth of penetration.

If the woman is obese, attaining and maintaining optimal weight is recommended. Heavy lifting or straining should be avoided.

There are some surgical procedures that can be done without removing the uterus, such as a sacral colpopexy. This procedure involves the use of surgical mesh for supporting the uterus.

Most surgery should be deferred until symptoms are significant enough to outweigh the risks. The surgical approach depends on:

* The woman's age and general health
* Desire for future pregnancies
* Preservation of vaginal function
* Degree of prolapse
* Associated conditions

When indicated, a vaginal hysterectomy is performed. Any sagging of the vaginal walls, urethra, bladder, or rectum can be surgically corrected at the same time.

Expectations (prognosis) Return to top

With proper precautions (periodic check-ups and cleaning) vaginal pessaries can be effective for many women with uterine prolapse. Surgery, if done, usually provides excellent results, however, some women may require treatment again in the future for recurrent prolapse of the vaginal walls.

Complications Return to top

Urinary tract infections and other urinary symptoms may occur due to the frequently associated cystocele. Constipation and hemorrhoids may also occur as a result of the associated rectocele. Ulceration and infection may occur in more severe cases of prolapse.

Calling your health care provider Return to top

Call for an appointment with your health care provider if symptoms of uterine prolapse occur.

Prevention Return to top

Prenatal and postpartum Kegel exercises (tightening of the pelvic floor musculature as if trying to interrupt urine flow) help to strengthen the muscles and reduces the risk.

How an episiotomy and other obstetric procedures affect the later development of uterine prolapse is unclear. Estrogen replacement therapy in postmenopausal women tends to help maintain muscle tone.

Update Date: 6/6/2006
http://www.nlm.nih.gov/medlineplus/ency/...

4 years ago I had a 'relationship' with a much older woman in my neighborhood who had had a full hysterectomy over 10 years prior... she may have gotten used to the effects after that long or something, I don't know, but her sex drive was certainly quite high.

You've already had some good answers which I won't duplicate.

If your left ovary is seriously cystic it's probably more dysfunctional than functional.

Where the uterus is already prolapsed, most surgeons prefer to do a vaginal hysterectomy.

If you don't have the prolapse attended to there's a fair chance that it will eventually reach the stage where first the cervix will reach the mouth of the vagina then the whole vagina will turn inside-out as the uterus pushes outside the body. However, the equation is not as simple as it appears, because it's not terribly uncommon (though surgeons aren't terribly open about the statistics) for other organs (eg bladder or rectum) to prolapse in later years after a hysterectomy which is why in older women they may carry out a vaginal ablation -- remove the vagina and sew up the entrance.