Uterine prolapse, with its symptoms that affect the person’s quality of life quite badly, is a condition that must certainly be treated correctly. The uterus is an organ whose capacity for movement is very low and around which there are ligaments so that it stays fixed in its place. Birth, advancing age, the menopause or damage due to trauma cause the ligaments that hold the uterus in place to weaken. As a result of this, the uterus can slide downwards through the vagina.
What Are the Symptoms of Uterine Prolapse?
Because the symptoms of uterine prolapse are symptoms that lower the person’s quality of life, they must certainly be observed well and treated within a short time. Constipation is a quite important problem in this condition. When the problem of constipation, which appears both as a symptom and as a cause, continues in the long term, it is recommended that a doctor certainly be consulted. Just as a long-lasting serious problem of constipation can cause uterine prolapse to develop, more importantly it can also be a symptom of uterine prolapse. Apart from constipation, the most important symptom of uterine prolapse is a feeling of pressure occurring in the groin area and the protrusion from the vagina of a mass that is sometimes smaller and sometimes quite large. The prolapsing part can come outside and can be felt by hand. Because of rubbing outside, there may be sores on the mass. The protrusion of the mass from the vagina is a quite advanced symptom and, as soon as it is noticed, a specialist in obstetrics and gynaecology must certainly be consulted. Symptoms such as urinary tract infections, urinary incontinence, being unable to pass urine because the mass blocks the urinary tract, leaking wind, faecal incontinence and loss of sexual desire may point to uterine prolapse.
Why Does Uterine Prolapse Occur?
Having a large number of births, giving birth to a large baby, a severe chronic cough, long-lasting serious constipation, working while lifting heavy loads, obesity and genetic causes are the best-known causes of uterine prolapse. One or several of these causes can bring about uterine prolapse. For this condition, which is treatable and which at an initial level does not even require a direct surgical procedure, being under a doctor’s follow-up is quite important. If the uterine prolapse is at an initial level, the progression of the problem can be prevented with certain exercises without the need for a surgical procedure, and the prolapse can even be made to disappear.
How Is It Treated?
In mild prolapse, relief can be achieved with pelvic floor exercises (Kegel exercises). In the case of advanced uterine prolapse, suspension operations are performed vaginally (from below) or through the abdomen. Operations performed through the abdomen are, unless there is a very exceptional situation, carried out with the closed method, that is, with the laparoscopic or robotic surgical method. The most important point in these operations is that all the parts where there is prolapse and tearing in the ligaments must be repaired. Otherwise, in tissues with little prolapse in the early period, more prolapse can occur. For patients severely affected by births, a vaginal tightening (repair) operation can also be added. Can Robotic Surgery Be Used in Uterine Prolapse Operations? Today, robotic surgery is used successfully in pelvic floor disorders such as prolapse. The most important obstacle is that the robot system is not available everywhere and that the number of doctors who can perform these operations with the robot is small. The types of operation in which the use of robotic surgery is most advantageous are uterine prolapse operations. Being able to place stitches very comfortably under a three-dimensional image with jointed instruments affects the success of the operation.
Is There a Hidden Danger in Prolapse Operations?
In these patients there may be a hidden condition of urinary incontinence. The prolapsing mass can block the urinary tract and cause an inability to pass urine instead of urinary incontinence. To understand this situation we use a simple method. We place the mass inside the vagina and perform the urinary incontinence tests. When we remain in doubt, a urodynamic test is also added to the same procedure. Therefore it is necessary to know before the operation whether a condition of urinary incontinence is present, and accordingly it is decided whether an incontinence operation will be added to the prolapse operation.
Can Prolapse Develop Again in the Patient After Prolapse Operations?
There are 4 important factors for the success of prolapse operations; 1: Before the Operation the Patient Must Be Examined in Great Detail. All the places where there is prolapse should be assessed as a whole; not a single defect but the whole prolapsing structure should be repaired. 2: Whether a Hidden Condition of Urinary Incontinence Is Present must certainly be investigated. If urinary incontinence accompanies the prolapse, an incontinence operation should also be added to the prolapse operation. 3: The Type of Operation Chosen; it should be decided according to the patient’s age, whether only the uterus or also the bladder and bowel prolapse accompany it, and according to the patient’s age and previous operations. A surgical technique that will be very good in one patient may not be a very good method in another. 4: The Experience of the Surgical Team That Will Perform This Operation; be sure to ask the doctor who will perform your operation about their success rates and recurrence rates. In these operations the most important factor for success afterwards is the long-term success rate. And this is extremely closely linked to the experience of the surgical team and to the changes the patient will make in her lifestyle.