Prolapse Repair Surgery

The aim of prolapse repair surgery is to restore normal anatomy, correct bladder and bowel abnormalities, and restore normal sexual function.  Dr Marshall will thoroughly assess the symptoms and signs of dysfunction and will discuss with you a plan for the best type of surgery to restore normal anatomy and reduce the likelihood of a recurrence, with the least risk of complications. 

There are a variety of procedures and techniques for this surgery and these include:

  • Anterior and posterior repair (with or without the use of mesh). A cut is made in the vagina and the weakened deeper tissues are reinforced and stitched together.  The vaginal skin is then closed over the repair.
  • Vaginal hysterectomy
  • Sacrospinous fixation
  • Sacrocolpopexy

Prolapse surgery can be complex surgery, depending on the grade, severity and the areas involved.  Therefore careful assessment and discussion about the correct surgery will be done.  There are different types of surgery and different methods and Dr Marshall will individualise treatment specific to your problems. 

At your consultation Dr Marshall will describe these procedures in detail and will use illustrations to help you understand your surgery. There are advantages and disadvantages to each of the procedures, particularly to the use of vaginal mesh. Vaginal mesh procedures can give better long term results but can have higher complication rates. Long term data is still being compiled on the use of mesh and therefore Dr Marshall uses mesh carefully after due consideration and discussion.  Dr Marshall has extensive training and experience in pelvic reconstructive surgery, including using mesh, over many years and has had excellent results.  Dr Marshall is experienced in using Elevate Mesh and is now is a preceptor / teacher, training other gynaecologists in this procedure.

Possible complications of surgery

As with all surgical procedures, pelvic prolapse surgery can have risks but these are minimised with an experienced gynaecologist who has undergone appropriate training.  The possible complications include:

  • Injury to other organs near the surgery such as bladder, urethra and bowel.  These injuries are rare and are usually recognized and repaired during the procedure.
  • Urinary tract infection
  • Intercourse may be painful in a small percentage of women
  • Prolapse may recur in about 20% of women over the long term.  This may not necessarily be the same prolapse but could be a new prolapse in other areas of the vagina.
  • The procedure may fail in about 5% of women
  • About 5-10% of women may develop stress urinary incontinence which was not present before the surgery.
  • Some women may have difficulty passing urine for a short while and this may require use of a urinary catheter short term.
  • The use of mesh may have specific complication in 5-10% of women such as mesh erosion into the vagina, pain with intercourse, or infection.  If these complications are severe the mesh may need to be removed but this is rare.

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