? anyone with stage 4 prolapse repair without hysterectomy

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Have a stage 4 cystocele. 2 rectocele, small enterocele, vault prolapse, uterne prolapse. Want it repaired but can't find a surgeon willing to do without also doing a hysterectomy. My uterus is normal size and not diseased.  Has anyone had prolapse repair of stage 4 and their uterus suspended instead of being taken out? Or is it age discrimination (66)? Live in Texas

 

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  • Posted

    Hello janet I can't speak for Urogynaecologists in the USA but in the UK no surgeon would remove your uterus if you didn't want it removed. I'm in the UK so I hope someone in your country can help but can I as why do they want to perform a hysterectomy rather than repairing your prolapse?
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  • Posted

    Hi,

     I just wanted to say my case  was a bit similar to yours. I had  a severe bladder prolapse that when I saw the consultant he said you have a mild uterine  prolapse and rectocele so repair 2 and  too  remove uterus. I was shocked and said can't you just repair it and he said no..you will just be back.  I then talked to my GP (NHS) who was surprised as well,  so asked  could I have a second opinion and was allowed a referral to a very experiences Urogynaecologist. He said exactly the same thing   And when I said could you just not repair the uterus he said there woild be nothing to stitch it to?! Well I still didn't understand really as others have repairs!?  But I believed him far more so I went ahead .  I am just a bit younger than you so I thought I don't need the uterus and it's the something else to fall down ! and they must know what they're talking about. I had the op 5 months ago and it's been fantastic , no problems whatsoever now  so after all these years it's quite amazing .  Basically I would say just go with it . The uterus seems nothing but a problem in later life!  All the best.

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  • Posted

    Hello Janet

    I had a hysterectomy for stage 4 prolapse along with anterior and posterior repairs.  I was under one of the top urogynaecologists in the UK and this is standard practice.  I'm 64 and being past the menopause I can see no need to keep the uterus.  I feel it is 100% worth having a hysterectomy even though I'm still very tired after 3 months.  I was very uncomfortable and unable to do much before the op.  Doctors don't think they can successfully repair a stage 4 prolapse long term, especially with the weaker muscles that we have in our 60s.  I wonder why you are so keen to keep your uterus.

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    • Posted

      Believe it or not moira a lot of women don't want a hysterectomy and I can fully understand why after working in gynaecology/urogynaecology for so long. There are several reasons but the main one it seems is that is the loss of something that determines us as women. I know many gynaecologists when the train medical students or junior doctors mention how women can "mourn their womb" and they are absolutely right. Even though we may not have a use for it remember you are having a major organ removed and with that can be complications.
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    • Posted

      Hi Matron - if I'd been younger I could have felt a loss but really don't have any issue about it now.  I appreciate I had a major organ removed and major surgery but it was a choice between this and extreme discomfort with a very limited lifestyle.  Any medical intervention is a choice and we balance pros and cons.  I'm having some incontinence still post op but feel I can live with this rather than have any other intervention.
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    • Posted

      I understand exactly why you had a hysterectomy I was merely pointing out why women question the decision of a Urogynaecologist or gynaecologist. Hysterectomy is now relatively safe but once you start removing other bits and pieces then obviously you increase the risk which is always discussed thoroughly with the patient, I hope anyway. I was 36 when I had a hysterectomy and oophorectomy so very young but I had no choice, however I was very depressed afterwards despite having the best care. Just to add so I put other ladies minds at rest, all Urogynaecologists are at the top of their game so to speak because of the extra training and the close monitoring of prolapse surgery so rest assured the most appropriate advice will be given.
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  • Posted

    Hi Moira,

     I just want to say I echo your thoughts exactly. Matron I think it's totally different having  a hysterectomy  when young and I can see that could be almost traumatic but  post  60 when you have so many problems and discomfort and know you have had your reproductive life as it were it is  more just a relief and a step forward, some hope for the future without all the problems .  It's definitely a matter of weighing it all up  and looking at your own individual case.  And Moira I also just want to say that I had slight incontinence issues  still at 3 months too and  thought  oh well it's still heaps better  but was planning to see the GP but  then by 4 months they had all gone and it's actually fantastic so hang in there and hopefully you'll be the

    same.

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    • Posted

      It is different when you are young but even women in their 60's feel the same way. I have found that age doesn't come into it in some cases. We've had ladies in their 60's change their mind on the way to the operating theatre despite their problems. Yes we mostly been able to speak to them and give them more time so the surgery eventually takes place but actually working in that area you see a totally different side to things. It's not like on the television eg Holby City
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    • Posted

      Alybee - thank you for your advice on the incontinence.  I hope mine improves.   I'm seeing a physio so getting the best advice on pelvic floor exercises.
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    • Posted

      Yes, I assumed that all physios work only in specialised areas in hospitals, as with doctors and nurses (I used to work at this hospital so know it well).
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    • Posted

      Unfortunately a lot of physios work with patients with pelvic floor problems but haven't undertaken the specialist training this is why I asked. In some health trusts Urogynaecologists have specialist physiotherapists working alongside them as part of the team but due to financial constraints in the NHS this isn't always the case. The specialist physios have all the necessary equipment to ensure ladies are doing their pelvic floor exercises correctly. 
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  • Posted

    I am under the care of a London teaching hospital with a large team of women's health specialists, including women's health physios and incontinence specialist nurses - as I said, I used to work there so know the system.
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