WOMENS-HEALTH Messages for March, 1997: Re: Uterine Prolapse

Re: Uterine Prolapse

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Wed, 26 Mar 1997 20:48:26 -0600 (CST)

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Hi Janet,

At Wed, 26 Mar 1997, Janet wrote: >
>I Have a prolapsed uterus to the point where my cervix is sometimes
>protruding about an inch outside of me . I also have a cystocele and a
>rectocele.(They occured before the prolapse) I really do not want a
>hysterectomy.

I can understand you not wanting to have surgery, especially a hysterectomy which carries so many different connotations for libido, sexuality and pelvic support.

>I live on Long Island

Me too!

>and I am having trouble finding a
>doctor that will do a uterine suspension.Does anyone know of any doctor
>that specializes in this?

I am not aware of anyonewho specializes in uterine suspensions other than infertility specialists who had done it on rare occasions to elevate the uterus out of the pelvis (to reduce scarring from assorted problems). It really isn't done any more. Besides, with prolapse, cystocele and rectocele, you are not considered a candidate for suspension, IMHO. I'm sure the treatment recommended to you was a vaginal hysterectomy (for the prolapse) and anterior and posterior repair (for the cystocele and rectocele). It is possible that you may be a candidate for a Manchester-Fothergill procedure and a posterior repair. (The M-F procedure would maintain the uterus but requires amputation of the cervix and transfixation of the ligaments of the cervix. It also includes the anterior repair). This may not be possible to do and may not be to your liking since some patients feel that vaginal moisture and ability for orgasms are related to the presence of the cervix.

>I am 42 years old and have not gone through
>menopause yet. I have read that a hysterectomy cuts off some of the
>blood supply to the ovaries and causes a woman to go into menopause
>sooner than she normally would.

This has been reported in some studies but may not be a significant (medically speaking) time difference.

>I also have heard the uterus affects
>sexual response,

Not corroborated by studies I've seen.

>affects the support of other organs

With prolapse, cystocele and rectocele, this had already happened.

>and releases
>chemicals in the body that contribute to your overall feeling of well
>being(endorphins).

Haven't seen that in the medical literaure either.

>I am sorry that this is so long, but if there is
>anyone out there that can help me please write. Oh, also at what point
>should I give up on doing Kegels.

Now would be fine. Kegels are good for minor symptoms of stress incontinence but has not been shown to reduce prolapse, cystocele or rectocele.

>They seem like they don't do a darn
>thing.

Exactly. And BTW, there are psychological studies showing that libido, sexuality, depression and other negative effects assigned by some to hysterectomy, can be predicted in advance of the surgery by intensive psychological testing. The conclusion of this study is that people who expect a problem after hysterectomy, will. And people who expect no change in the above noted attributes, usually don't. Good luck in your search.

-- Harvey S. Marchbein, M.D. FACOG, FACS OBGYN.net U.S. Representative, New York Great Neck, New York

*Note: Opinions expressed here are for educational purpose only. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options.

Next message: anonymous@obgyn.net: "Re: About endometrosis"
Previous message: barbara: "Re: STD's"
In reply to: Janet: "Uterine Prolapse"
Next in thread: D. Ashley Hill, M.D.: "Re: Uterine Prolapse"

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