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

Re: Uterine Prolapse

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Wed, 26 Mar 1997 23:02:41 -0600 (CST)

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In reply to: Janet: "Uterine Prolapse"

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.

Janet-

Others have provided detailed and well-reasoned responses to your question, but I wanted to add my input. I am reluctant to perform surgery unless there are significant indications for it, since complications can occur during even "easy" surgeries. For this reason I often try to convince patients to "hold off" and try other treatments before resorting to surgery. However, in some situations surgery offers the most effective treatment for the problem, and in cases of uterine prolapse to the degree you report, surgery is usually the most effective treatment we have.

Since you have other support problems, such as cysto- and rectocele (and probably diminished vaginal support as well) a uterine suspension would be temporizing, at best. Furthermore, I doubt Kegal's will do much at this stage, although they are good for less severe problems. Finally, a pessary is a reasonable choice for many women (discussed, I believe, by Dr Braun) but I find that women with bad prolapse don't do very well with pessaries, while many women with minimal prolapse do quite well.

Finally, despite the extremist opinions one reads in women's magazines and in the newspaper, *many* women are thrilled with the results of their hysterectomy, and this is well-documented in the medical literature. For example, I had 3 women in for post-operative appointments the other day after hysterectomy (1 for severe prolapse, one for a soccer ball-sized uterine fibroid, and another for pain from severe endometriosis) who literally laughed at a newspaper article that day suggesting hysterectomies were not worthwhile. Try telling that to the lady with endometriosis who had pain-free intercourse with her husband for the first time in 3 years!

So, you do have a number of options to discuss with your doctor. Good luck to you.

--
Ashley Hill
D. Ashley Hill, M.D.
Assistant Director, Department of Ob/Gyn
Florida Hospital Family Practice Residency
Orlando, FL
dahmd@gate.net

Next message: Marty: "Blood Glucose Levels"
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In reply to: Janet: "Uterine Prolapse"

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