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post vag hystFrom: charlie chambers (cchamber@ic.owatonna.mn.us)Tue May 21 11:47:34 1996
Answer and opinions sought. Performed a TVH with anterior and posterior colporrhaphies on a postmenopausal woman approximately 6 months ago for symptomatic pelvic prolapse. Initial check at 6 weeks normal. Approximately 2 months later noted pelvic discomfort with coitus. Exam shows top 10-20% of the cuff to have significant scarring despite estrogen. Returns with significant post void residual with frequency which I believe is secondary to the residual volume. Now, exam shows 40% of the upper cuff scarred and I believe the bladder to be pulled down into the cuff and scar. Patient quite determined to pursue repeat procedure though I warned her that scarring may recur and make the results less than optimal. Any other suggestions as to management and what procedure would you use, repeat A&P repair, paravaginal repair?
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