Are there alternatives to hysterectomy with a cystocele, enterocele, rectocele condition?

Are there alternatives to hysterectomy with a cystocele, enterocele, rectocele condition?

Dear Donna-
Any good gyn can perform a uterine suspension for a prolapse. The long term success rates depend on the technique used and the skill of the surgeon. I would ask to speak to some other patients about their outcomes. You can also have an anterior and posterior repair for your cystocele and rectocele.
I would not recommend a hysterectomy for this condition, unless the prolapse is extreme and other alternative procedures have been attempted first.

Hello-

I am a 40 year old with a cantalope-sized fibroid. I have a stage 2-3 uterine prolapse and a cystocele and small rectocele. (2 nine pound babies). When I bear down my cervix emerges but then goes back in when I relax. I have been told my pelvic floor is pretty well toned for someone w/my problem (constant kegels!) My complaints are frequency of urination, bloating, weight gain, difficulty having sex, lower back pain, clotting during periods. I have been to 3 doctors in the Boston area. Two suggested vaginal hysterectomy with extensive reconstruction for the cystocele/rectocele. (I do not want a hysterectomy!) One said she could do an abdominal myomectomy and uterine suspension and would leave the cystocele alone since it isn’t causing major problems now and repairing it could cause more problems than it would fix. Would you be able to do FAS for my fibroid(s) AND a uterine suspension at your center? What about pelvic repair fro the rectocele/cystocele?

Thanks! I await your reply with baited breath!

Jen

Dear JenJen-
No need to have a hysterectomy….FAS would easily take care of your tumors and your suspension.The cystocele may resolve once the uterus is lifted off the bladder. Rectocele can be repaired at a later date on an outpatient basis, by a local physician.
We would be happy to help you…give my office a call.

I am 47, in excellent physical shape, live a very outdoor life, and still compete in road and canoe races. Since the birth of my second, and last child ten years ago, I have suffered increasing incontinence, occasional rectal pain, and persistent UTI’s.
9 months ago, I had a Birch procedure which immediately felt good, especially during sex. 6 weeks later when I resumed exercise, my bladder began to leak and now I feel it is worse than ever. It has been recommended that I have another Birch repair and removal of the uterus as this may be creating pressure on the bladder. Also, my lower abdomen is still “pouchy” since the operation. Is this a sign that my internal organs are prolapsing?
My partner is scared for me to go through with this as his mother almost died undergoing hysterectomy.
Will it?
If I choose to have this procedure and then resume vigorous exercise, will the muscles continue to weaken?

Dear Tasilassie-
Unfortunately, prolapse is one of the only benign situations when hysterectomy might be necessary…the success of suspension surgery is dependent on many things. Prolapse surgery outcomes are extemely variable depending on technique and skill of the surgeon. They are also highly dependent on how severely the internal ligaments that suspend the organs have stretched. It is like a rubber band…once the elasticity is gone..it cant hold much. Outcomes are also dependent on activity..you are an active women and repeated running jolts the body..this could possibly weaken the surgical repair. I would reserve a hysterectomy as the last choice…I would recommend attempting a uterine suspension to remove the weight of the uterus from the bladder..and see how things go.
Of course, your quality of life comes first.
Good Luck