What is a Prolapse?
Prolapse of the uterus is a medical condition in which the structures of the vagina and the uterus get weakened and move down the vagina towards the vulva. The condition affects a large number of women so it can be considered as a fairly common one. The aforementioned structures get damaged so the condition gradually develops. There are numerous factors which may lead to the development of a prolapse and these include the natural process of aging, obesity, chronic cough, constipation, straining and lifting heavy objects. In some instances prolapse may be associated with childbirth. Some cases may also be connected to genetic weakness of the tissues which are in charge of supporting the uterus or the vagina. The most common symptoms of this uncomfortable medical condition may include a feeling of fullness in the vagina or a sensation which may be described as a dragging one.
What is a Vaginal Hysterectomy?
Vaginal hysterectomy is a certain type of surgical procedure which involves the removal of the uterus through an incision in the vagina. This type of surgery is in most cases accompanied by sling and bowel procedures for urinary incontinence and prolapse repairs of the bladder. Not all cases of prolapse of the uterus require a vaginal hysterectomy as there are also certain alternatives to surgery which may sometimes be helpful. This is mainly due to the fact that there are different degrees of prolapse. One of the most commonly utilized alternatives to vaginal hysterectomy is physiotherapy. In some cases it is used in conjunction with certain types of devices inserted into the vagina which are exceptionally efficient in improving its muscle tone. Other alternative treatment methods include vaginal pessary which is a plastic sort of device which serves a purposes of holding the prolapse up. Some cases may also be relieved by utilizing specially designed pelvic floor exercises.
How is a Vaginal Hysterectomy Performed?
Vaginal hysterectomy needs to be performed in a hospital
setting and it requires either spinal or general anesthesia, which may sometimes be accompanied by sedation. The surgeon first needs to make a cut
around the cervix, before carefully pushing the bladder and the bowel away from
the uterus. The next step of the surgical procedure involves clamping, cutting
and tying the blood vessels that supply the uterus and all the surrounding
tissues. The uterus then gets removed and the vaginal vault gets closed. Some
cases of vaginal hysterectomy may involve the use of additional supporting
stitches to the vaginal vault. Once the surgery is performed, the patient is
returned to the ward where the nursing staff checks the vaginal bleeding, the
temperature, respiration, pulse and blood pressure of the patient. The
patient needs to move onto alternate sides every two hours in order to prevent
pressure sores from occurring on the heels, the bottom and the back. One also
needs to take a really deep breath every hour in order to prevent any chest
infections from developing. The patient will also receive an absorbent dressing
in the vagina which is very efficient in preventing any excessive bleeding.
Some patients may receive a catheter as well in order to be able to pass the urine
much more easily.
Complications of Vaginal Hysterectomy
Even though vaginal hysterectomy is in most cases completely safe, it may still be associated with certain types of complications. One of the possible complications includes the urinary retention which may occur in a couple of days after the surgery has been performed. Due to difficulties in passing urine, the patient may need to use a catheter in order to pass it normally. Some cases of vaginal hysterectomy are involved with injuries to certain adjacent organs such as the rectum, the ureters or the bladder. Some rare cases may also involve the development of a vaginal fistula. Among the most dangerous complications of vaginal hysterectomy are different sorts of infections. Antibiotics are commonly used before and after the surgery in order to prevent infection, but there are still small chances of the development of pelvic or vaginal infections. Such types of infections may easily be detected by symptoms like fever, an unpleasant smelling vaginal discharge and burning or stinging sensations when passing urine. Some rare cases of vaginal hysterectomy may involve severe blood loss and hematoma. The cases in which hematoma occurs are usually taken care of by utilizing surgical drainage, while blood loss may be compensated for with blood transfusion. Embolism or blood clots in the legs or the lungs are a pretty much rare risk in pelvic surgery and even if they do occur, they may be relieved by utilizing certain types of blood thinning agents or support stockings. Most surgical interventions require the use of modern anesthetics and there are certain problems associated with those which may also take place in some cases of vaginal hysterectomy.