Vaginal Prolapse Repair
Childbirth and pelvic surgery can both weaken the support structures of the vagina. As a result, prolapse (falling out) of the small intestine, rectum, bladder, and urethra (the tube that empties the bladder) can occur, thereby affecting the function of these organs. In the event of vaginal prolapse, some support structures can be restored laparoscopically.
Laparoscopic vaginal prolapse repair combines the superior access of the abdominal approach with the minimally invasive nature of the vaginal approach. Laparoscopic correction using small “button-hole” size incisions not only reduces the operative risk and recovery time compared to large incision surgery, but also improves the precision of the repair. However, some prolapse problems are best repaired vaginally by an expert vaginal surgeon. At times, two surgeons with different areas of expertise will work together.
Similar to other laparoscopic procedures, the surgeon makes a button-size incision in the center of the abdomen for the insertion of a surgical telescope. After expanding the body cavity with carbon dioxide gas, two or three additional small incisions are made to place narrow tubes used for interchangeable instruments. The surgeon can then visualize the internal organs and the interchangeable instruments on a television monitor.
The pelvic organs are then fully exposed. The normal anatomy is meticulously restored to its original position with suture. Often, additional repair through a vaginal incision is performed to ensure all areas of vaginal support are restored. The urinary drainage catheter usually remains overnight. The skin openings are closed with shower-resistant glue as a substitute for both stitches and bandages.
Results & More
Laparoscopic vaginal prolapse repair facilitates quicker recovery, less pain, and a lower complication rate as compared to the typical open-incision vaginal prolapse repair. Our success has matched any published series for vaginal prolapse repair. Vast experience and a world-class surgical team help ensure this high level of success.
Most patients are discharged from the hospital the day following surgery. Risk of transfusion, damage to surrounding organs, blood clots, pneumonia, and wound infection are each under 1%.
Q: How much pain can I expect after the procedure?
A: Pain is typically less with laparoscopic procedures when compared to open-incision surgery. Some abdominal cramps and shoulder discomfort can occur from the carbon dioxide gas used during surgery. This type of pain is best treated with anti-inflammatories rather than narcotics. Although everyone is different, post-operative discomfort is usually easily managed and short-lived.
Q: Is bruising normal after a laparoscopic procedure?
A: When a narrow tube is placed through a button-size skin incision, a small blood vessel just below the skin can break. However, since the snug fit of this tube will compress the blood vessel during surgery, bleeding will often not occur. If this blood vessel were to re-open at a later time, a small amount of blood could track over a large surrounding area (including the genitalia). This is not a true bruise but will have the same appearance. Most important, this finding is not an indication of internal problems.
Q: When can I return to work or other normal activities following my surgical procedure?
A: Scott D. Miller, MD recommends at least two weeks away from work. Very few jobs would require more than four weeks of leave. In many cases, a small amount of light work-related duties are acceptable during the first two weeks. All patients should move around frequently from the time of surgery and resume light exercise at one week (gradually increasing to a normal routine by four weeks). Driving a car is often reasonable in approximately one week if reaction time is good. Of course, Dr. Scott Miller will provide guidance for each individual situation.
Q: When can I start having sexual intercourse after surgery?
A: To allow the proper time for healing, nothing should enter the vagina for four weeks following the surgery.
Q: How long does the surgery take Dr. Scott Miller to perform?
A: Although many variables can affect the time necessary for Dr. Scott Miller to meticulously perform the surgery, he usually completes the procedure in one to two hours. However, the time away from family members also includes preparation (30-40 minutes), anesthetic reversal (15-20 minutes), and recovery room stay (2 or more hours). Dr. Scott Miller asks patients to arrive two hours prior to this process, during which time family members can remain present. Occasional updates are given to the family by the operating room nurse. Dr. Scott Miller will come to the waiting area when the patient is ready for transfer to the recovery room.
Q: How long do I stay in the hospital following surgery?
A: Most patients are ready for discharge on the day following surgery.
Q: Should I donate blood prior to my procedure?
A: Since the risk of needing a blood transfusion is less than 1%, blood donation is not necessary.
Q: When can I shower or bathe following my surgery?
A: Since shower-resistant glue was used as a substitute for both stitches and bandages, showering is acceptable once discharged from the hospital. Although water will not harm the surgical areas, mechanical cleansing of the incisions should be avoided for the first week to prevent premature removal of the glue. Complete immersion such as bathing or swimming is allowed at two weeks.