Prolapse (Uro-genital) in Women: Laparoscopic Management

What is Genital Prolapse?

Genital prolapse is a condition where the uterus and/or vagina start descending down and coming out of the body on their own, like a hernia, causing discomfort to the patient.

Usually, it is seen in elderly women after menopause because of tissue weakness associated with age and deficient female hormones (estrogen). Some young women may have prolapse due to inherent tissue defects or after difficult vaginal delivery, compromising the support of the uterus that holds it up in the body.

Symptoms

• Dragging sensation
  

• Organs coming out of the vagina
  

• Difficulty while walking
  

• Difficulty in passing urine and stool
  

• Need to reposition organs back inside to pass urine
  

Young women with prolapse may have additional difficulty conceiving due to inability to have intercourse.

Treatment

Pessary

A ring pessary can be inserted in the vagina to hold the uterus up. It is a temporary measure until surgery is planned.

Exercises

Early prolapse can respond to pelvic exercises, but once it is already coming out of the body, it has to be corrected surgically.

Surgery surgical correction is done from vaginal or abdominal approach. To provide extra strength to weak tissue, mesh is used like in hernia correction surgeries. Vaginal mesh is no more used due to high complication rate. Thats why Abdominal mesh is used to fix the vagina and uterus to the body again and gives excellent outcome with minimal complication. Open surgery is to b avoided in these patients bcoz they have high risk to develop hernia through big abdominal incision site later on. Hence laparoscopic surgery does wonder job to correct the prolapse with mesh and avoiding hernia formation in future too. Patient’ recovery is very fast after laparoscopic surgery and she can go home within 24hrs of surgery.