What preparations must be made before the operation? | Surgery of a uterus prolapse

What preparations must be made before the operation?

The operation is normally performed under general anesthesia. Only in exceptional cases is it performed under local anesthesia alone. Before a general anesthesia, there is always an informative conversation with an anesthesiologist, in which, among other things, the risks of anesthesia and the medical history are discussed.

Immediately before the operation, you must fast for the anesthesia. This means that you are not allowed to eat or drink for several hours before the operation. This will also be discussed with the anesthesiologist during the preliminary consultation. Since the operation is performed in the company of a stay in the clinic, the gynecologists on the ward discuss the risks of the operation with the patient in advance of the operation and obtain her consent.

Procedure of the surgery

In the most common surgical method, the uterus is removed via a vaginal access. This means that an incision in the abdominal area is not necessarily necessary. Excess vaginal tissue is then removed and the vaginal stump is closed.

This is fixed to the sacrum. This is followed by pelvic floor plastic surgery (colporraphy). Anterior pelvic floor surgery is mainly used when there is a lowering of the bladder in addition to the uterus.

For this purpose, an incision is made in the anterior vaginal wall and the bladder is detached. The ligaments that are in contact with the bladder are gathered together so that the bladder can lie slightly higher. In posterior pelvic floor plastic surgery with perineoplasty, the posterior vaginal wall is detached from the rectum.

This allows the tissue around the vagina to be gathered. In the next step, the muscles of the pelvic floor are then connected to the muscles of the perineum. These gathers and connections are intended to increase the stability of the holding apparatus and thus prevent further prolapse.

Since this surgical procedure has a high risk of causing further subsidence, newer surgical methods use nets that are inserted into the pelvis.In women with an existing desire to have children, the uterus is left in place and only the support apparatus and the pelvic floor muscles are tightened in order to achieve new stability. The duration of the operation depends very much on the surgical method and the extent of the operation. Nevertheless, it is a rather short operation, lasting on average between 30 and 60 minutes. If the bladder is also operated on to restore continence or the uterus is removed completely, the surgery time is longer.