For 90 year old women, uterine prolapse can be a daily struggle, but surgery is not worth the risk, pessaries are not comfortable and result in putrid discharge sometimes. In a woman who is no longer having intercourse, why not sew up the lips to keep the uterus in? Has anyone tried this?
Dear Judy Slome Cohain
Greetings, surely the way you mentioned is not going to support the prolapse. Istead, you can suture the vagina which is more strong(Colpocleisis)
Any putrid discharge that accumulates in a pessary would presumably also be accumulating inside the sutured vagina, wouldn't it? With a pessary, you can take it out and clean it, which wouldn't be so easy with a sutured vagina. The vagina is meant to be self-cleaning, with regular outflow. As far as I know, this is still true for a 90-year-old woman.
Suturing the labia will not alleviate the symptoms not to talk of being an effective treatment. If intercourse is not an issue Colpocleisis can be an effective treatment
All helpful. 1. My client has no discharge unless the pessary is in
2. Colpocleisis sounds good.
3. Femicushion worth a try.
Prabhat: I understand something has made you angry. I suggest that if you think something on a research website is irrational, you do the following 2 things
1. Specify WHAT you think is irrational
2. Specify WHY you think it is irrational, bringing scientific support for your theory.
Oh Madam,
Don't be angry. It's debate. Nothing else. What you posted, must have some points and evidences. If you think it is right go and do it. And publish it as you did. I follow this. Problem is your proposition is just your opinion and juniors are seeing it. If you have any patients you can do a strong perineoplasty. However, I have a modified video sent by one of my friends from Portugal. If you want I can share.
But academically, you can do a colpocleiosis with local anesthesia and IV sedation or saddle block. That is rational.
With the aging demographics in the US and around the globe, colpocleisis may be a better option for the elderly than more involved surgeries, and there is still a way for drainage to exit the vagina from what I understand. Getting to and from appointments and even getting up on the exam table gets harder for my patients in their 90's who use a pessary. I now use an electronic exam table just because of this.
Prabhat Chandra Mondal " perineoplasty. However, I have a modified video sent by one of my friends from Portugal. If you want I can share." Yes please! Please send it to me
.
It is better to think about le forte or colpocliesis which can be done by local anaesthia
while closure of both labia minora has a risk of soiling with urine and retention of debris
The pelvic ligaments (the utero-sacral, the cardinal transverse ligaments and the pubo-cervical ligaments are the main factors supporting the uterus and keeping it in situ. Weakness of those ligaments is the main cause of uterine prolapse. The labia minora have nothing to add to the support of the uterus, so sewing the labia minora together would not be effective treatment for Uterine Prolapse in woman who no longer has intercourse. The prolapsing uterus would push the sewed labia minora down and we will get prolapsed uterus covered with sewed labia.