Is it usual to have a hysterectomy with a pelvic floor repair ?

[underactivethyroidmum]

I've just been to see a consultant gynae as I have a prolapse at the front and rear of my vagina. One of the things that has left me quite upset is that she has said that if once I'm on the table she thinks my uterus has fallen down, she will have to remove it.
Tbh I'm in floods of tears ! I am 43 and although my family is complete I really don't feel ready to loose my womb ffs
So my question is, how many people have a hysterectomy while under going a pelvic floor repair and if I do have a hysterectomy what are the implications of that ?
Will I still have periods or will I go through the menopause straight away ???
At the moment I am debating whether its worth putting up with wearing tena pads rather than loose my womb

Get a second opinion - I'm not a DR or been in that situation, but it seems extreme. I completely understand why you are devastated at the thought.

If it is the worst case scenario, then I'm sure MN will supply some advice. I'd get a second, and even a third private opinion before I went ahead with surgery of that nature.

Both my mum and sister has full hysterectomies as a result of prolapse. Sorry you are going through this

I don't think it's uncommon sadly, but not a certainty. Removing one of the pelvic floor organs would put less pressure on the repair I guess! Have you tried other interventions to try to manage your symptoms and possibly delay surgery e.g seen a women's health physio or tried a pessary?

AFAIK the overies are often left in this sort of situation, meaning that one doesn't plunge straight into menopause.

A second opionion might well be wise though. There's a long running thread on here about prolapse repair that might be of use to you.

Good luck

I had pelvic floor repair for bladder and bowel prolapses in May this year and my womb wasn't removed (it wasn't prolapsed). I think, though I'm NOT an expert that if it isn't prolapsed, it's better for the other repairs, if it's kept.

Under your gynae is right in that it can be difficult to assess a uterine prolapse when you're lying in clinic tense and its much more obvious under anaesthetic. If the uterus isn't prolapsing it should stay as it helps support the repairs but if it is prolapsing then any other repairs won't work and will likely recur requiring further treatment. Although your womb would be removed your ovaries would remain in place and so there would be no change from a hormonal perspective. Obviously you'd no longer have periods or require smears and the risks of bleeding or other organ damage are slightly higher at the time of surgery but not as high as having two separate operations if you did need a further repair.

There are various ways to sort all of this out.
TBH she doesn't sound very competent.
It's relatively easy to see uterine descent as they call it. You lie on your side, cough or bear down and they take a look with a speculum.
You can also be examined while you stand up on the couch ( Don't ask!- Been there and got the T-shirt.) You can also examine yourself when standing up and see how far down it's dropped.

Removing your womb can have side effects such as earlier menopause (even when your ovaries are left) but also vaginal prolapse because the uterus actually provides support.

There are repair operations that can lift the uterus back in place- called suspension- where it's fixed to the pelvic bones.

I really suggest that you ask for a 2nd or 3rd opinion and also google the topic so you can go in better informed and ask the right questions.

If you uterus is a long way down- at the vaginal opening- then removal may be best in the long run, but if it's only slightly dropped then they can shorten the ligaments and lift it back up a bit.

This is a tough one - and definitely get a second opinion

but - if this is what others echo maybe you should consider it . I was very anti hyster and I had a different surgery to remove fibroid - like you I was very 'attached' to womb

Now I kind of wish they had whipped it out - as I will hit the menopause in about 8 years anyway

So I understand the emotional attachment - and saying it's worth thinking hard at your end too

Shocking news though X

I had prolapse repair last year and when I first saw my consultant/surgeon he couldn't tell if my womb had prolapsed as well due to the severity of the bladder and bowel prolapses so its not always easy for them to tell during examination. I was warned that they may have had to do hysterectomy and I'm early 30's. While I am definitely finished having children its still a big step. I had a number of conversations with my surgeon over the course of about 6 months before finally agreeing the best option for me.

We did look at sacrial fixation (sorry cant remember exact term or spelling) where they can stitch it to the muscles in your lower back but that would have caused me permanent back pain as I already have a weak point with my sacrial muscles. But this could be an option for you.

Also, if they do a hysterectomy that then leaves room for things to prolapse again so its not always the best option. But you need to have trust and faith in your surgeon/consultant so definitely get a second opinion.

I didn't need the hysterectomy in the end, but the surgery has changed my life for the better.