Suprapubic Uterine Suspension aims to suspend the uterus and the vagina to its normal position by shortening and strengthening the round ligaments (supportive vaginal wall). It keeps the uterus from descending into (and out of) the vagina. When a firm mass is felt or a hard bulge is seen protruding out the vagina it is usually a cervix and uterus prolapsing past the vaginal opening. This problem typically was treated with a hysterectomy or an abdominal procedure to shorten stretched out ligaments thereby suspending the uterus and cervix. Anyway, another alternative surgery is the Suprapubic Uterine Suspension.
Recently, laser has been applicable to the Suprapubic Uterine Suspension, consequently benefits of Laser Vaginal Rejuvenation including more precision and accuracy as a result of the surgical wound control, less blood loss, lower vessel and tissue damages and quicker recovery time thus bringing about better results than using the old conventional scalpel procedure.
Procedure and Post-Operative Processes
- In the appointment day, you will be informed of the procedure details again. You may ask for any additional information including consent forms and post-operative suggestion form. In case of uncertainty, doubt, worry, or unconfidence for any reasons, you should postpone the procedure appointment.
- The surgery will be performed in our Operating Room for 1-1.5 hour under general anesthetic by our board-certified anesthesiologist. This problem typically was treated with an abdominal procedure with a horizontal surgical wound over the mons pubis bone (Some patients need the surgery with a vertical surgical wound under the navel, e.g., those who have had abdominal operations with residential vertical surgical wounds.). Afterwards, the abdominal wall will be operated level by level into the belly. The procedure draws each round ligament through the intra-abdominal peritoneum and brings each ligament beneath the anterior (abdominal) rectus sheath. There the round ligament is sutured along the wound length so as to hold the uterus forward and upward.
- Afterwards, the surgical wound will be covered with a vagina pack to staunch the bleeding. As a result of the urinary retention or difficulty in urination after the surgery, the patient may be catheterized to avoid the residual urine which may be the cause of cystitis in at least 1-2 days after the surgery.
- After the procedure, the patient will be monitored at recovery room for an hour. When the patient is conscious with normal pulse, the anesthesiologist will allow her to be monitored in In-patient Building. There the patient will take antibiotic, anti-inflammatory drug to lessen the wound pain, paracetamol drug and laxative. Should the patient have no recovery from the paracetamol drug, she will get the analgesic injection.
- In the first day after the procedure, the patient should not take a shower because the surgical wound and water should be separated (perhaps rub the body dry); the patient is allowed to take a shower in 2 days after the procedure or after the removal of the catheter, which will be the day that the patient will leave the Hospital. The physician will ensure that no abnormal bleeding occurs and the patient can have urination herself, as well as the patient is asked to well review post-operative care. Then the physician will allow her to return home.
- For post-operative care, the patient must take antibiotics, anti-inflammatory drug to lessen the wound pain, paracetamol drug and laxative, as prescribed by the physician, especially the antibiotics which should be wholly completed.
- The patient should refrain from the moisture around the surgical wound, bath tub or swimming pool for about 6-8 weeks after the surgery.
- The patient may experience light reddish bleeding out of the vagina in around 1-2 weeks after the procedure. In case of so much bleeding in the sanitary napkin or dark reddish thrombus, swollen reddish wound and essential hyperthermia, please contact the Hospital for suggestions or come to see the physician for the surgical wound examination.
- The patient needs no worry for disorders. Complications are in so low rate that you may return to work within 3-5 days. There is no risk of sexual feeling lack. Moreover, the patient should follow the physician appointment for examination or treatment in case of initial complications to avoid worsening.
Uterus in Normal Position
Like all other surgeries, Suprapubic Uterine Suspension has its risks and complications such as :
Abnormal bleeding which may lead to hematoma formation, which is very seldom noted and occurring in 1 out of 100 patients, and where the blood loss is not severe, with less than 1% of patients needing blood transfusion. In this connection, Aspirin and other anti-coagulant drugs should be avoided at least 10 days before and after the scheduled surgery.
Urinary frequency or difficulty in urination may be noted a few days after the surgery. It may then be necessary to catheterize the patient for 1-2 days to prevent cystitis.
Pain at or around the surgical wound may be felt as the anesthetic wears off, but which is easily relieved by pain medications prescribed. Strenuous activity should also be avoided as this may also cause pain.
Inflammation or infection of the wound occur very rarely, and are usually noted in patients who have been having the infection before the surgery. It is for this reason that antibiotics are given to these patients before the surgery.
The patients with bacterial or fungal vaginal infections complete treatment is necessary before the surgery can be done, otherwise it is not allowable.
Transient round ligament pain about 5-7 days after the operation and transient pain with vigorous physical activity.
Cost of the procedure and other expenses
The cost of the operation will include all the instruments, operating room, the professional fees for the anesthesiologist and the surgeon,the medications used for the procedure, and the home medications as well.
However, fees for laboratory work-up for other existing diseases that the patient may have, and the professional fees for the anesthesiologist and the surgeon for corrective surgery is not included in the package.
If excessive bleeding from the surgical wound occurs after surgery, all expenses for services and treatment for this post-surgical complication will no longer be charged to the patient.
- However, if the bleeding or other complications occurred due to the patient’s non-compliance to the doctor’s orders, she will be charged accordingly.