Frequently Asked Questions Hysteropexy
What is a hysteropexy?
A hysteropexy (uterine suspension) simply means to surgically lift the uterus or to suspend the uterus and is usually performed for uterine prolapse (ie a falling uterus).
What are the indications for a hysteropexy?
Patients get a hysteropexy or uterine suspension for 3 main conditions including: 1) uterine prolapse 2) infertility 3) collision dyspareunia (pain with deep penetration)
What type of incision is made?
Many surgeons will do a large incision to do this surgery and Drs Miklos & Moore perform the surgery through miniature incisions i.e. laparoscopic surgery
What is the average blood loss?
Drs Miklos & Moore average less than one tablespoon (30 mL) of blood during this surgery. The chance of a blood transfusion is < 1/500 cases
What are the intraoperative complications associated with the hysteropexy?
Complications are rare in the hands of Dr Miklos & Moore but they include:
Injury to bladder, ureters, bowel or colon < 1%
Blood transfusion < 1%
Large abdominal incision < 1/500
Failure of the surgery (5 years after) < 2 %
How long is the hospital stay for hysteropexy?
The average hospital stay for a laparoscopic hysteropexy is 24 hours or 1 day
Must I use mesh for the laparoscopic hysteropexy?
It is your body and you will make the decisions on your body but we encourage you to make the decision after you have a thorough discussion with Drs Miklos & Moore. You do not need to do anything you do not want to do; however, the highest chance of cure is using a piece of synthetic mesh. The patient does have an option of using cadaver, pig or cow skin but both Drs Miklos & Moore caution you that cure rates are dramatically reduced with these products versus synthetic mesh. Drs Miklos & Moore are experts in mesh removal and legal experts against industry which make mesh for “some types” of mesh especially transvaginal mesh surgical procedures for prolapse. This is not a transvaginal mesh procedure this is an abdominal approach to prolapse surgery and this type of surgery is endorsed in the U.S.A. by the FDA.
If mesh is used for the hysteropexy what kind of mesh is used?
Drs Miklos & Moore use a lightweight, large pore polypropylene mesh. Light weight means less than 35 grams/ meter2. Dr Miklos & Moore typically use meshes of approximately 20 grams per meter2
If I use mesh what are the associated complications of mesh?
The complications most often associated with mesh and surgery of the female pelvic floor include: infection, vaginal skin extrusion, bladder or rectal erosion, and pain. Drs Miklos & Moore rate of complications are listed below:
Infection < 1/500 (Dr M & M have never had this complication)
Erosion < 1/500 (Dr M & M have never had this complication)
Extrusion < 1/500 (Dr M & M have never had this complication)
Hysterectomy < 1/500 (Dr M & M have never had this complication)
Dyspareunia <1/500 (Dr M & M have never had this complication)
This doesn’t mean the complications can’t occur but as noted above they are rare.
How long before I can fly home from my surgery?
Depending upon whether you have other surgical procedure done simultaneously. If a patient only has a hysteropexy and the surgery is performed and she does not suffer from an intra operative complications the patient can usually go home within 24-48 hours after the surgery.
How long will I need to be in Atlanta or Beverly Hills for the surgery?
Most patients will fly in the day before surgery and have an evaluation (Day #1). They will often have surgery the very next day (Day #2) and spend that night in the hospital (Atlanta – Northside Hospital) or in a hotel nursing unit (Beverly Hills – SLS hotel) and are discharged the next day (Day #3). Sometimes Drs Miklos & Moore recommend staying one more day in town prior to heading home.
So, if you suffer from uterine prolapse and want true international experts in hysteropexy surgery for uterine prolapse with or without infertility or have collision dyspareunia i.e. painful sex with intercourse contact Drs Miklos and Moore’s team to schedule an appointment.