Laparoscopic & Vaginal

Patient consent on laparoscopic and vaginal pelvic floor repair

At FBW we strive to help you be as healthy as possible with as little medical intervention as possible. However, when conservative management fails to improve your quality of life we recommend surgery. Although we offer very sound surgical skills there are possible complications which are well recognised in the medical literature and we have preventative measures in place to reduce the possibility of these happening. One should be aware of these possible complications to make the recovery path smoother should a complication occur, and to avoid disappointment.

Anaesthetic complications:

Such as headache, nausea, vomiting, dizziness, drowsiness, low blood pressure.

Surgical complications:

During the operation, immediate post-operative (up to 24 hours) and late post-operative (up to 10 days).

General risks and complications of the laparoscopic  operation:

  • Pain
  • Infection (wound, bladder, lung, pelvis)
  • Bleeding requiring blood transfusion
  • Damage to the surrounding organs (bowel, bladder, womb, vessels and ureters needing open surgery (laparotomy)
  • Damage to nerve, muscle or bone( due to positioning)
  • Forming clots in the legs (DVT) & lungs (embolism)
  • and death

The chance of a minor complication is 1/100, major complication 1/1000, and death 1/100,000.

Infection of mesh, graft, suture or anchor:

This is uncommon & most will settle with antibiotics. Rarely is removal necessary.

Bleeding:

May cause bruising or a clot (haematoma). Seldom is a blood transfusion or further surgery required.

Another prolapse:

Is uncommon however may develop at the same site or nearby. Most require no further treatment. Some are helped by physiotherapy or a pessary. A minority need more surgery.

Mesh problems:

  • Proud tissue (granulations) in 10%
  • Exposure in the vagina (10%)
  • Pelvic pain including pain with intercourse (10%)
  • Erosion or migration into an organ(<1%)
  • Distortion of anatomy (rare)

1/20 women require further surgery to treat mesh-related problems. There are fewer problems when mesh is placed via the abdomen than through the vagina.

New bladder problems:

Urgency, leakage & trouble emptying occur in a minority & most settle with time & simple treatments (physio, medicine or catheter). Occasionally a tape operation is needed to cure leakage.

Constipation:

Occurs commonly after prolapse surgery, especially when the back wall is repaired. Most cases respond well to laxatives & enemas. A minority require physiotherapy assistance or referral to a bowel surgeon.

Estimated 5 year success (no symptoms, bulge or need for further surgery): Native tissue repair 60-70%, with surgisis up to 70-75% with mesh repair up to 90%

If no treatment is undertaken: prolapse is rarely life-threatening but tends to progress over time & affect one’s quality of life by causing discomfort &/or interfering with bowel, bladder & sexual function.

Surgery:

Traditional vaginal repair or keyhole repair.

Non-surgical:

Vaginal oestrogen, a pessary, magnetic chair, platelet rich plasma and non-surgical laser treatment, physiotherapy.

From time to time it may be necessary and advisable to perform operations or procedures different from, or in addition to, that described. I authorize and consent to the performance of such additional or different operations and procedures that are considered necessary and advisable.

Pathology and radiology services as needed and In keeping with standard medical practice

Photographing, filming or videotaping of the operation for educational or diagnostic use. Photos/videos for educational purposes would be unidentifiable.

There are risks involved in any procedure or treatment, and it is not possible to guarantee or give assurance of a successful result. FBW team always endeavour to provide the best care but cannot guarantee the outcome.

Any additional questions about the treatment and procedure always will be answered happily.