_______________________________________________________

Staphylococcus Aureus
www.StaphylococcusAureus.net

Feminine Hygiene, Tampon Safety

and

Toxic Shock Syndrome

While Rare, Toxic Shock Syndrome 
Still Happens from Tampon Use

Suggestions for Tampon Use and Tampon Safety: 


1. Don't Use Tampons Overnight,

2. Don't Leave the Same Tampon in your Vagina 
for More than 4-6 hours, 

3. Change Your Tampon Every 4 Hours,

4.  Avoid "Super Absorbent" Tampons, 

5. Remove the Last Tampon at the End of your Period!

What is Staphylococcus Aureus?

Staphylococcus Aureus was first discovered in Aberdeen, Scotland in 1880 by Dr. Alexander Ogston who was a surgeon. 

Every year, as many as 500,000 patients contract Staphylococcus Aureus during their stay in America's hospitals.

Staphylococcus Aureus, also known as Staph Aureus or S. Aureus, means the "golden cluster seed" or "the seed gold." It is also known as golden staph and is the most common cause of staph infections. 

Staphylococcus Aureus is found in humans the following:

• the skin flora found in the nose and on skin 

• the vagina - especially during menstruation and with tampon use

It has been shown that 20% of the population are long-term carriers of Staphylococcus Aureus. 

Staphylococcus Aureus can cause a range of illnesses from minor skin infections, such 
as pimples, impetigo (may also be caused by Streptococcus pyogenes), boils (furuncles), cellulitis folliculitis, carbuncles, scalded skin syndrome and abscesses.   

Staphylococcus Aureus has been linked to life-threatening diseases such as pneumonia, meningitis, osteomyelitis, endocarditis, toxic shock syndrome (TSS), and septicemia. 

Staphylococcus Aureus remains one of the five most common causes of nosocomial infections, often causing postsurgical wound infections. 

_______________________________________________________

Staphylococcus Aureus
www.StaphylococcusAureus.net

An Online Resource about Staphylococcus Aureus,
Feminine Hygiene, Tampon Safety and Related Information, 
Resources and Feminine Hygiene Alternatives

To Advertise on this site, call/email:

info@StaphylococcusAureus.net

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According to the grapevine in 12-year-old Jerri's North Carolina school, tampons not only cause AIDS, but also can be lost in a woman's body, never to be seen again.

If you're hooked into the Internet, you may notice that tampon tales such as these get more creative as they're passed around. The latest stories claim tampons are tainted with cancer-causing toxins and that rayon tampons are especially dangerous. Another Internet rumor suggests that manufacturers add asbestos to tampons to promote excessive bleeding and boost sales.

"It can be hard to tell what stuff is true," says Jerri.

The truth is that tampons can't get lost forever in a woman's body. Rayon tampons are as safe as cotton ones. And asbestos has never had anything to do with fibers that make up tampons.

"The only way asbestos could be connected to tampons would be through tampering," says Mel Stratmeyer, Ph.D., chief of the Food and Drug Administration's health sciences branch. "And we haven't received any reports of such tampering."

FDA regulates tampons as medical devices, and "we ensure that tampon design and materials are safe through a solid, scientifically valid premarket review process," says Colin Pollard, chief of FDA's obstetrics and gynecology devices branch. Tampon manufacturers conduct a battery of safety studies, and tampons must pass through FDA review and clearance before they can be marketed.

FDA also regulates the absorbency ratings for tampons. While high levels of absorbency were initially linked to an infection called toxic shock syndrome (TSS), FDA recently proposed a rule to provide an absorbency term for 15- to 18-gram tampons (ultra absorbency) that may help women manage heavier menstrual flows. 

"Tampons with this absorbency are available in other countries with very low rates of toxic shock syndrome," explains Kimber Richter, M.D., deputy director of FDA's office of device evaluation. Toxic shock syndrome is the only disease with a proven association to tampon use, according to FDA and the national Centers for Disease Control and Prevention.

Tampon Safety and Toxic Shock Syndrome

Any fear still surrounding tampon use likely dates from a time when toxic shock syndrome was first identified. About half of all cases occur in women using tampons, although the exact link between toxic shock syndrome and tampons remains unclear.

Tampons enjoyed a quiet history from 1933--when the first ones hit the market--until about 1980. That's when CDC noticed a sharp rise in the number of cases of toxic shock syndrome, a serious and sometimes fatal disease caused by toxin-producing strains of the Staphylococcus aureus bacterium. Experts believe the bacterium releases one or more toxins into the bloodstream.

Between October 1979 and May 1980, 55 toxic shock syndrome cases and seven deaths were reported. Most were among women who experienced onset of illness within a week following their periods. The TSS epidemic reached its peak in 1980 with a total of 813 cases of menstrual-related toxic shock syndrome, including 38 deaths, according to CDC.

CDC carried out national and state-based studies to pinpoint toxic shock syndrome risk factors and used its national surveillance system to track trends. Research suggested one factor was the use of very highly absorbent tampons made from new materials.

Studies showed that women who used Proctor & Gamble's Rely tampons were at substantially greater risk for TSS than other tampon users. This brand consisted of polyester foam and a special type of highly absorbent cellulose, a combination no longer used in tampons. "Toxic shock syndrome was NOT only limited to Rely tampons, but the Rely tampons did play a major role," says Pollard. Proctor & Gamble voluntarily withdrew that tampon from the market in 1980, and competing manufacturers of tampons made from other superabsorbent materials began removing them as well.

Toxic Shock Syndrome Cases Drop Dramatically

Compared with the 813 menstrual toxic shock syndrome cases in 1980, there were only three confirmed cases in 1998 and six in 1997. "Although there is some underreporting of cases, this is a real decline," says Rana Hajjeh, M.D., a medical epidemiologist with CDC's division of bacterial and mycotic diseases. She attributes the drop in toxic shock syndrome rates to the removal of Rely from the market and advances in the way FDA regulates tampon materials and absorbency. Women also are much better educated about toxic shock syndrome prevention, she says.

FDA took its first step to protect the public in 1982, when it required that all tampon labels include toxic shock syndrome warning signs. In addition, packages had to include a note that the risk of menstrual TSS can be reduced by not using tampons and by alternating tampons with sanitary napkins. FDA also required that labels advise women to use the lowest absorbency needed to control their flow. CDC studies suggested that, in general, higher tampon absorbency was related to higher toxic shock syndrome risk.

In response to CDC findings and FDA regulatory activities, manufacturers standardized and, in some cases, lowered tampon absorbency. "What's considered superabsorbent today is much less absorbent than superabsorbent tampons used in 1980," Hajjeh says. In 1980, 42 percent of tampon users used very high absorbency tampons, according to CDC. That number dropped to 18 percent by 1983 and to 1 percent by 1986.

In 1990, FDA standardized absorbency labeling, allowing women to compare absorbencies across brands. Before the regulation, super absorbency in one brand could have been the same as regular in another brand. Now, FDA's labeling requirements ensure that a Playtex junior absorbency has an absorbency range of 6 grams of fluid or under, just as an O.B. junior absorbency does.

FDA's Pollard points out that the material of the Rely tampon and its absorbency were very different from that of tampons on the market today. "FDA also has improved its premarket review process and has begun looking at additional tampon characteristics," he says. He adds that all tampon manufacturers, including those introducing new materials, report to FDA on absorbency, as well as on the safety of all components of a tampon, including the cover, string and applicator, and on the chemical composition of any fragrances and color additives.

Companies conduct clinical tests in tampon users to look for bacterial growth and adverse effects, such as allergies and ulceration, with tampon use. Through toxicological testing, manufacturers must show that the tampon will not enhance the growth of Staphylococcus aureus or increase the production of toxic shock syndrome toxin.

"This testing is ongoing for new tampon products," Richter says. "We continue to monitor tampons for safety issues."

FDA also tracks medical device problems through its MedWatch system, which allows consumers and health professionals to report adverse effects from FDA-regulated products.

Though toxic shock syndrome is rare, tampon users should still be aware of it, says Richter. "All tampons are associated with the risk of TSS, and it's important for women to know the signs," she says. "If a woman becomes ill or has any concerns at all about TSS, she should remove her tampon immediately and contact her doctor." 

Today, tampon manufacturers in this country produce tampons made of rayon, cotton, or a blend of the two. Cotton is commonly referred to as "natural," while rayon is considered "synthetic." But consumers shouldn't assume that "synthetic" means bad and "natural" means safer, says Jay Gooch, Ph.D., a toxicologist and senior scientist at Proctor and Gamble. Rayon is made from cellulose fibers derived from wood pulp. "Technically speaking, rayon is synthetic, but it's more like natural cellulose than it is different," Gooch says. "There is a lot of confusion out there about what rayon is and a lot of unsupported allegations about the safety of the two fibers." Previous CDC studies have found no increased risk with rayon versus cotton for the same absorbency and brand of tampon.

Other Tampon Ingredients

John McKeegan, spokesman for Johnson and Johnson, makers of O.B. tampons, says his company tells women who call with questions about the presence of cancer-causing dioxin in tampons that the company uses elemental chlorine-free bleaching, which does not produce dioxin.

Chlorine gas, which can produce a small amount of dioxin, used to be the bleaching agent for rayon used in tampons, says Gooch. "But elemental chlorine-free bleaching uses a chlorine dioxide agent. Chlorine dioxide may sound like chlorine gas, but they are two very different things," he says. Bleaching is necessary because all fibers have impurities associated with them that will inhibit absorbency. "Bleaching cleans and purifies raw material, but it does not leave toxins," he explains. And unlike what some people think, he adds, the white color of tampons is a consequence of the purification process, not an appearance goal.

Using a method approved by the Environmental Protection Agency, major tampon manufacturers have tested their products for dioxin. Data show that dioxin levels in tampons range from undetectable to 1 part in 3 trillion, far below the level that occurs through daily environmental exposure and considerably below the level FDA believes would put consumers at risk, Stratmeyer says.

"That doesn't mean that dioxin couldn't get there from another source," he adds. "You could end up with dioxin in rayon or cotton simply because of decades of pollution." It can be found in air, water or the ground before the wood pulp or the cotton is produced. "But what we know today is that you will find more dioxin already in your body than in any tampon," he says.

Many experts say the proof of tampon safety lies in its long history. But others want more research into diseases other than toxic shock syndrome. Rep. Carolyn Maloney (D-N.Y.) introduced the Tampon Safety and Research Act in 1997 and again in March 1999. The bill, which was referred to the Subcommittee on Health and Environment, proposes to provide NIH with research support to determine the extent to which dioxin, synthetic fibers, and other additives in tampons pose health risks such as cancer, endometriosis, infertility, and pelvic inflammatory disease.

But from FDA's perspective, there is no indication right now that such research is necessary, Stratmeyer says. "We are not aware of evidence that would call for a large-scale study on tampons' relation to these diseases."

Toxic Shock Syndrome Warning Signs

Symptoms of toxic shock syndrome can be hard to recognize because they mimic the flu. If you experience sudden high fever, vomiting, diarrhea, dizziness, fainting, or a rash that looks like a sunburn during your period or a few days after, contact your doctor right away. Also, if you're wearing a tampon, remove it immediately. One or two weeks after initial symptoms begin, flaking and peeling of the skin occurs, mainly on the palms and soles. If your doctor determines that your symptoms are toxic shock syndrome, you will probably be sent to a hospital for treatment. With proper treatment, patients usually get well in two to three weeks.

Women under 30, especially teenagers, are at a higher risk for toxic shock syndrome, because some females that age may not yet have antibodies to the toxin. Using any kind of tampon--cotton or rayon of any absorbency--puts a woman at greater risk for toxic shock syndrome than using menstrual pads.

Absorbency--the rate at which a tampon absorbs or soaks up menstrual blood--is measured in grams of fluid. Research suggests that the risk of toxic shock syndrome may increase with tampon absorbency. But that doesn't mean you have to steer clear of higher absorbency tampons completely, according to Colin Pollard, chief of FDA's obstetrics and gynecology branch. "You should match absorbency to your flow," he says. For a lighter flow, use regular or junior absorbency. If your tampon absorbs as much as it can and has to be changed before four hours, you may want to try a higher absorbency. There's usually less need for higher absorbency when your period is ending.

When you shop, you'll find these absorbency terms and ranges on all tampon packages:

• Junior absorbency: 6 grams and under

• Regular absorbency: 6 to 9 grams

• Super absorbency: 9 to 12 grams

• Super plus absorbency: 12 to 15 grams

According to the American College of Obstetricians and Gynecologists, your tampon is probably too absorbent if the tampon is hard to remove, you experience vaginal dryness, if a tampon shreds, or if it doesn't need to be changed after several hours. Vaginal dryness and ulcerations may occur when a tampon is too absorbent for your flow.

Tips to Avoid Tampon Trouble

The strategy had worked for years, says Tracy, 28. She always inserted a small tampon on the morning she expected her period. But a few years ago, her period started one day late. "By the time it came, I had forgotten about the first tampon," she says. "The bleeding was so heavy that I figured I must not have had one in. So I put another one in."

All day she changed her tampon every few hours like she normally does. Then on one trip to the bathroom that night, she noticed a second string. When she finally removed the first tampon, the mild cramps she had experienced all day worsened. The pain became so intense she couldn't walk. Severe cramps and heavy bleeding ultimately landed her in the emergency room.

Putting in a tampon and forgetting about it is rare, but it does happen, says Gerald Joseph, M.D., former chairman of the department of obstetrics and gynecology at the Ochsner Medical Foundation. Joseph says he sees such cases--mostly among women under 30--a few times each year. Joanne, 44, says she forgot once and didn't realize the tampon was still there until six days later when she went to her doctor complaining of foul odor and vaginal discharge.

FDA recommends the following tips to help avoid tampon problems:

• Follow package directions for insertion.

• Choose the lowest absorbency for your flow.

• Change your tampon at least every 4 to 8 hours.

• Consider alternating pads with tampons.

• Know the warning signs of toxic shock syndrome.

• Don't use tampons between periods.

_______________________________________________________

Gynecologic Urology
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Advertise Your  Product, Company or Medical Practice 
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What is Gynecologic Urology?

Gynecologic Urology, also referred to as Uro-gynecology, is a subspecialty within the field of Obstetrics and Gynecology. Uro-gynecology's specialty is female pelvic disorders such as pelvic organ prolapse (bulges that extend from the uterus into the vagina or extend out of the vagina), urinary incontinence, fecal incontinence and constipation. 

Doctors that complete their residency in Obstetrics and Gynecology, then go onto complete fellowship training in Uro-gynecology, where they spend several years focusing only on Uro-gynecology and female pelvic disorders.


What is Adhesiolysis?

Treatment for the removal of Pelvic Adhesions is through a surgical procedure called "adhesiolysis."  The adhesiolysis procedure may involve cutting and releasing the adhesions during a laparoscopy procedure or treating the adhesions during a laparotomy.

What are Pelvic Adhesions?

Pelvic adhesions are bands of scarlike tissue that form between two surfaces inside the body. Inflammation from infection, surgery, or trauma can cause tissues to bond to other tissues or organs.

Pelvic adhesions are the cause of many gynecological problems including significant pain, infertility and conception. Pelvic adhesions are irritations of a woman's pelvic organs as a result of a "pelvic inflammatory event" or from trauma to the area such as in the case of pelvic or gynecological surgery.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse or Pelvic Prolapse, is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapsee in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse, vaginal relaxation or vaginal vault prolapse.

What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "Pelvic Organ Prolapse."  Pelvic Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor dysfunction, urogenital prolapse or vaginal vault prolapse.

What are the symptoms that indicate a woman is suffering from Pelvic Organ Prolapse?

• Loss of bladder control.

• Loss of bowel control.

• Increasing need and frequency to urinate - and then difficulty in completely emptying your bladder.

• The feelings that your of pelvic or vaginal heaviness, bulging, fullness and/or pain, or a feeling that something is "dropping."

• Recurrent bladder infections.

• Excessive vaginal discharge.

• Pain or lack of sensation during sex

But Pelvic Organ Prolapse is a real, common and treatable problem. Consider this:

About half of all women over age 50 suffer from some degree of Pelvic Organ Prolapse.

One in 10 women undergo surgery for Pelvic Organ Prolapse by age 80.

What is Pelvic Reconstruction?

Pelvic Reconstruction is a surgical procedure performed by gynecologists or uro-gynecologies to repair pelvic organ prolapse and vaginal vault prolapse, among types of prolapse, and to correct the problem(s) and relieve the symptoms. 

Typically, Pelvic Reconstruction is performed vaginally and uses an implant to reinforce the strength of the weakened pelvic tissues. 

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

What is Perineoplasty?

Perineoplasty, also known as "Perineorrhaphy,"is one of the fastest growing elective medical procedures and is the reparative or plastic surgery of the perineum which helps women with problems with vaginal opening laxity or looseness - medically referred to as "Vaginal Relaxation."  Many also incorrectly call this procedure "vaginoplasty" or "vaginaplasty."

Perineorrhaphy is the reconstruction of the muscles and tissues at the opening of the vagina and has successfully decreased the vaginal "introitus" or size of the vaginal opening. Perineorrhaphy does NOT reduce sexual sensation, in fact, properly performed, Perineorrhaphy INCREASES sensation for the woman as well as her husband.

What is Colporrhaphy? 

Colporrhaphy is the surgical repair of the vaginal wall. This includes repairing many types of vaginal surgery, including the repairs of the vagina in a "Pelvic Organ Prolapse," "vaginal prolapse," "Vaginal Vault Prolapse," or the repair of a "cystocele" in the vaginal wall(s) or vaginal vault or a rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele when the rectum protrudes into the vagina.

In the Colporrhaphy procudeure, a uro-gynecologist, or gynecological surgeon, places a vaginal speculum inside the vagina, which spreads/keeps the vagina open, for the doctor to inspect and repair the vagina. The vaginal wall is cut opened to reveal an opening in the supporting structures, or fascia and the defect is closed and then the vagina is repaired by suture and closed, and the speculum removed. 


Who performs the Colporrhaphy and where is it performed?

Colporrhaphy is usually performed in a nearby hospital operating room by a uro-gynecologist, urologist or gynecological surgeon.


What is Colpopexy?

Colpopexy is the surgical suturing of the prolapsed vagina to a surrounding structure - such as the abdominal wall or the sacrum, which is then called Sacral Colpopexy or Sacrocolpopexy 

What Is Sacral Colpopexy (Sacrocolpopexy)?

Sacral Colpopexy, also referred to as also referred to as also referred to as also referred to as also referred to as Sacrocolpopexy, is the preferred surgical procedure for treating and correcting Vaginal Vault Prolapse with excellent results. Sacral Colpopexy (Sacrocolpopexy) has a very high rate of success  and the surgical procedure involves suturing a synthetic mesh that connects and supports the vagina to the sacrum, or tailbone. The Sacrocolpopexy operation is performed from the abdomen to support the vagina to the ligament on the spine (after previous or present surgery to remove the uterus) by using a synthetic mesh.

Why Is Sacrocolpopexy Performed? 

Sacrocolpopexy is performed to treat severe protrusion or bulge(s) of the vagina after removal of the uterus.

A woman's vagina that has one or more of these vaginal protrusion(s) may experience one or more of the following:

• The vaginal lump/bulge or protrusion feels uncomfortable or causes pain.  
• Difficulty with urination (e.g. unable to completely empty the bladder) 
• Bowel difficulties (e.g. constipation, incomplete emptying of bowels) 
• Pain 
• Infection 
• Bleeding 

The objective of the Sacrocolpopexy operation is to relieve the woman's symptoms and to restore her vagina and her vaginal anatomy (as much as possible) and recover her sexual function.

Are there any risks associated with Sacrocolpopexy surgery? 

Sacrocolpopexy surgery is a very common and relatively safe operation with excellent prognosis and outcomes.  However, like any surgical procedure, there are complications which may occur. Possible complications from Sacrocolpopexy surgery may include:

• Bleeding 
• Infection 
• Injury to surrounding tissues (e.g. nerve or blood vessels, ureter, intestines) 
• Formation of blood clot(s) in the legs or lungs 
• Recurrence of problem
• Slow return of bowel or bladder function 
• Erosion of synthetic material through vaginal mucosa 


What Happens Before Sacrocolpopexy Surgery? 

1. Blood tests, electrocardiography (ECG) and chest X-ray may be done to ensure that you are in optimal health for Sacrocolpopexy surgery. 

2. Your doctor may prescribe oral or vaginal estrogen (hormone) if you are already menopausal. It is important to comply with this medication as it ensures that your vaginal tissues are optimal for surgery and healing. 

3. You will be admitted to the hospital one day before Sacrocolpopexy surgery. 

4. You will be given preparations to clear your bowels.

5.  Your pubic hair surrounding your vulva will be shaved. 

6. You will not be allowed to eat or drink after midnight on the day before the surgery. 

7. All your medical and surgical conditions, if any, must be made known to the doctor and must be optimally controlled. 

8. If you are on aspirin, please keep your doctor informed. You must stop taking aspirin at least one week before Sacrocolpopexy surgery. 

What happens during the Sacrocolpopexy surgery? 

The surgery is done under general or regional anesthesia. The anesthesiologist will discuss with you the advantages and disadvantages of both methods.

An abdominal incision is made. The synthetic mesh is stitched to the posterior surface of the vagina and to the ligaments in front of the spine.

A tube / drain may be inserted into the abdomen to monitor the bleeding.

Another tube will be inserted into the urethra as there may be difficulty in urination after the Sacrocolpopexy procedure.

Painkillers, laxatives and antibiotics would generally be prescribed after the procedure.

What happens after Sacrocolpopexy surgery? 

1. Immediately after the operation, you may experience one or more of the following:

• Tiredness - You should rest and gradually increase your mobilization until you feel fit to return to your normal activities. 

• Discomfort - In the lower part of the abdomen, over the incision. This is to be expected and painkillers should help to relieve the discomfort. 

• Vaginal bleeding - Mild to moderate amount of reddish watery discharge after surgery is quite normal. You will need to wear a menstrual pad during the recovery period, but you will not be permitted to use tampons for obvious reasons.

2. One day after surgery, you will usually be allowed to drink and eat. You will be encouraged to move around. Blood chemistries and normal follow-up visits will be performed. 

3. The catheter that was placed in your urethra is usually removed the day after surgery. The drain is usually removed two days after the operation.

4. You may be discharged on the third or fourth day after surgery if the doctor is pleased with your progress and the outcome of the Sacrocolpopexy procedure. 

5. You should refrain from:

• Strenuous exercise for 2 months. You may return to normal activity after that, or upon clearance by your doctor. 

• Using tampons, douching, sexual intercourse and driving for 4 weeks. 

• Carrying heavy weights (> 10 pounds) for 6-8 weeks after Sacrocolpopexy surgery.

6. You should (immediately) return to the hospital or notify your doctor if you notic any of the following:

• Heavy vaginal bleeding 
• Foul smelling vaginal discharge 
• Severe abdominal distension and / or pain not relieved by painkillers 
• High fever 
• Pain associated with passing urine 
• Difficulty in passing urine 
• Constipation 

Follow-up doctor visits after Sacrocolpopexy surgery 

You will be examined by your doctor (at your doctor's office) at approximately; 2 weeks, 4 weeks, six months and and one year after Sacrocolpopexy surgery. 

It is important to keep your follow-up appointments to ensure the best possible results.

What is "Colposuspension" surgery?

Age and vaginal childbirth takes it toll on women's pelvic organs.  

"Female Urinary Incontinence" is one of the problems most (over 50%) women who have delivered babies vaginally have to contend with.  Women with Female Urinary Incontinence "leak" urine when they strain,  cough, laugh or run. This condition is also called "stress urinary incontinence" meaning the stress of physical activity, not emotional stress is causing her to "leak" urine.  

The problems associated with female urinary incontinence are corrected in the the "floor" of the woman's pelvis by several methods or types of surgeries - one of which is called Colposuspension. 

A woman's pelvic floor is a sheet of special muscles and ligaments that stretch across the inside of the female pelvis. Women can feel it "tighten" when they try to hold back the flow of urine - or when they strain,  cough, laugh or run. The uterus and bladder are located above the pelvic floor. The vagina and the opening of the bladder (the urethra) pass through the pelvic floor. If the pelvic floor weakens, the uterus and bladder "drop" down. The control of the urine is thereby weakened. 

Colposuspension surgery strengthens the pelvic floor to lift, or "suspend" the uterus and bladder back up to their correct position within the woman's pelvis

Colposuspension comes from the Greek word for vagina - "colpos."

What is "Urethropexy"?

Urethropexy is a surgical procedure where the support of a woman's urethra is re-supported through sutures that surround the urethra's pelvic floor  and vaginal tissues to her pubic bone.

What is the Vaginal Vault and Where is the Vaginal Vault Located?

As previously stated, Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons. Vaginal Vault Suspension is the surgical procedure that corrects and repairs Vaginal Vault Prolapse.

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). 

Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

Vaginal Vault Suspension is a surgical procedure that may be selected to correct/repair Vaginal Vault Prolapse.

What is Vaginal Vault Suspension?

Vaginal Vault Suspension is the surgical procedure that repairs Vaginal Vault Prolapse and also provides support for the apex or "vaginal vault" of the vagina to pelvic structures.

What is a Trachelectomy?

A trachelectomy, also referred to as a cervicectomy, is the surgical removal of the cervix. 

In this surgery, the uterus itself is saved or preserved, and therefore this type of surgery preserves a woman's chance of becoming pregnant and having children.  The trachelectomy surgical alternative - as opposed to the more radical hysterectomy which removes the uterus in addition to the cervix - is typically elected by younger women with early stage cervical cancer.

What Everyone Needs to Know About Reconstructive Pelvic Surgery.

Reconstructive pelvic surgery is an area of surgery dealing with a woman's pelvis, and includes gynecology and uro-gynecology.  Pelvic reconstructive surgery is many times very complex surgery that may require not just the removal of certain organs or tissues in a woman's pelvis, but may also include the resection of areas and putting her organs and tissues back together in a way that makes her more functional, with less/no pain and feels better. 

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease, or "PID" is an infection of a woman's pelvic organs which include the uterus, fallopian tubes, and ovaries. 

Bacteria causes pelvic inflammatory disease. Bacteria can move upward, from a woman's vagina or cervix - which is the opening to the uterus, or womb - into her fallopian tubes, ovaries and uterus, which then cause an infection. Many types of bacteria can cause pelvic inflammatory disease. But bacteria found in two common sexually transmitted diseases - chlamydia and gonorrhea - are the most frequent causes of pelvic inflammatory disease. 

After a woman becomes infected, it can take from a few days to a few months to develop pelvic inflammatory disease. 

The major symptoms of pelvic inflammatory disease are lower abdominal pain and abnormal vaginal discharge. 

Other symptoms of pelvic inflammatory disease may include one or more of the following; fever, pain in the right upper abdomen, pain during vaginal intercourse, and irregular menstrual bleeding.  

Pelvic inflammatory disease, particularly when caused by chlamydia, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs. 

Untreated, pelvic inflammatory disease causes scarring and can lead to infertility, tubal pregnancy, chronic pelvic pain, and other serious problems. 

Pelvic inflammatory disease is more common and more aggressive in HIV+ women than in uninfected women. Pelvic inflammatory disease may become a chronic and relapsing condition as a woman's immune system deteriorates. 

Women can play an active role in protecting themselves from pelvic inflammatory disease disease by following these steps and precautions: 

*  Call your doctor if you have discharge with odor or bleeding between cycles. 

*  Use either male or female condoms during sex. 


What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction, which is also referred to as outlet obstruction or outlet delay, refers to a condition in which the pelvic floor muscles of a woman's lower pelvis - that surround the rectum, do not function normally. It is not known why these muscles fail to work properly in some women, but they can make the passage of stools difficult even when everything else seemingly is normal.

What Causes Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction find that muscle pain occurs when muscles are tense, strained, traumatized and/or otherwise inflamed. Their pelvic muscles are no exception. Causes of pelvic floor dysfunction can include:

*  Chronic faulty posture with weak core musculature 
*  Trauma (fall on tailbone, old tailbone fracture, auto accident)
*  Inflammation or infection
*  Pelvic organ disease (endometriosis, irritable bowel syndrome, interstitial cystitis) 
*  Repetitive motion injuries such as those from gymnastics, volleyball, soccer, ballet or ice
    skating
*  Abdominal muscle wall weakness or hernias 
*  Chronic constipation
*  Pregnancy or complicated vaginal delivery 
*  Abdominal or pelvic surgery such as a hysterectomy 

Do I have Pelvic Floor Dysfunction?

Women with pelvic floor dysfunction often have changes in their spine and/or pelvis.  Symptoms or conditional might include; scoliosis, short leg, swayback or a "torsioned" sacrum. The most common symptoms of pelvic floor dysfunction include one or more of the following:

*  Vaginal pain 
*  Pain with urination 
*  Urinary urgency and frequency 
*  Rectal pain 
*  Pain during vaginal intercourse 
*  Pain with sitting, standing, walking 
*  Pain and/or difficulty getting up from a seated or lying down position
*  Hip pain often with loss of range of motion in hips 
*  Deep pain in lower back radiating to legs, thighs, groin, hips 
*  Abdominal and lower abdominal/intestinal pain
*  Pelvic pressure or a feeling like your vagina or uterus are "falling out."
*  Involuntary loss of urine or stool 

What are Pelvic Adhesions?

Pelvic adhesions are the cause of many gynecological problems including significant pain, infertility and conception. Pelvic adhesions are irritations of a woman's pelvic organs as a result of a "pelvic inflammatory event" or from trauma to the area such as in the case of pelvic or gynecological surgery.

Examples of a pelvic inflammatory event include; fallopian tube infections that might occur from endometriosis, removal of an ovarian cyst, sexually transmitted diseases such as gonorrhea, post surgery infections, and even appendicitis and appendectomies.

As a woman's body's pelvic area recovers from an inflammation, trauma or surgery, it begins the healing process and starts to repair itself.  The woman's body and its' healing process may cause some tissues and structures in the pelvis to become unintentionally "stuck" to another tissue or structure. In a normal woman's healthy pelvis, this space is lined with a tissue called the peritoneum, which also covers the outside of organs located in the abdomen and pelvis. In the pelvis of a non-injured/non-irritated woman, the peritoneum can be very "slippery" with the the organs and structures lying immediately next to each other that "slip" off each other and do not become bonded together. With a woman who has had a pelvic inflammation, trauma or injury, her body's healing process starts a sequence of events that may result in some of the pelvic tissues becoming "stuck" to or "adhering" to tissues or organs next to the inflamed, or injured tissue, and when this occurs, the outcome may be pelvic adhesions.

What is Menorrhagia?

Menorrhagia is the medical term for women (and young girls first starting their menstrual cycles) that excessive menstrual bleeding. Excessive menstrual bleeding is defined as having a period that lasts 7 or more days each menstrual cycle (period) or is so heavy that you saturate your menstrual pad and/or tampon and need to change your feminine hygiene product(s) every one to two hours.  It is very important to inform your doctor if you have excessive menstrual bleeding! 

Women that are suffering from Menorrhagia may experience; anemia, fatigue,  embarrassing menstrual accidents, and feel that you have to restrict your life and social activities to such an extent that you "miss out on life."  Many women prefer to stay close to home so as to avoid embarrassment due to their need to go to the restroom so often so that they can change their feminine hygiene products before they become too saturated and cause even more embarrassment.

How many women have Menorrhagia?

Approximately 1 in 5 women have Menorrhagia.

Are there any treatments or therapies for Menorrhagia?

Yes, there's hope and help for women with Menorrhagia!

Here are a few of the options and therapies you will want to discuss with your doctor.

Hormone therapy - also known as "both control pills," and/or other medications may be prescribed to treat hormone imbalance. Hormone therapy is effective about 50% of the time, and may be required for a long period of time. 

Uterine Balloon Therapy - Also known as Thermal Balloon Ablation) (see below for more information)

Dilation and curettage - also referred to as a "D & C" - is a surgical procedure whereby the doctor scrape the inside of the woman's uterus to remove the lining. For most women with Menorrhagia, a D&C is temporary and reduces excessive bleeding for only a few periods.

Endometrial Ablation is another possible therapy but only if you and your husband don't plan to have children in the future. Typical Endometrial Ablation removes the lining of the uterus with an electrosurgical tool or laser. Like any surgical procedure, there are risks, which include perforation of the uterus, bleeding, infection, or even heart failure due to fluids used to open up or distend the uterus.

Hysterectomy is the surgical removal of the uterus.  As a hysterectomy involves the removal of the woman's uterus, Menorrhagia will no longer be a problem. Hysterectomy is also a surgical procedure and also involves risks. The recovery period after hysterectomy is 3 to 6 weeks.

_______________________________________________________

Uterine Balloon Therapy 
www.UterineBalloonTherapy.com

What is "Uterine Balloon Therapy"?

"Uterine Balloon Therapy" - also known as "Thermal Balloon Ablation" - is a minor surgical procedure that destroys the lining of the uterus using a balloon that is inserted through the vagina, which is then filled with a fluid and then heated.  The heat - which isn't that hot, and never felt by the patient undergoing the therapy - then destroys the lining of the uterus. 

How is is Uterine Balloon Therapy performed?

Uterine Balloon Therapy  requires light general anaesthesia, or local anaesthesia. 

Uterine Balloon Therapy involves inserting a balloon catheter through the vagina, then through the cervix and into the uterus. The balloon is then filled with sterile liquid so that it expands and fills the contours of the patient's uterus. The liquid inside the balloon is then heated and maintained at 87°C for 8 minutes which scalds the endometrial lining. 

After 8 minutes, the liquid in the balloon is then withdrawn and the balloon catheter is deflated and removed back out of the uterus and vagina. 

The lining of the uterus (endometrium) will gradually shed away (through the vagina - like a period) over a 2 to 3 week period.  The woman will experience a vaginal, bloodstained discharge over this 2-3 week period.

Almost all patients are discharged the same day after the Uterine Balloon Therapy procedure and may experience uterine cramps - very similar to menstrual cramps, for a few hours to 1-2 days at most. 

Who are candidates for Uterine Balloon Therapy?

Women who have been suffering from Patients suffering from Menorrhagia, or excessive menstrual bleeding due to benign causes, are excellent candidates for Uterine Balloon Therapy. 

The overall success rate for women that undergo Uterine Balloon Therapy is around 80% and significantly reduces menstrual bleeding for these women.

However, Uterine Balloon Therapy is not a suitable therapy for patients with submucous fibroids or patients with large and irregular uterine cavities. 

In addition, this procedure is NOT for patients who have not completed their family planning and intend to have children as becoming pregnant after Uterine Balloon Therapy can be life-threatening.


Benefits of Uterine Balloon Therapy

Uterine Balloon Therapy has the distinct advantage of being handled on an outpatient basis and with a very low risk for complications. 

Additionally, there is no effect on a woman's hormonal functioning and she will not require hormone replacement therapy unlike in the case of a hysterectomy with removal of ovaries.

Finally, most women find that Uterine Balloon Therapy is their preferred treatment for menorrhagia as they get to keep their uterus, as opposed to a hysterectomy, which removes the uterus and may lead to other complications in the future, including Pelvic Organ Prolapse. 

What is Perineoplasty?

Perineoplasty, also known as "Perineorrhaphy,"is one of the fastest growing elective medical procedures and is the reparative or plastic surgery of the perineum which helps women with problems with vaginal opening laxity or looseness - medically referred to as "Vaginal Relaxation."  Many also incorrectly call this procedure "vaginoplasty" or "vaginaplasty."

Perineorrhaphy is the reconstruction of the muscles and tissues at the opening of the vagina and has successfully decreased the "introitus" or size of the vaginal opening. Perineorrhaphy does NOT reduce sexual sensation, in fact, properly performed, Perineorrhaphy INCREASES sensation for the woman as well as her husband/partner.

What is Colporrhaphy? 

Colporrhaphy is the surgical repair of the vaginal wall. This includes repairing many types of vaginal surgery, including the repairs of the vagina in a "Pelvic Organ Prolapse," "vaginal prolapse," "Vaginal Vault Prolapse," or the repair of a "cystocele" in the vaginal wall(s) or vaginal vault or a rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele when the rectum protrudes into the vagina.

In the Colporrhaphy procudeure, a uro-gynecologist, or gynecological surgeon, places a vaginal speculum inside the vagina, which spreads/keeps the vagina open, for the doctor to inspect and repair the vagina. The vaginal wall is cut opened to reveal an opening in the supporting structures, or fascia and the defect is closed and then the vagina is repaired by suture and closed, and the speculum removed. 

Who performs the Colporrhaphy and where is it performed?

Colporrhaphy is usually performed in a nearby hospital operating room by a uro-gynecologist, urologist or gynecological surgeon.