HYSTEROPEXY
Dr. Miklos & Moore have been performing laparoscopic hysteropexy, uterine suspension or uterine preservation surgery for more than 20 years for uterine prolapse, collision dyspareunia (painful sex with penile thrusting) and infertility associated with uterine prolapse. With a 98% surgical success rate and International acclaim see why patients from the world over come to Atlanta or Beverly Hills for their surgery.
What is a hysteropexy?
“Hystero” means uterus and “pexy’ means to support in other words hysteropexy simply means to lift and support the uterus. Another name for this specific type of hysteropexy is the sacrocolpohysteropexy which means lifting the uterus and vagina to the tailbone. There are other forms of hysteropexy which surgeons utilize because they are easier to perform and require less skill. One of these procedure is shortening the round ligaments known as the Gilliam procedure another procedure attempts to restore the original uterosacral ligaments to support the uterus. Dr Miklos and Moore were trained to do these surgical techniques but have abandon them due to low cure rates.
 Normal Uterus Support  Uterine Prolapse  Hysteropexy |
What are the indications or reasons for a hysteropexy?
Patients seek a hysteropexy for a number of reasons including: 1) the uterus has prolapsed i.e. has fallen due to broken uterosacral ligaments 2) the patient experiences pain with deep thrusting this condition is also known as collision dyspareunia (painful sex) and 3) infertility when a patient’s uterus has prolapsed ie lacks support
Does a hysteropexy work for uterine prolapse?
Absolutely!!! In Drs Miklos & Moore’s hand the surgical success of uterine prolapse suspension ie hysteropexy is 98% 5 years after surgery. Most hysteropexies performed by Drs Miklos and Moore will last a life time or until the uterus has another problem which may require that the uterus be removed. In fact, Drs Miklos & Moore are so confident in the success rate of their hysteropexy known specifically as a laparoscopic sacrocolpohysteropexy they will redo the hysteropexy for no out of pocket surgical fee if it fails in the first 5 years.
If my uterus is prolapsed will the hysteropexy fix all the problems of uterine and vaginal prolapse?
Yes and no! Most patients who have symptomatic uterine prolapse have advanced uterine prolapse ie usually falling to the lower 20% of the vagina. When the prolapse is this advanced state most patients will also have a cystocele and rectocele. The ceiling of the vagina which supports the bladder is broken and allowing the bladder to fall (ie cystocele) and the floor of the vagina which hold the rectum down can also break and then the rectum displaces upwards creating a bulge in the floor of the vagina. These two conditions are treated with a paravaginal repair and a posterior repair respectively and should be performed concurrently with the hysteropexy if these conditions are present. If the patient only has a uterine prolapse then the patient will only be offered a hysteropexy.
What is “Collision Dyspareunia”?
Collison dyspareunia is painful intercourse usually felt deep inside the vagina, pelvis or lower abdomen. The patient will feel pain with deep thrusting of the penis during sex. This pain is elicited when the partner’s penis strikes the cervix. The collision of the penis with the cervix i.e. tip of the uterus creates a chain reaction and pushes the uterus into the tailbone i.e. sacrum which is rich in nerves and this in turn is what creates the pain. This condition is most common in women with retroverted uterus. That means the uterus bends backwards i.e. towards the hollow of the sacrum or tail bone and this increases the chance the uterus will hit the nerves during intercourse.
Does hysteropexy work for collision dyspareunia?
It certainly can especially if other reasons for painful intercourse have been ruled out. In other words, there are other reasons why a woman can suffer from pain during deep thrusting. If the surgeon can eliminate these other reasons (infections, pelvic inflammatory disease, fibroids) and of the exam confirms the diagnosis of collision dyspareunia the patient has a > 90 % chance of alleviating her symptoms of collision dyspareunia.
Does hysteropexy work for infertility?
The answer is “yes it can” if the patient has uterine prolapse and other reasons for infertility have been ruled out. If the uterus is falling out of the body or in the very lower portion of the vagina it is obvious that the sperm has a greater chance to exposure to air. When sperm is exposed to air it dries and it kills the sperm. When sperm has a moist warm environment such as the vagina or uterus it can often live for 3-5 days and then fertilize the egg. So, moving the uterus up into the deepest part of the vagina allows for the sperm to live longer and help with fertilization.
How long does the surgery take?
Drs Miklos & Moore perform the surgery routinely ie weekly in less than 30 minutes. Studies have shown that most surgeons require 2-4 hours to do the surgery. If the patient also requires a paravaginal repair and posterior repair the whole surgery takes 1.5 hours on average.
Can hysteropexy be performed using laparoscopy?
Absolutely this is the only way Dr Miklos & Moore perform the surgery. Of course, they could do the surgery through a large incision known as a laparotomy but this is more invasive and will only do the surgery through a large incision at the patients request or if the patient is undergoing concurrent surgery that requires a large incision. Dr Miklos & Moore are experts in minimally invasive surgery and prefer to do the surgery for the patients through mini incision so they will have less pain, less blood loss and a more rapid recovery.
How long am I in the hospital?
99% of patients spend 23 hours at Northside Hospital in Atlanta Georgia and are discharge to a hotel for 1 day. In Beverly Hills the patients will spend one day in an outpatient nursing facility and get discharged the next day to go home.
How do I get schedule an appointment?
Patients can go to our website at www.miklosandmoore.com and click on contact to talk to our patient coordinators. They can discuss everything with you from logistics, costs and scheduling an appointment call Drs Miklos & Moore today and invest in your healthcare, invest in your future and invest in yourself by choosing a surgeon with experience.