Saturday 25 February 2017

Gynecological Reconstructive Surgery

WHAT IS UTERO-RECTAL PROLAPSE?

The uterus (womb) and/or rectum (end of large intestine that hold feces before defecation) can prolapse (fall through) the vaginal opening or anal opening. This can happen because of weakness in the muscles that form the floor (Pelvic Floor Muscles) and holds them up into the pelvic cavity (small room/space below the abdominal cavity) by these muscles contracting. The floor may become weak, because of Old Age or Disease.

We have successfully reconstructed the supporting structures in an 87-Year-Old Woman with Utero-Rectal Prolapse, due to Old Age (reported below).

The Normal Anatomy of the Female Pelvis (Pelvic Organs).

Note the Black Line (Level) of Pelvic Muscles that forms the floor (Below), supports & holds the Urinary Bladder, the Uterus & the Rectum above and in place, without them collapsing down & outwards. 

Prolapsed Uterus (Uterus or Womb falling through & out through the vaginal canal, inside out)



Prolapsed Rectum (Part of or the end of the large intestine, falling through & out the anal canal opening, inside out)


RECONSTRUCTION OF UETRO-RECTAL PROLAPSE (HERNIATION) IN AN 87-YEAR- OLD WOMAN

STEPS:


1. Anesthesia (Sedation, Analgesia, Oxygen via Mask, IV Antibiotics & IV Fluids)


2. Positioning (Lithotomy Position)



3. Close-up View of Utero-Rectal Prolapse*Note the Catheter Inserted into the Urethral Opening to Secure the Removal of Urine into a Urine Bag (Yellow/Golden Tube)



4. Reduction of Rectal Prolapse Commences



5. Reduction of Rectal Prolapse Ends



6. Reduction of Uterine Prolapse Commences



7. Reduction of Uterine Prolapse Ends



8. Reconstruction of Structures that Holds the Uterus & Rectum into the Pelvic Cavity
-After Reconstruction of the Vaginal Vault, Now Reconstructing the Anal Canal & Anal Opening



9. Post Reconstruction, After 3 Days-Note the Urine Catheter Still Left in Place & Some Degree of Tissue Swelling that may Regress Over Time



*The patient was discharged home uneventfully
*The Remaining Quality of Life (QOL) of the Patient has been improved

Dr. William Nimle Mol can also work closely with Gynecologic Surgeons in 'Team Surgery' to reconstruct any defects within the Pelvic Region.

If you have any questions, regarding this procedure/technique or would like to enquire & know more in-depth information, then contact Dr. William Nimle Mol on this email address: molwillie@yahoo.com 

WHAT ARE THE PELVIC FLOOR MUSCLES.....????

INCASE YOU STILL WONDER! 

BELOW ARE ILLUSTRATIONS BY DR. GRANT, THE GREATEST ANATOMY ILLUSTRATOR & TEACHER OF ALL TIMES!




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