She walked with womb outside body for a month
Six years
after doctors removed womb, her bladder also started to drop
out
April
22, 2007
IT was sliding out of her body, but Mrs Jean Margaret Peris had no
idea it was her womb.
When she finally went to see a doctor, they had to remove it - and
her ovaries too.
Then last year, her bladder started to drop as well.
Mrs Peris, 55, is not the only one with this condition.
A medical expert says that in Singapore, one in two women suffer
from some form of uterovaginal prolapse where internal organs 'fall
out'.
Fortunately, there is a new technique called the Prolift operation
to the rescue.
And surgeons here have been using this technique for the past 20
months.
A mesh is inserted through the vagina and is held in place by
threading it through the thighs and pelvis. It acts as a new pelvic
floor to hold the affected organ in.
The new treatment has helped to improve the cure rate from 75 to 95
per cent.
But when Mrs Peris' womb fell out six years ago, all doctors could
do then was to remove it.
Mrs Peris, a housewife, said: 'When my womb first fell out, I
didn't really know what it was. It happened gradually.'
Over a month, her womb prolapsed until much of it was hanging
outside.
It became increasingly uncomfortable for her.
'BALL' BETWEEN LEGS
'I could not walk or stand or sit,' Mrs Peris recalled. 'It was
like trying to move around with a ball between my legs.'
The mother of three grown-up daughters did not feel any pain and
her dropped womb did not bleed. So she delayed going to the
doctor.
One day, her eldest daughter saw how uncomfortable she was and
asked her to get it checked.
'By then, the womb was almost all out,' Mrs Peris said. 'I could
hardly move around to do my housework.'
That was when she consulted a polyclinic doctor, who took one look
and referred her to KK Women's and Children's Hospital (KKH).
At the time, because her condition was so serious, doctors could
not push her womb back. The part that was hanging out looked like a
ball with a 10cm diameter.
They had to operate to remove her womb and ovaries.
Dr Han How Chuan, who is the head and senior consultant of the
urogynaecological unit at KKH, said: 'Six years ago, there was
nothing much we could do except to either push the womb back and
sew it up - which is not ideal because it could drop again - or we
perform a hysterectomy and remove the womb and ovaries.'
But even a hysterectomy is not ideal because 25 per cent of women
who have had their wombs and ovaries removed will experience a
collapse of their vaginal skin.
Or as in Mrs Peris' case, another internal organ, such as the
bladder, will start falling out.
The main reason women have this problem is because of pregnancy and
natural childbirth.
Dr Han said: 'Even though the pelvic floor heals, it does not
return to its original strength.'
The Prolift technique first surfaced in Europe in 2004.
'I was quite excited by it,' Dr Han said. 'I saw it as a good way
to help many women here.'
He went to France in May 2005 to learn how to do the procedure and
started offering it to his patients in July 2005.
So far, he has operated on 120 women.
When Mrs Peris' bladder started to descend some time last year, Dr
Han offered her the Prolift option.
She had the operation last August.
After the mesh was threaded, the excess mesh is cut off and nothing
is seen on the outside of her thighs.
The non-absorbable mesh (see graphic above) then stays put in the
area and integrates with the body's tissue to form new
collagen.
Mrs Peris said: 'I feel much more comfortable now. I can walk
around without fear and carry things without thinking, 'Oh, will
something start coming down?'
Dr Han said that of the women who suffer uterovaginal prolapse, 10
per cent will suffer the severe form. With Prolift, these women now
do not need to have their wombs and ovaries surgically
removed.
However, one of the complications of Prolift is that the mesh may
come out of the vaginal skin. But this can be fixed quite easily by
the surgeon.
A more serious complication is post-surgical infection. But, so
far, none of Dr Han's patients has had this problem.
After the operation, one in 10 women are unable to pass urine. This
usually resolves itself within a week. In the meantime, doctors
will insert a catheter.
The operation costs $6,000 for non-subsidised patients, and about
$2,300 for subsidised patients.
In one year, Dr Han sees about 2,000 new patients aged 45 to
65.
'There is a misconception that this is part of the ageing process
and no treatment is needed,' he said.
'I would like to tell women that they can seek treatment early to
improve their quality of life.'
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PUBLIC FORUM
KKH is holding a public forum today, 22 Apr, on Treatment for
Incontinence and Uterovaginal Prolapse.
It will be held from 1pm to 4pm at the Auditorium (Training
Centre), Level 1, Women's Tower. Call 6398 3096 for details or log
on to www.kkh.com.sg
