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Had vaginal hysterectomy, anterior, posterior repair, McCall's culdoplasty and after POP repair diagnosed Enterocele, taking Vagifem

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XXXXXXX 2012 vaginal hysterectomy, anterior, posterior repair, McCall's culdoplasty (cystocele 2, rectocele 1, unterine prolapse 3 - no mesh) Tram flap breast reconstruction 20 years ago after mastectomy, adriamycin, cytoxcin, 5 years tamoxafin, 2yrs raloxifene, 3 yrs fosamax. Ovaries removed with tram flap (mother breast cancer twice, her sister breast cancer twice, maternal grandmother ovarian cancer). One year post POP repair new prolapse diagnosed as stage 3 enterocele. Taking Vagifem. Can I have laproscopic surgery to repair enterocele? Even with mesh will repair hold? Wondering about pelvic defects due to tram flap? Any research regarding POP after tram flap?
Posted Sat, 28 Sep 2013 in Women's Health
Answered by Dr. Kulsoom Qureshi 2 hours later
Brief Answer:
You may have laparoscopic surgery, if you are fit

Detailed Answer:
Thanks for consulting us & providing such a good account of your history.
Enterocele is a known complication of vaginal repairs. This may arise as a new prolapse or some previous "not so obvious" defects become apparent once the rest of the area gets extra support.
Laparoscopic surgeries are the new & advanced techniques used to repair such pelvic defects. Their use along with the mesh is supposed to give better results as compared to a repeat vaginal surgery.
Your fitness for laparoscopic surgery can only be determined after assessing your general health by an anesthetist & the surgeon who is going to operate upon you.
They will examine you pre-operatively & request a set of tests to confirm your medical fitness for general anesthesia.
Tram flap breast reconstruction decreases the strength of abdominal muscles but NOT the pelvic muscles. So, we cannot relate pelvic organ prolapse to this procedure.
Hope I have given you the desired information. Please write back if you have any question.
Wish you good health.
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