The treatment of previous operationís complications and failures

Each and very operation has its own specific complications and failure rates, so is the case with pelvic organ prolapse and anti-incontinence surgery. It is obvious that the less experienced is the surgeon the more likely he is to have operative complications and failures.

Early identification and effective treatment are crucial for the cure of operative complications and failures, yet preliminary prevention of these is desired. Again, surgical experience and maintenance of the skills are mandatory.

Operative complications are sub-grouped to intra-operative, early and late post-operative. Examples for intra-operative complications are operative bleeding and iatrogenic damage to neighboring viscera and nerves. Although rare, these complications might influence negatively patientís future health and occasionally lead to death. Thus, extreme efforts are advocated to avoid these complications, and if occurring - for early detection and proper management. This is crucial for reducing potential functional impairment.

Early post-operative complications, as surgical field infection or hematoma are mostly dealt with by non-surgical measures as antibiotics and expectancy. The late post-operative complications include urine and feces voiding difficulties, urine and feces incontinence, vaginal and pelvic pain, mesh exposure and shrinkage. Those, together with operative failure and pelvic organ prolapse or urinary incontinence recurrence, are best treated by re-operation.

Many patients with previous operationís complications and failures are referred to Prof. Neuman Urogynecologic center for further treatment. This includes patients with recurrent stress incontinence or recurrent pelvic organ prolapse (descent of the uterus, bladder or intestine) as well as patients with various post-operative complications. Re-operation is performed when indicated, either for achieving the preliminary curative goal or for correcting the complications. Wrongly placed meshes and slings are removed and new ones are properly implanted. Most of the secondary operated women are released from hospital on the same day or on the day after, and the results are usually very satisfactory.

Prof. Neuman published some articles regarding the management of the pelvic floor and incontinence surgery complications and failure treatment.


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