Cost of Prolapse Surgery in Nigeria (Uterine, Vaginal and Others)
Prolapse is the protrusion of an organ or structure beyond its normal anatomical confines. Vatious other terms have been used to describe this condition and these include:
Pelvic organ prolapse
Genital prolapse
Urogenital prolapse
Uterine prolapse
Uterovaginal prolapse
Vagina prolapse
Rectocele
Cystocele
Urethrocele
Eneterocele
Vaginal vault prolapse
Uterine prolapse is normalmy stages as follows:
First degree: when there is descent of the cervix but not beyond the level of the vaginal opening
Second degree: when there is descent of the cervix beyond the level of the vaginal introitus especially when the woman strains.
Third degree: when there is descent of the cervux and the whole uterus outside the vulva
This type of prolapse is sometimes referred to as procidentia
Vaginal prolapse is normally classified as follows:
Cystocele
Rectocele
Enterocele
Vault prolapse
Incidence of prolapse in Nigeria
The incidence of prolapse in female Nigerian or African society is difficult to determine with accuracy as most of the women do not seek medical attention unless symptoms are pronounced and disturbing. This is even more so in the rural areas. Prevalence as high as 30 percent has however been reported in parts of Europe.
Causes of prolapse
They include:
1. Congental: Some authors have claimed that true congenital prolapse may be associated with connective tissue abnormalities in the form of collagen metabolism. Congenital prolapse is very rare in our own community.
2. Parturition: Prolapse may follow labourin which the woman tries to bear down before vacuum extraction in the first stage of labour. The pathology could be explained on the basis of overstretching and damage to the ligaments that holds the pelvic organs. Injuries during childbirth may also results in denervation of the pelvic nerve muscles. Some authors have shown that injury to the nerve that serves the very important pelvic muscle called levator ani is a possible cause of prolapse.
3.Menopause: following menopause, there is withdrawal of the ovarian hormones and this renders the pelvic organs and ligaments atrophic and unable to perfom their supportive role. It has been shown that menopause results in deterioration of the supportive collagenous tissue.
4. Increased intra-abdominal pressure: this is the predisposing factor which includes chronic cough or bronchitis, ascitis and tumor formation. Heavy lifting of load has been blamed for vaginal or uterine prolapse.
5. Iantrogenic factors: prolapse may follow surgical operations such as hysterectomy (removal of the uterus) which involves cutting of the uterosacral ligament which are supportive to the uterus. The common types of prolapse in this category is vault prolapse and enterocele.
Symptoms of prolapse
A woman with prolapse may not complain of any symptoms. However, symptoms associated with prolapse include:
➡️feeling of swelling or fullness un the vagina
➡️feeling of something comung down the vagina
➡️dragging discomfort in the lower abdomen
➡️constipation
➡️back pain
➡️urinary frequency and urgency
➡️ vaginal discharge which may be blood stained
➡️ulceration
Treatment of Prolapse
The treatment of prolapse may be palliative (to relieve symptoms) or curative (called prolapse surgery).
Cost of Prolapse Surgery in Nigeria
Cost of prolapse surgery in Nigeria is quite exoensive and depends on the type of surgical procedure that will be applied to solve your problems. For example, laparocospic prolapse surgery Nigeria (Lagos, Abuja, Benin, Port Harcourt, Delta and Kano to be precise) costs around #1,500,000 naira.
Open abdominal surgery for the repair of uterine or vaginal prolapse costs around #500,000 – #700,000 Naira in Nigeria. During my internship programme at the University of Benin Teaching Hospital(UBTH) a few years back, a 55 year old woman who underwent uterine prolapse repair surgery paid about #300,000 naira.
The end
CREDIT:
1.Textbook of Obstetrics Md Gynaecology by Akin Agboola.
2. Dr Udomoh
