So if the hysterectomy & prolapse repair is being done in conjunction with a c-section, it would not be laparoscopic and the risk of cuff dehiscence is reduced, correct? Ginger Chun, BA, IBCLC, RLC Breastfeeding Education and Support www.freshmilkbaby.com On Sat, Sep 21, 2013 at 3:26 AM, Elizabeth Boggs <[log in to unmask]> wrote: > Several posters seemed concerned about the assertion that estrogen is > associated with wound healing. When I replied to the initial post I did not > have access to my references. > > Estrogen has been demonstrated to increase vascularity of the vaginal > tissues in postmenopausal women. > > Am J Obstet Gynecol. 1982 Jun 15;143(4):375-8. > Effect of conjugated estrogens on vaginal blood flow in surgically > menopausal women. > Abrams RM, Stanley H, Carter R, Notelovitz M. > > There are studies that have demonstrated that estrogen is associated with > improved wound healing. > > Cornea. 2012 Oct;31(10):1158-64. doi: 10.1097/ICO.0b013e31823d03ca. > Effects of 17β-estradiol on human corneal wound healing in vitro. > Oh TH, Chang DJ, Choi JS, Joo CK. > Source > Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, > College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, > Korea > > Int Urogynecol J. 2012 Dec;23(12):1763-9. doi: 10.1007/s00192-012-1793-0. > Epub 2012 May 12. > Vaginal incisional wound healing in a rabbit menopause model: a histologic > analysis. > Abramov Y, Golden B, Sullivan M, Goldberg RP, Sand PK. > Source > Division of Urogynecology and Reconstructive Pelvic Surgery, Carmel > Medical Center, Technion University, Rappaport Faculty of Medicine, Haifa, > Israel. [log in to unmask] > > Prevalence, pathophysiology and current management of dehisced perineal > wounds following childbirth (784kb) > Lynn Dudley, Christine Kettle, Khaled Ismail > British Journal of Midwifery, Vol. 21, Iss. 3, 07 Mar 2013, pp 160 - 171 > (this article references a midwifery textbook that cites vaginal blood > flow as a primary effector of perineal wound healing, re:Abrams above) > > > Cuff dehiscence is not a common occurrence, but the rate can approach 5% > if the woman has a total laparoscopic hysterectomy. > > J Minim Invasive Gynecol. 2007 May-Jun;14(3):311-7. > Incidence and patient characteristics of vaginal cuff dehiscence after > different modes of hysterectomies. > Hur HC, Guido RS, Mansuria SM, Hacker MR, Sanfilippo JS, Lee TT. > > > And a relatively recent study looked specifically at postoperative tissue > and estrogen therapy. > > Female Pelvic Med Reconstr Surg. 2012 Jul-Aug;18(4):211-5. doi: > 10.1097/SPV.0b013e31825e6401. > A randomized clinical trial of the impact of local estrogen on > postoperative tissue quality after vaginal reconstructive surgery. > Karp DR, Jean-Michel M, Johnston Y, Suciu G, Aguilar VC, Davila GW. > Source > Section of Female Pelvic Medicine and Reconstructive Surgery, Department > of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, > GA 30322, USA. [log in to unmask] > > > I want to be clear that I am not advocating that the original poster's > patient stop breastfeeding; I am only seeking to answer her question about > why a pelvic floor surgeon would want estrogen levels to be normal. > Personally, I endorse Joanne's approach of an open discussion with her > surgeon. > > > > Elizabeth Boggs, MD > Women Physician Associates > Columbia SC > > > > > > *********************************************** > > Archives: http://community.lsoft.com/archives/LACTNET.html > To reach list owners: [log in to unmask] > Mail all list management commands to: [log in to unmask] > COMMANDS: > 1. To temporarily stop your subscription write in the body of an email: > set lactnet nomail > 2. To start it again: set lactnet mail > 3. To unsubscribe: unsubscribe lactnet > 4. To get a comprehensive list of rules and directions: get lactnet welcome > *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome