Pelvic Support Surgery
Pelvic support surgery, also known as pelvic floor surgery or pelvic organ prolapse surgery, is a medical procedure performed to address issues related to the pelvic floor. The pelvic floor is a group of muscles, ligaments, and tissues that provide support for the pelvic organs, including the bladder, uterus, and rectum. When the pelvic floor weakens or becomes damaged, it can lead to various pelvic health problems, including pelvic organ prolapse.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs when one or more of the pelvic organs descend or “prolapse” into the vaginal canal or rectum due to weakened pelvic floor muscles and connective tissues. This can result in symptoms such as urinary incontinence, vaginal bulging or discomfort, and bowel dysfunction.
Pelvic support surgery is performed to repair and restore the normal position of these prolapsed pelvic organs. The specific surgical procedure and approach may vary depending on the type and severity of the pelvic organ prolapse, as well as the patient’s overall health and preferences.
Common Types of Pelvic Support Surgery
Vaginal Vault Suspension
Vaginal vault suspension is a surgical approach used to correct vaginal vault prolapse, a condition where the top of the vagina loses its structural support and drops, often following a hysterectomy or due to weakened pelvic muscles. This procedure repositions the vaginal apex to its proper location, alleviating symptoms such as pelvic pressure, urinary leakage, or bowel difficulties. Depending on the patient’s needs, the surgery can be performed using techniques such as attaching the vaginal apex to the sacrum (sacrocolpopexy), the sacrospinous ligament (sacrospinous ligament suspension), or other pelvic structures.
The suspension is achieved through the use of sutures, which secure the vaginal apex to a stable support structure, or surgical mesh, which provides additional reinforcement. Both methods aim to restore normal pelvic function, enhance quality of life, and reduce prolapse symptoms. This procedure can be performed through various approaches, including vaginal, laparoscopic, or robotic-assisted surgery. Each technique is designed to promote quicker recovery, maximize effectiveness, and lower the likelihood of prolapse recurrence, providing long-term relief for patients.
Vaginal Vault Suspension
Vaginal vault suspension is a surgical procedure aimed at correcting vaginal vault prolapse, a condition where the upper portion of the vagina loses its support and descends, often due to weakened pelvic floor muscles or following a hysterectomy. This condition can cause symptoms such as pelvic heaviness, pressure, discomfort during physical activity, urinary incontinence, or bowel dysfunction, significantly impacting a patient’s quality of life. The goal of vaginal vault suspension is to restore the normal anatomical position of the vaginal apex, providing long-term relief and improving overall pelvic health.
During the procedure, the vaginal vault is lifted and secured using either sutures or mesh. The choice of material and technique depends on the patient’s specific condition, overall health, and personal preferences. For example, the vaginal apex may be anchored to the sacrum (sacrocolpopexy) using a synthetic mesh, or to the sacrospinous ligament (sacrospinous ligament fixation) using sutures. These anchoring points provide stable and durable support to the vaginal apex. Advanced surgical techniques, such as laparoscopic or robotic-assisted methods, allow for precise placement of the sutures or mesh while minimizing recovery time and surgical risks.
In addition to restoring proper anatomical support, vaginal vault suspension also addresses associated symptoms like urinary incontinence or bowel irregularities. Surgeons may combine the procedure with other pelvic repairs if needed, such as repairing cystoceles (bladder prolapse) or rectoceles (rectal prolapse), to provide a comprehensive solution to pelvic organ prolapse. Recovery typically involves a few weeks of reduced activity to allow healing, with patients experiencing significant symptom relief and improved quality of life once fully recovered. This procedure offers a durable and effective solution for patients struggling with prolapse, helping them regain comfort, function, and confidence in their daily lives.
Vaginal Wall Repair
Vaginal wall repair is a surgical procedure used to address specific areas of pelvic organ prolapse, where the front or back walls of the vagina have weakened or collapsed. This condition can occur due to factors like childbirth, aging, hormonal changes, or chronic straining. The goal of the repair is to restore strength and support to the vaginal walls, improving symptoms such as pelvic pressure, urinary incontinence, and bowel dysfunction. The procedure involves tightening the vaginal walls and reinforcing the weakened tissue, which can be achieved using the patient’s natural tissue or surgical mesh, depending on the individual case and the surgeon’s recommendation.
Pelvic support surgeries, including vaginal wall repair, are often performed using minimally invasive techniques such as laparoscopy or robotic-assisted methods. These advanced techniques provide several benefits, including smaller incisions, reduced postoperative pain, shorter hospital stays, and quicker recovery times compared to traditional open surgery. By utilizing these approaches, patients typically experience less discomfort and can return to their normal activities sooner, making these options highly appealing.
It is important for individuals experiencing symptoms of pelvic organ prolapse to seek evaluation from a qualified gynecologist or urogynecologist, as untreated prolapse can worsen over time and impact quality of life. Symptoms such as a feeling of pelvic pressure, difficulty with urination or bowel movements, and visible bulging in the vaginal area should be discussed during a medical consultation. The most appropriate treatment plan, whether surgical or non-surgical, will depend on the severity of the prolapse, the patient’s medical history, lifestyle, and individual needs.
When surgery is recommended, a tailored approach ensures the best outcomes. Dr. Jeffrey Kotzen emphasizes the importance of patient education, offering a thorough explanation of the procedure, its risks and benefits, and what to expect during recovery. By working closely with patients, Dr. Kotzen provides personalized care, ensuring each treatment plan aligns with the patient’s goals and medical needs. Vaginal wall repair can significantly improve physical comfort and overall well-being, helping patients regain confidence and a better quality of life.
