Pelvic organ prolapse occurs when the pelvic organs (bladder, rectum, or uterus) push into the vaginal canal due to the weakening of pelvic muscles. These are repaired in several different ways, either conservatively, with non-surgical treatments or with surgery.
Women who experience urinary incontinence often have this procedure to treat symptoms caused by prolapse and stress incontinence, which is treated with a urethral sling.
The type of surgical procedure conducted depends on the amount (degree) of prolapse and the location. Specific procedures include:
Understanding the conversation around transvaginal and synthetic mesh can be confusing.
Here are the findings:
Like any surgical procedure, pelvic organ prolapse repair is associated with certain risks. These may include excessive blood loss, an infection requiring antibiotic treatment, developing scar tissue, and childbirth complications.
Recovery is dependent upon the extent of the organ prolapse and the type of surgery the woman has undergone.
Before undergoing surgery, you will likely have many questions for your doctor or OB-GYN. Below are some recommended questions to ask – and background information to help you weigh the answers. You can also download a printable version.
The choice of the procedure depends on the degree/grade and location of prolapse.
Open surgery for pelvic organ prolapse is never required. Minimally invasive techniques, such as DualPortGYN, can be used to repair all types of pelvic organ prolapse with fewer complications, less pain and faster recovery times.
When it comes to any form of surgery, training, skill and practice matter, which is why GYN surgeons who specialize in minimally invasive surgery are the most qualified. The reality is that OB-GYNs are highly skilled obstetric practitioners, but very few perform GYN surgeries often enough to be surgical specialists. This is borne out by studies, which find that GYN surgery is commonly a secondary component of what an OB-GYN does.
Robotic, open and conventional laparoscopic GYN surgeries can lead to longer recovery times, increased blood loss and larger scars than newer procedures. Make sure your surgeon is trained in the latest minimally invasive techniques, such as The Center for Innovative GYN Care’s DualPortGYN, that prevent injury to the pelvic structures and minimize blood loss – resulting in reduced complication rates and improved recovery times.
While most OB-GYNs are highly trusted generalists, they spent most of their time focusing on obstetrics and basic GYN care and therefore, perform specialized GYN surgeries rarely. Be sure to choose a surgeon who has received comprehensive training and is an expert in prolapse repair.
The FDA has issued several documents on the use of reconstructive materials for pelvic floor surgery. The conclusions to date have been that transvaginal placement of these materials are of uncertain effectiveness and are associated with safety risks. In contrast, use of synthetic mesh for sacral colpopexy (for apical prolapse repair) or for full-length retropubic or transobturator midurethral slings (for incontinence treatment) was considered safe and effective.
Make sure to ask your surgeon plans to use transvaginal mesh and in what way. This way you can weigh the benefits against the risks.
Although the American Medical Association and other leading medical societies have issued statements discouraging robotic techniques due to dramatically higher costs to patients without any medical advantages, robotics continue to be used in GYN surgeries. This is because robotic procedures “enable” an OB-GYN not well trained in laparoscopic GYN surgical techniques to complete GYN surgeries through a “minimally invasive” approach. This is why women need to ask if robotics will be used during a GYN surgery and to seek a specially trained surgeon able to perform the latest minimally invasive surgical techniques, such as DualPortGYN and retroperitoneal dissection that do not use robotics.
New minimally invasive techniques require, on average, only a week to recover. Other procedures such as open abdominal surgery can take up to 8 weeks.
Ask your physician if he or she is aware of new, minimally invasive procedures.