SURGERY FOR PELVIC FLOOR PROLAPSE

Surgery for pelvic support problems attempts to restore the normal anatomic position of the prolapsed areas and to improve symptoms, which may be caused by the prolapse. The choice of surgical procedure is individualized. Factors that may influence this choice include examination findings, previous surgery, age, other medical illnesses and patient/physician preference. The surgery typically includes repair of tears in the muscle or suspension of the prolapsed tissues to stronger structures in the pelvis. In some cases, a piece of tissue may be taken from another area to help strengthen the area. The surgery may be performed through a vaginal or abdominal incision or a combination of both. One of the goals of surgery for pelvic organ prolapse is to repair all of the defects that are present in order to prevent the need for surgery in the future. Therefore, many women will require a combination of these procedures.

Vaginal Procedures are done through an incision in the vagina. Some of the common vaginal procedures are described below.

  • Anterior repairs help strengthen the front wall of vagina overlying the bladder.
  • Posterior repairs correct tears that may exist in the back wall of vagina-the area directly above the rectum. This type of surgery may involve the use of a graft (taking a piece of tissue from another part of the body) to help strengthen the area.
  • Vaginal Vault Suspension procedures use sutures (stitches) to attach the top of the vagina to stronger structures in the pelvic region.
  • Perineorrhaphy involves reconstruction of the area between the vagina and rectum.
  • Colpocleisis includes partial or complete closure of the vagina.
Abdominal Procedures are done through an incision in the abdomen. Some of the common procedures are described below.
  • Abdominal Sacrocolpopexy suspends the top of the vagina to a strong ligament on the front part of the sacrum (lower back bone) using a mesh.
  • Paravaginal Defect Repair repairs places where the vagina has torn away from its attachment to the tissue that connects to the pelvic bone.

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Last updated: 09/09/09 The University of California, San Francisco, CA 94143
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