Pelvic Floor Reconstruction
Pelvic floor reconstruction is a surgical procedure that addresses a condition called pelvic organ prolapse. Prolapse occurs when one or all of your organs around your pelvis herniated or collapse into your vagina. It’s not a life-threatening condition; you may not even have any symptoms. But if you do, several treatment options are available to you, including pelvic floor reconstruction.
Prolapse often occurs because of muscle or ligament damage. These muscles and ligaments support your pelvic floor, but a difficult labor or a hysterectomy can leave them weak. Other causes are the menopausal lack of estrogen and chronic pressure on your abdomen from lifting, coughing and constipation. The types of prolapse you can experience include:
- Uterine prolapse (except after a hysterectomy)
- Vaginal ceiling prolapse (usually after a hysterectomy)
- Bladder prolapse
- Rectum prolapse
As you can see, pelvic organ prolapse can happen before or after a hysterectomy. Pelvic floor repair and hysterectomy are not interrelated. In other words, your organs can prolapse whether or not you’ve had a hysterectomy, and getting a hysterectomy doesn’t mean you’ll experience organ prolapse.
Most women who suffer from a prolapse have mild symptoms or no noticeable symptoms at all. In these cases, your gynecologist may not prescribe any treatment beyond regular check-ups. On the other hand, severe prolapse symptoms include:
- Feeling like there’s a lump in your vagina
- Tissues that protrude past your vaginal opening
- Feeling like your pelvic area is full or heavy
- An ache that originates in your pelvis or lower abdomen
- Discomfort or even pain during sexual intercourse
- Discomfort when trying to urinate or move your bowels
- An unusual urgency or frequency in urinating
- Not being able to empty your bladder completely
- Recurring urine tract infections
- Low back pain
Treatment Options for Pelvic Floor Repair
There are two types of treatments available: non-surgical alternatives for mild cases and surgical procedures for more severe cases. The most common nonsurgical option is inserting a pessary, which lifts the prolapsed organs from inside your vagina. But a pessary doesn’t often work in severe cases.
The best surgical option is reconstructive surgery. The other choice is obliterative surgery, and as the name implies, it seals off your vagina permanently, so vaginal intercourse is no longer possible. Reconstructive surgery, on the other hand, reinforces your pelvic floor to push those prolapsed organs back into place.
Risks for Pelvic Floor Reconstruction
Every surgical procedure comes with some risk, especially if you have to be sedated. If you know you’re allergic to anesthesia, please tell your surgeon. Considering the pain caused by prolapsed organs, though, the risks of reconstructive surgery may seem minor. Consider the following factors before deciding to have the surgery:
- Your overall health. The best scenario for a successful surgery is when you’re in great physical health with no problems besides prolapsed organs. While that’s rarely the case, the surgery may be riskier for you if you:
- Smoke cigarettes
- Are overweight or obese
- Suffer from diabetes
- Have heart disease or a breathing condition
- Your age. Older patients must understand that previous surgeries may complicate this one. Younger patients must understand that surgery now increases the risk that organ prolapse will occur again.
- Your family plans. You should plan on pelvic floor repair after childbirth. If you plan to have children in the future, you will likely have to repeat this surgery. Pregnancy and delivery stress your abdominals, increasing the risk of another organ prolapse.
The general risks for surgeries apply here. You may get an infection. You run the risk of excessive bleeding as well. As a result of this particular surgery, but less likely, you may experience blood clots in your legs or damage to your organs. Furthermore, there’s always the chance that the surgery will introduce new problems: urination issues such as incontinence, pelvic pain and pain during intercourse.
There are actually many types of surgery to reconstruct your pelvic floor. Which one you and your gynecological surgeon choose depends on a number of factors. The choices include:
- Uterosacral ligament suspension, which uses your own tissues to reconstruct your pelvic floor
- Colporrhaphy, which strengthens the vaginal wall from the inside
- Sacrocolpopexy and sacrohysteropexy, which uses surgical mesh to re-anchor your organs into place
- Vaginally placed mesh, which reinforces the pelvic floor using surgical mesh just inside your vagina
- Laparoscopy, which uses a small tool with a camera to aid in the reconstruction
While every procedure has pros and cons, the laparoscopic pelvic floor repair procedure may offer the most advantages, such as:
- It’s minimally invasive, using smaller incisions.
- You lose less blood during the procedure.
- There’s less pain after the surgery.
- You’ll recover faster.
Laparoscopic Pelvic Floor Repair
Before your procedure, you must fast for six hours. Right before the surgery, you’re given an enema and the surgical area is shaved. The laparoscopic procedure requires that you take a general anesthetic, so you’ll be unconscious during the operation.
Your surgeon makes a small incision and inserts the laparoscope to examine your prolapsed organs and pelvic structures. Using pelvic floor repair stitches, the doctor strengthens the inner walls of your vagina and the surrounding muscles as needed, which pushes the organs back into place. Often, your bowel and bladder are freed up and suspended so they’ll stay in place.
Finally, your wounds are stitched closed. The entire procedure takes between one and two hours.
Recovery from Pelvic Floor Reconstruction
You may have a catheter in your bladder after the procedure, but it can be removed the following day. You’ll be in some pain for several days as your body recovers from the surgery, but your doctor provides you with a prescription for pain relief. You need to rest for several days, after which you can slowly ramp back up to your normal routine — but you have to avoid heavy lifting, running or jumping.
Pelvic floor reconstruction recovery time is about six weeks, although you can usually return to work in one to two weeks, depending on how you feel. You should start walking as soon as possible once you’re up on your feet to avoid blood clots, but you can have no sexual intercourse for six weeks after your surgery.
Consider taking painkillers if you experience back pain and laxatives if you feel constipated. Encourage your body to return to normal. Chances are great that the surgery will get you back to full activity with no restrictions or pain after six weeks.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Do you have questions about Pelvic Floor Reconstruction? Would like to schedule an appointment with one of the best Gynecologist in Manhattan NYC, Dr. Pedram Bral, please contact our office.
Dr. Pedram Bral, Gynecologist (Gynecologist NYC, Midtown)
New York, NY10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4575