Prolapse Repair

Pelvic reconstruction refers to the repair of pelvic support structures to correct pelvic organ prolapse. The pelvic floor is composed of muscles and ligaments that support the pelvic organs. These organs include the bladder, the urethra, the vagina, and the rectum. Loss of support to any of these organs is referred to as pelvic organ prolapse. Pelvic organ prolapse results in the movement of pelvic organs from their normal anatomic position to produce a bulge or protrusion in the vagina. Pelvic organ prolapse may involve any or all of the pelvic organs. Usually multiple support defects coexist in patients affected. Loss of support to the bladder results in a cystocele. Loss of support to the rectum results in a rectocele. If the uterus has loss of support then it is referred to as uterine prolapse.

The loss of pelvic support may contribute to alternations in the function of the pelvic organs. This may include the involuntary loss of urine called urinary incontinence or the involuntary loss of stool referred to as fecal incontinence.

The risk factors for the development of one or more of these problems is affected by sex, age, race, childbirth, menopause, estrogen use, obesity, and the use of tobacco. Some of these risks may be decreased by changes in life style choices but others are inherent.

Treatment for pelvic organ prolapse attempts to improve the quality of life in women affected and return normal function to the pelvic organs. Surgical repair of pelvic floor anatomic defects is aimed at correction of defective or torn support structures with restoration of normal anatomy. This repair may include the use of synthetic or bioengineered graft material if natural support structures are suboptimal for long term success. Restoration of normal anatomic support usually leads to improved quality of life in most patients.

Nonsurgical options for treatment may include a change in life style choices, weight loss, medication, or the use of a pessary. A pessary is a device inserted into the vagina to provide support to prolapsed pelvic organs and thereby relieve some of the symptoms of pelvic floor defects. However, nonsurgical options do not correct the anatomic defects responsible for the organ prolapse.

For additional information please refer to our link to the Center for Pelvic Reconstrutive Surgery on our home page.