Pelvic Floor Reconstruction and Incontinence Surgery

What is pelvic floor reconstruction and incontinence surgery?

Pelvic floor reconstruction is a surgical procedure that is used to treat severe pelvic organ prolapse in women. The pelvic floor includes the muscles, ligaments, connective tissue and nerves that support and hold pelvic organs in place. Examples of pelvic organs include the bladder, uterus (womb), vagina and rectum (bowel).

When the pelvic floor weakens and can no longer support the weight of pelvic organs, one or more of the pelvic organs may drop or ‘prolapse’ below their normal position to press against the walls of the vagina.

Symptoms of pelvic floor prolapse

The sagging or falling pelvic organs can cause pain, discomfort and pressure in the vagina. It can also cause urinary and bowel problems. Common symptoms of pelvic floor prolapse include:

  • A bulge coming out of the vagina
  • Discomfort or pain in the pelvis
  • Problems with bowel movement
  • Incontinence

Types of pelvic organ prolapses

Depending on the type of pelvic organ prolapse you have, your doctor may recommend different surgical options.

Vaginal prolapse

If you had a hysterectomy (a surgery that removes the womb) your doctor may recommend sacrocolpopexy. This procedure sews a synthetic mesh onto the prolapsed pelvic organs. The other end of the mesh will then be stitched to the lower part of the spinal column to keep the pelvic organs in place.

Rectal prolapse

If you have a rectal prolapse, your doctor may recommend rectal prolapse surgery. This procedure tightens the tissue between the vagina and rectum and is typically performed as traditional open surgery.

Bladder prolapse

If you have a bladder prolapse, your doctor may recommend reconstructive surgery for bladder prolapse. As part of this procedure, your surgeon will push the bladder back up into your pelvic region. Reconstructive surgery for bladder prolapse aims to secure the tissue between your vagina and bladder to keep your bladder in place.

Uterine prolapse

If you have a uterine prolapse, your doctor may recommend surgery to repair a prolapsed uterus to repair the weakened pelvic floor tissues. As part of this procedure, your surgeon may graft your own tissue, tissue from a donor or a synthetic material into the weakened pelvic floor structures. Another treatment option for a prolapsed uterus is a hysterectomy or removal of the uterus.

Why do you need pelvic floor reconstruction and incontinence surgery?

When non-surgical treatments (such as self-care measures like pelvic floor exercises) are deemed ineffective for more severe cases of pelvic organ prolapse, your doctor may recommend pelvic floor reconstruction as the option to restore the normal structure and function of your pelvic organs.

Surgery to correct pelvic organ prolapse can be performed through the vagina or through the abdomen, depending on the problem and the chosen treatment. The objectives of the surgery are to:

  • Relieve your symptoms
  • Restore normal vaginal anatomy
  • Restore sexual function

What are the risks and complications of pelvic floor reconstruction and incontinence surgery?

While pelvic floor reconstruction surgeries are safe, these medical procedures still carry some risks and side effects, including:

  • Infection
  • Excessive blood loss
  • Constipation
  • Back pain
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