What is a Pelvic Reconstructive Surgery?
Pelvic reconstructive surgery is performed for the treatment of women's pelvic health issues which include female urinary and reproductive tract disorders. The goal of reconstructive surgery is to restore the organs to their original positions. It is commonly used for the treatment of pelvic organ prolapse.
Some of the pelvic reconstructive surgeries are performed through an incision in the abdomen, while some are performed through an incision in the vagina. Some may be performed through a minimally invasive procedure called laparoscopy.
What is Pelvic Organ Prolapse?
Pelvic organ prolapse is a condition characterized by displacement, slipping, or dropping down of the pelvic organs. It is caused by the weakening of the tissues and muscles that support the pelvic organs which include the bladder, uterus, and vagina.
What are the Indications for Pelvic Reconstructive Surgery?
Pelvic reconstructive surgery is recommended if you have:
- Pelvic organ prolapse
- Congenital deformities of the hymen, vagina, or uterus
- Complications from previous prolapse surgery
- Fecal or urinary incontinence
Different Types of Pelvic Reconstructive Surgeries and their Procedures
The different types of reconstructive surgeries include:
- Sacrocolpopexy: In this procedure, a surgical mesh is attached to the front and back walls of the vagina and then to the tail bone (sacrum). This restores the vagina to its original position. Sacrocolpopexy can be performed through a single long abdominal incision or through laparoscopy. Sacrocolpopexy is used to treat vaginal vault prolapse and small bowel prolapse also called enterocele.
- Colporrhaphy: This surgical procedure is performed through the vagina. The anterior (front) and posterior (back) wall of the vagina is stitched. This strengthens the vagina and is also able to support the bladder and the rectum. Colporrhaphy is used to treat vaginal prolapse.
- Sacrohysteropexy: This surgical procedure is performed through the vagina. A surgical mesh is attached to the cervix and then to the sacrum. This lifts the uterus back in place. It is performed for uterine prolapse.
- Uterosacral ligament suspension and sacrospinous fixation, also called native tissue repair: In this procedure, a fixation or suspension using your own body tissues is used to treat uterine or vaginal vault prolapse. It is performed through the vagina. The prolapsed part is sutured to a muscle or ligament in your pelvis.
- Surgery using vaginally placed mesh: In this procedure, a mesh is placed in the vagina. It can be used to treat all types of prolapses. The vaginal mesh can be used for women who are unsuitable for native tissue repair.
Post-Operative Care for Pelvic Reconstructive Surgery
Your doctor will give you specific instructions to follow after your surgery to facilitate smooth and quick recovery.
- You may have a catheter placed inside your body for a few days to facilitate urination.
- You will be prescribed stool softeners during the immediate post-operative period to prevent constipation and avoid straining with bowel movements.
- Avoid strenuous activities such as lifting heavy objects, exercising, and vaginal intercourse for at least 6 weeks following surgery.
- You should perform mild stretching and walking and avoid complete bed rest.
What are the Risks and Complications of Pelvic Reconstructive Surgery?
Every surgical procedure carries some amount of risk. Likewise, pelvic reconstructive surgery may also have certain risks and complications such as:
- Bladder or bowel injury
- Mesh erosion
- Bleeding or hematoma formation