Pelvic organ prolapse (POP) affects millions of women in the United States. It can result from the aging process, childbirth, or a hysterectomy. Let's look at the many types of pelvic floor reconstruction surgery used to treat this disease.
Apical Suspension
Apical prolapse occurs when the uterus, cervix, or vaginal vault loses normal attachment or flexibility within the body and descends. Apical suspension is a kind of pelvic floor reconstruction that restores support to the top of the vagina, also known as the vaginal vault or apex. Apical suspension is classified into several forms. Search “pelvic floor reconstruction near me” to discover which are available in our area.
Uterosacral Ligament Fixation
Uterosacral ligament suspension is a surgical procedure that restores support to the uterus (womb) or the vaginal vault (the top of the vagina after a hysterectomy). Uterosacral ligaments are the strong, supporting ligaments that connect the cervix to the sacrum. If these ligaments weaken and strain, it can lead to pelvic organ prolapse.
Anterior Vaginal Prolapse Repair
An anterior vaginal prolapse happens when the bladder or urethra moves out of position and down into the vagina. An anterior vaginal prolapse repair is the pelvic floor reconstruction method for correcting an anterior vaginal prolapse. This specialized surgery restores the vaginal wall and tightens the front wall of the vagina. Tightening these muscles and soft tissues helps draw the bladder and urethra into appropriate alignment and prevents them from prolapsing.
Posterior Vaginal Prolapse Repair
Posterior vaginal prolapse, also known as rectocele, happens when the tissues connecting the rectum and the vagina weaken, allowing the rectum to intrude into the vagina. Posterior vaginal prolapse can result in vaginal or rectal pressure, difficulties in bowel movement, and discomfort during sexual intercourse.
Rectocele or posterior vaginal prolapse can be repaired using one of three different surgeries. These surgical techniques, which can be performed alone or in conjunction with other prolapse remedies, include:
- Posterior colporrhaphy
A minimally invasive procedure for correcting pelvic organs that have fallen out of their proper position. A posterior repair tightens the vagina's back (posterior) wall. During this surgery, an incision is performed in the vagina's posterior wall to detect the weak spot. Sutures are inserted into the weaker area to strengthen the fibromuscular layer of the vagina that divides the rectum and the vagina.
- Perineorrhaphy
A minimally invasive approach for reconstructing the perineal body. A perineorrhaphy, which is frequently performed concurrently with a posterior colporrhaphy, provides additional support for the posterior vaginal wall. This treatment removes extra vaginal skin and closes the minimally invasive incision with absorbable sutures.
Obliterative Procedures
Unlike reconstructive procedures that restore normal anatomy to a prolapsed vagina, obliterative surgeries cure a prolapse by removing (or sealing off) all or part of the vaginal canal. The goal of obliterative techniques is to avoid further prolapse.
This treatment, reserved for women who are no longer sexually active, separates the vaginal skin from the underlying connective tissue and moves the top wall of the vagina to the bottom wall, shortening it. Patients' bodily functions are unchanged; they can pass urine and have bowel motions, and the vagina appears normal from the outside.
Obliterative procedures are categorized into two types:
- Partial
Also known as colpocleisis. Developed to treat urine incontinence and prolapse in elderly women who are not sexually active. This involves a partial vaginal closure.
- Complete
Also known as colpectomy. It requires the surgical removal of the whole vagina. It is a minimally invasive and highly effective method for treating pelvic organ prolapse in women who are no longer sexually active.
The bottom line
Pelvic floor reconstruction surgery procedure choice depends on a woman's age, overall health, symptoms, and diagnosis. Consult a doctor to help you the one ideal for you.
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