Getting to Know Pelvic Floor Surgery Options

October 2016

There are many pelvic floor surgery options, so it’s best to discuss the risks and benefits of each with your doctor.

In medicine, the acronym POP stands for pelvic organ prolapse, the dropping of a pelvic organ from its usual position such that it presses on the vagina wall. The issue leads 1 in 9 women to need pelvic floor surgery by the age of 80. The first line of defense against POP is usually an inserted support device called a pessary. But if your symptoms are severe and disruptive despite a pessary—and all the Kegel exercises you could muster—it might be time to start thinking about pelvic floor surgery.

There is more than one surgical procedure that can help with POP, depending on your lifestyle, age, childbearing plans, personal health, and severity of the prolapse. Let’s talk first about obliterative surgery. This type of pelvic floor surgery narrows or closes off the vagina to create support for the pelvic organs. Once a woman has it done, she can no longer have vaginal intercourse. Since the likelihood of POP increases with age, while libido and sexual activity generally decline, there’s a markedly high satisfaction rate among older women who opt for this procedure.

That said, if the thought of retiring your sex life just made your heart drop, you’ll be glad to hear that most women with POP opt instead for one of the many reconstructive surgery options. These include:

  • Uterosacral ligament suspension and sacrospinous fixation
    Through a small incision in the vagina, the surgeon will place stitches into a strong ligament in the pelvis and then to the cervix or upper part of the vagina. 
  • Colporrhaphy
    This type of pelvic floor surgery is performed vaginally and deals with prolapse of either the bladder or rectum. The surgeon will push the fallen organ back into its normal spot before tightening and reinforcing the support tissue between the organ and the vagina.
  • Sacrocolpopexy or sacrohysteropexy
    This pelvic floor surgery involves placing mesh to support a prolapsed uterus or prolapsed top of the vagina. It is usually done through small abdominal incisions laparoscopically or robotically. This approach decreases the risks of using vaginally placed mesh, and yields excellent anatomic and functional restoration. This procedure has success rates that approach 95 to 97% and usually you can go home the day after surgery!

Choosing the right pelvic floor surgery is a matter of balancing risks and rewards to achieve the best possible quality of life for you. Talking over your concerns and preferences with your doctor should help you land on the type of pelvic floor surgery that’s best for you. Contact us today to schedule an appointment with Dr. Ken Ostermann, a board-certified female reconstructive surgeon who can help you find relief.

This is a public forum, by which BDWH provides general information to patients and prospective patients. You should not post any personal or identifying information on this Blog. The information that appears on this Blog does not constitute medical advice and is not a substitute for a consultation with a Healthcare Professional.

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