Pelvic reconstruction is a surgical procedure performed to treat pelvic organ prolapse that results from muscle weakening. Pelvic organ prolapse occurs when the muscles that hold the pelvic organs in place become stretched or weakened allowing the various organs to shift or drop from their normal position and bulge or protrude through the vaginal canal.
The condition is common and is seen most often in women who have experienced childbirth. Other risk factors for pelvic organ prolapse include aging, hysterectomy, obesity, long-term cough, and chronic constipation. Any organ in the pelvis may be affected including the bladder, urethra, uterus, vagina, small bowel or rectum.
Pelvic reconstruction surgery to repair pelvic organ prolapse may be considered when the following symptoms are present:
- Loss of bowel or bladder control
- Sexual activity is affected
- Physical activity is difficult
There are numerous pelvic reconstruction procedures and techniques that can be used to correct pelvic organ prolapse depending on which organs are affected. Surgery may be performed laparoscopically, vaginally or through an abdominal incision. Some pelvic reconstruction procedures can be done robotically.
During the pelvic reconstruction procedure, the organs are returned to the correct position and attached to the ligaments. A synthetic vaginal mesh may be used to hold the organs in place. The vaginal canal may be surgically closed in older women who are no longer sexually active.
When more than one organ is affected, multiple repairs may be performed during a single procedure. Surgery may also include removing excess tissue, tightening the surrounding muscles and ligaments and adding extra support through tissue grafts or mesh.
After pelvic reconstruction
Even after pelvic reconstruction, it is possible for pelvic organ prolapse to reoccur. Your physician may recommend certain steps to prevent future prolapse including weight loss, treatment of chronic constipation and Kegel exercises to strengthen the pelvic floor muscles.