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Pelvic Reconstructive Surgery
Pelvic Reconstructive Surgery
What is Pelvic Reconstructive Surgery?
This is surgery that reconstructs and repairs the pelvic floor so as to restore the organs to their original position. Pelvic reconstructive surgery may be done through an incision in the vagina, the abdomen or with laparoscopy.
The pelvis and pelvic floor
The pelvis is the lowest part of your abdomen and it houses organs such as ovaries, uterus, bladder, and bowel. Usually, pain in the pelvis, pelvic pain, means that there is pain emanating from one or more of these organs. However in some cases, the pain may come from your pelvic bones, joints, muscles, blood vessels or nerves which lie next to these organs. The pelvic floor supports the organs in the pelvis and if the muscles, tissues or ligaments become weak, damaged or stretched, the organs may drop down or protrude into the vagina. In rare cases that are severe, the organs may protrude all the way to the outside of the body.
Why have pelvic reconstructive surgery?
Your doctor may recommend reconstructive surgery of the pelvis if symptoms persist after trying nonsurgical treatment options such as Kegels (pelvic floor) exercises and pessaries. Surgery may also be recommended if the symptoms are so severe that they disrupt your life. Conditions that require pelvic reconstructive surgery include rectocele, enterocele, cystocele, and cystourethrocele.
Factors to consider before having pelvic reconstructive surgery
- Age: Having the surgery at a young age means that there is a chance that the prolapsed will recur. Having the surgery at an older age increases general health issues.
- Childbearing plans: If you plan to have children it is best to wait until after your family is complete because prolapsed may recur after the surgery.
- Health conditions: Surgery carries risks such as blood clots, infection, and problems related to anesthesia which is increased by health conditions such as heart disease, diabetes, obesity or smoking.
- Complications: The surgery may add new problems such as pelvic pain, urinary incontinence, and painful sexual intercourse.
Types of pelvic reconstructive surgery
The doctor uses tissues which are built up around the weakened area to prevent organ prolapse. Vaginal surgery is done through the vagina and no external incision is required. Abdominal surgery is done by making one or two incisions in the abdomen. Recovery time for vaginal surgery is shorter as compared to abdominal surgery. They include:
- Colporrhaphy: The doctor may perform a colporrhaphy by reconnecting tissues which have separated over time but normally support the vagina.
- Perineorrhaphy: In some cases, the doctor may perform a perineorrhaphy by repairing the tissues between the opening of the anus and the vagina.
- Sacrocolpopexy : The vaginal apex is suspended to recreate the natural support provided by the cardinal and the uterosacral ligaments.
- Sacrohysteropexy: The doctor will resuspend the prolapsed uterus using a strip of synthetic mesh which lifts the uterus and holds it in place.
- Hysterectomy: The doctor removes the whole uterus. Stitches may be used to attach the upper part of the vagina to a nearby strong ligament or bone in the pelvis.
- Synthetic mesh placement: The mesh is used to repair the prolapse and makes the support stronger. This method is mainly used when surgery is done using an abdominal incision or laparoscopy.
What should be cared?
Depending on the type of surgery the recovery time varies. You will need to take a few weeks off for resting. You should avoid straining, lifting, vigorous exercise and sexual intercourse for the first few weeks.
