When pelvic organs such as the uterus protrude into or beyond the vaginal canal, a condition known as vaginal prolapse develops; symptoms of this illness include:
- A sluggish pelvic floor.
- A feeling of fullness.
- Problems urinating or defecating.
- Even erectile dysfunction.
A Vaginal prolapse repair procedure may be necessary if kegel exercises, weight loss, and other non-invasive treatments are unsuccessful. You may also hear the term “pelvic reconstructive surgery” or “pelvic organ prolapse surgery” when referring to this procedure. Its aim is restoring proper organ positioning.
The operation guarantees that the organs will stay where they should be. A sample of the patient’s tissue will be needed for the process. Sometimes donor tissue or even synthetic materials are employed. The vaginal route is the most common, but it can also be accomplished with little incisions in the stomach. The surgical procedure will be different based on the patient’s health.
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What Causes It?
The pelvic floor muscles provide structural support for the pelvic organs. These muscles might weaken due to pregnancy, childbirth, or old age, which can result in prolapse.
· Hormonal shifts:
During menopause, a decline in estrogen levels can lead to the weakening of pelvic support tissues. This, in turn, can cause prolapse, as the pelvic organs experience increased pressure, especially during persistent coughing. Conditions like asthma or chronic bronchitis can also contribute to prolapse in many cases.
· Multiple spontaneous abortions:
Repeated vaginal births can cause the pelvic floor muscles to become stretched and weakened, increasing the likelihood of prolapse.
· Obesity:
Vaginal prolapse can form because of the added pressure that extra weight puts on the pelvic floor.
Vaginal Prolapse Repair Operation
Surgery may be the next best option if pelvic floor exercises and using a pessary (a detachable device inserted in the vagina for support) do not help. The prolapse severity and the patient’s general health will determine the best surgical option. Some typical surgical procedures are as follows:
Virginal Approach
- Anterior Vaginal Repair: This surgery reinforces the front (anterior) vaginal wall to restore a prolapsed bladder or urethra. The surgeon might support the weak spot using synthetic mesh or adjacent tissues.
- Posterior repair: During this operation, the surgeon reinforces the weakening tissues or inserts mesh to fix a prolapsed rectum or rear vaginal wall.
- Apical Repair: The sinking of the uterus or vaginal apex is known as apical prolapse. Sacrocolpopexy is a surgical treatment in which the height of the vagina is anchored to the sacral bone or ligaments using synthetic mesh.
Abdominal Approach
- Sacrocolpopexy: A small incision is made in the patient’s stomach for this surgery. A synthetic mesh is placed over the vagina by the surgeon and fastened to the sacrum to stabilise the prolapsed organs.
- Hysterectomy: Removal of the uterus is advised if it is determined that the uterus is the root cause of the prolapse.
Techniques Requiring Minimal Intrusion
- Sacrocolpopexy with a laparoscope or a robot: Comparable to open sacrocolpopexy, these operations use a surgical robot or laparoscope to increase visibility and precision through fewer incisions.
- Transvaginal Mesh Procedures: These vaginal mesh insertion procedures are minimally invasive since they use synthetic mesh to stabilise prolapsed organs.
This kind of repair carries the same risks and problems as any other type of surgery. Some of the risks include:
- Hemorrhage
- Causing harm to surrounding organs
- Experiencing pain during sexual activity.
- And in some instances, recurrence of prolapse.
Conclusion
Vaginal prolapse is a common condition. One that needs additional immediate attention. Sometimes surgery may be the only viable option when non-invasive therapies prove ineffective. However, discuss the benefits, risks, and expected outcomes before surgery. Your healthcare provider will decide on the best treatment approach for your condition.
