Pelvic Floor Reconstruction

What is Pelvic Floor Reconstruction?

Pelvic floor reconstructive surgery consists of several procedures for correcting a condition called “pelvic organ prolapse.” The procedure can consist of the anterior vaginal wall (front of the vagina) or posterior wall (back wall of the vagina). The uterus can also be removed in what is called a hysterectomy. If you have already had a hysterectomy, the top of the vagina can be lifted and supported.

What is Pelvic Floor Dysfunction?

The pelvic floor consists of muscles, ligaments, connective tissue, and nerves that support and control the rectum, uterus, vagina, and bladder. This “floor” can be damaged by childbirth, repeated heavy lifting, chronic disease, or surgery. Pelvic floor dysfunction can lead to things including:

• Incontinence- Loss of bladder or bowel control and leakage of urine or feces.
• Prolapse- Descent of pelvic organs including dropped uterus, bladder, vagina, or rectum. About 35 percent of women will develop some form of pelvic organ prolapse.
• Emptying Disorders- Difficulty urinating or moving bowels.
• Pelvic Pain- Discomfort, burning or other uncomfortable pelvic symptoms, including bladder or urethral pain.
• Overactive Bladder- Frequent need to urinate, uncomfortable bladder pressure, urge incontinence, and difficulty holding a full bladder.

Who Needs Pelvic Floor Reconstruction?

When the muscles of the pelvic floor are damaged or become weak – often due to childbirth – they are sometimes unable to support the weight of some or all of the pelvic and abdominal organs. If this occurs, one or more of the organs may drop (prolapse) below their normal positions, causing symptoms including discomfort, pain, pressure, and urinary incontinence.
The goal of pelvic floor reconstruction is to restore the normal structure and function of the female pelvic organs.
About 35 percent of women will develop some form of pelvic organ prolapse. The condition can often be treated with nonsurgical therapies, but it sometimes requires pelvic floor reconstructive surgery. The expertise and skill of the physician are extremely important in these GYN procedures.

What Are the Types of Pelvic Floor Reconstruction?

You and your surgeon will determine which type of vaginal surgery best suits your needs based on your condition. The types of pelvic floor reconstruction include:

• Anterior Vaginal Repair- This type of surgery is aimed at repairing the weakened walls between the bladder and the vaginal wall. Anterior vaginal repair fixes vaginal bulging and improves bladder control. An incision is made on the front wall of the vagina. The weakened layers are tightened using stitches. Sometimes extra tissue is removed.
• Posterior Vaginal Repair- This type of vaginal surgery repairs the weak tissue that dividers the vagina and the bowels. The incision is made in the center of the back wall of the vagina. The weakened tissue is repaired or tightened with absorbable stitches.

How Long Does Pelvic Floor Surgery Take?

The entire surgery takes from 30 to 60 minutes to complete. Your surgeon will explain the benefits and risks associated with the procedure before your surgery. You will then see the anesthesiologist.

How Long is Recovery After Pelvic Floor Reconstruction?

When you wake up from surgery you may have a catheter and vaginal packing to decrease bleeding. These can be removed after 24 hours. It takes about 3 months to fully recover. During this time avoid heavy lifting or strenuous activity to prevent recurring prolapse. After about 3 weeks you will be able to return to your normal activities but at a leisurely pace. Do not have sex for the first 6 weeks.
While recovering make sure to eat a healthy balanced diet filled with fiber. This will help soften your stool. Try to add fruits and vegetables to your diet. Excessive straining to pass your bowels can have an impact on your incision.