Gynecology >> Prolapse Repair

Prolapse Repair

Pelvic Organ Prolapse

If you have pain and discomfort from pelvic organ prolapse that does not respond to nonsurgical treatment and lifestyle changes, you may want to consider surgery. The choice of surgery depends upon which organs are involved, how bad your symptoms are, and what other medical conditions are present. Also, your surgeon may have experience with and preference for a certain procedure. The goals of surgery are to relieve your symptoms and restore the normal functioning of your pelvic organs.

There are several types of surgery to correct stress urinary incontinence. These can be done at the same time as surgery to repair prolapse. These surgeries lift the urethra and/or bladder into their normal position. To learn more about these surgical procedures, see the topic Urinary Incontinence.

Surgical procedures used to correct different types of pelvic organ prolapse include:

  • Repair of the prolapsed bladder (cystocele) or urethra (urethrocele)
  • Removal of the uterus (hysterectomy)
  • Repair of the rectum (rectocele) and small bowel (enterocele)
  • Repair of the vaginal wall (vaginal vault suspension)
  • Closure of the vagina (vaginal obliteration)
  • Repair of vaginal wall prolapse (vaginal vault prolapse)

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Vaginal Vault Prolapse

Vaginal vault prolapse occurs when the upper portion of the vagina loses its normal shape and sags or drops down into the vaginal canal or outside of the vagina. It may occur alone or along with prolapse of the bladder (cystocele), urethra (urethrocele), rectum (rectocele), or small bowel (enterocele). Vaginal vault prolapse is usually caused by weakness of the pelvic and vaginal tissues and muscles. It happens most in women who have had their uterus removed (hysterectomy).

  • Symptoms of vaginal vault prolapse include:
  • Pelvic heaviness
  • Backache
  • A mass bulging into the vaginal canal or out of the vagina that may make standing and walking difficult
  • Involuntary release of urine (incontinence)
  • Vaginal bleeding

During surgery, the top of the vagina is attached to the lower abdominal wall, the lower back (lumbar) spine, or the ligaments of the pelvis. Vaginal vault prolapse is usually repaired through the vagina or an abdominal incision and may involve use of either your tissue or artificial material.

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