What is Pelvic Prolapse?
The way the uterus, bladder and rectum are all arranged around the vaginal canal leaves these organs susceptible to prolapse, a condition characterized by weakening of the pelvic muscles and connective tissues, resulting in a bulging of these tissues through the vagina. The tissue involved is usually the bladder (cystocele prolapse) but can also include the uterus (uterine prolapse), rectum (rectocele prolapse) or intestines (enterocele prolapse), which essentially slip out of place and push out through the vagina. A fairly common condition, the risk of developing pelvic prolapse increases with age, a lack of the hormone estrogen caused by menopause, and can also occur following a vaginal birth if supportive tissues are injured. Other contributing factors can include chronic coughing or constipation, frequent heavy lifting and obesity, all of which increase pressure on the pelvic floor and result in muscle straining.
In addition to the bulging of tissue through the vagina, other common symptoms of pelvic prolapse include:
• Frequent Urination
• Urinary Incontinence
• Painful Intercourse
• Constipation
Treatment Options for Pelvic Prolapse
Most women need not undergo treatment for pelvic prolapse unless the symptoms are bothersome. It is possible to slow the progression of the condition by avoiding constipation and straining, practicing Kegel exercises to strengthen muscles in the pelvic region, losing weight, quitting smoking, and receiving treatment for contributing medical problems. However, without treatment, the loss of uterine support will likely continue, potentially leading to more severe symptoms over time.
In circumstances where these symptoms interrupt daily living, such as the uterus dropping into the opening of the vagina or tissue becoming exposed outside the vagina, your doctor is likely to recommend surgery. Surgery to repair pelvic prolapse is called sacrocolpopexy. It is typically performed through the vagina (transvaginally) or abdomen and involves using stitches and surgical mesh to restore the natural position of the organs, repair tissues to provide long-term support, and sometimes permanently closing the vaginal canal with or without removing the uterus.
Robotic Surgery for Pelvic Prolapse
Unlike traditional pelvic prolapse procedures that are often performed at greater risk of damage to the pelvic organs, robotic surgery offers a minimally invasive approach that includes a few small incisions, coupled with technical advantages for the surgeon which allow for better vision, precision, movement and control during the procedure than he or she may otherwise achieve using the hands and wrists alone. In addition, women typically experience less blood loss, lower complication rates, improved urinary, bowel and pelvic symptoms. And since large incisions are avoided, recovery is often less painful with a return to normal activities much sooner than with open surgery. Above all, robotic sacrocolpopexy creates optimal circumstances to preserve healthy organs when possible, retaining natural vaginal length and depth, reducing scarring and maintaining female sexual function.
While pelvic prolapse surgery is frequently performed in conjunction with a hysterectomy, this isn’t always the case. When removal of the uterus isn’t medically necessary, I am a firm believer in preserving a woman’s healthy tissues and organs, not only for her health, but also for her emotional well-being. Unfortunately, there aren’t enough surgeons who specialize in robotic pelvic prolapse surgery who can safely and effectively preserve a woman’s uterus at the same time. Though technology and instrumentation are often the focus of robotic surgery considerations, most robotic surgery outcomes are more strongly tied to the training and experience of the surgeon performing the procedure. If you are suffering from the symptoms associated with pelvic prolapse and are considering surgery, I urge you to talk with a qualified and experienced professional to decide if a robotic approach to the procedure is right for you.