Pelvic Organ Prolapse Repair
Introduction
Poor pelvic organ prolapse (POP) is a disease in which at least one of the pelvic organs (e.g., bladder, uterus or rectum) drops out of its normal anatomical position, exerting upward pressure on the vaginal wall. This is because of weak or damaged pelvic floor muscles and ligaments frequently caused by childbirth (birth, etc.), old age (age), or other diseases. Surgeons perform pelvic organ prolapse repair to reposition organs, relieve symptoms, and improve quality of life.
In this paradigm, the medical team tailors the procedure to the prolapse and the patient. As a result of the spread of less invasive procedures, POP repair is safe and effective and leads to a saving of time in rehabilitation, as well as better results.
What is Pelvic Organ Prolapse Repair?
Pelvic organ prolapse repair consists of surgical procedures that aim to correct the position of the pelvic organs and at the same time reinforce the pelvic floor. The choice of surgical operation depends on the organ involved and the degree of prolapsus.
Common types of prolapse include:
- Cystocele (Bladder Prolapse): The bladder bulges into the vaginal wall.
- Rectocele (Rectal Prolapse): The rectum bulges into the vaginal wall.
- Uterine Prolapse: The uterus descends into the vaginal canal.
- Enterocele: The small intestine bulges into the vaginal wall.
- Vaginal Vault Prolapse: The upper part of the vaginal wall follows a hysterectomy.
Why is Pelvic Organ Prolapse Repair Needed?
POP repair is recommended for women experiencing:
- Pelvic Pressure or Discomfort: A heavy feeling or pressure in the pelvic area.
- Urinary Issues: Difficulty urinating, frequent urination, or stress incontinence.
- Bowel Problems: Abdominal discomfort or sensation of fecal incomplete evacuation.
- Vaginal Bulge: A visible or palpable bulge in the vaginal area.
- Pain During Intercourse: Discomfort or pain caused by prolapse.
- Reduced Quality of Life: Difficulty performing daily activities due to symptoms.
Types of Pelvic Organ Prolapse Repair
- Anterior Repair: Recycles a cystocele by thereby regenerating the anterior vaginal wall to strengthen the bladder.
- Posterior Repair: Management of rectocele by augmenting the resistance of the back wall of the vaginal canal to the rectum exercises the muscles in the management’s advanced stages.
- Uterine Suspension or Hysteropexy: In this paradigm, the medical team tailors the procedure to the prolapse and the patient.
- Vaginal Vault Suspension: Supports the top of the vagina after a hysterectomy.
- Sacrocolpopexy: Positions surgical mesh so it can be fixed to the sacrum (i.e., base of the spine) or uterine vault of the vagina, or uterus.
- Perineorrhaphy: Corrective and improves the perineum (between the vulva rect).
- Colpocleisis: Stop the vaginal opening in women who are not interested anymore in sexual intercourse (e.g.
Procedure Steps
- Pre-Surgery Evaluation:
- Pelvic Exams: Assess the severity and type of prolapse.
- Imaging Tests: Ultrasound, MRI, or CT scans to evaluate pelvic organs.
- Urodynamic Testing: Determines bladder function if urinary issues are present.
- Medical History: Discuss previous surgeries, childbirth history, and symptoms.
- Anesthesia:
- General or regional anesthesia (spinal/epidural) is induced for comfort.
- Surgical Process:
- Incisions: Irides are generated vaginally, abdominally or laparoscopically in a fashion depending on the type of repair that will be performed.
- Tissue Repair: The surgeon tightens and strengthens weakened tissues and ligaments.
- Mesh Placement (if required): Surgical mesh may be used to support the organs.
- Organ Repositioning: The prolapsed organ is restored to its original position.
- Closure:
- Incisions are sealed with sutures or surgical tape without any increase in scarring.
- Post-Surgery Monitoring:
- In this case, the patient is monitored for pain and bleeding, as well as for other acute complications.
Benefits of Pelvic Organ Prolapse Repair
- Symptom Relief: Eliminates discomfort, pressure, and bulging.
- Improved Bladder and Bowel Function: Restores normal urinary and bowel habits.
- Enhanced Quality of Life: Allows women to resume daily activities without discomfort.
- Aesthetic Improvement: Restores the normal appearance of the vaginal area.
- Minimally Invasive Options: Longer recovery time and less pain for laparoscopic or robotic procedures.
Cost of Pelvic Organ Prolapse Repair
- United States: $8,000 – $20,000
- United Kingdom: $6,000 – $15,000
- Thailand: $3,500 – $8,000
- India: $2,500 – $6,000
Best Hospitals in India for Pelvic Organ Prolapse Repair
India is home to world-class facilities for POP repair. Leading hospitals include:
Metro Hospital Faridabad:
- Specializes in advanced gynecological and urogynecological procedures.
- Renowned for minimally invasive and laparoscopic surgeries.
Fortis Healthcare (Delhi):
- Offers state-of-the-art infrastructure and experienced specialists for POP repair.
Max Healthcare (Delhi):
- Reputable for its broad range of women’s health services and satisfying postoperative outcomes for gynecological surgery of the perineal organ prolapse.
Risks and Complications
While POP repair is generally safe, potential risks include:
- Infection: Rare with proper postoperative care.
- Bleeding: Minimal with advanced surgical techniques.
- Mesh Complications: Rare cases of mesh erosion or rejection.
- Recurrence: Prolapse may recur in some patients over time.
- Urinary Issues: Temporary difficulty urinating after surgery.
Recovery
Immediate Recovery:
- Hospital Stay: Typically 1-3 days for monitoring and initial recovery.
- First Week: Rest is not optional; do not overuse heavy lifting work or heavy manual labor.
Long-Term Recovery:
- 4-6 Weeks: Most patients resume normal activities, including light exercise.
- 3 Months: Complete recovery is confirmed and patients return to physically demanding labor.
- Follow-Up Care: Regular check-ups ensure proper healing and monitor for complications.
