Pelvic reconstructive surgery treats pelvic organ prolapse, which can occur due to factors like childbirth or chronic coughing. Recovery varies depending on the type of surgery.
Pelvic reconstructive surgery involves repositioning the pelvic organs, such as the bladder, uterus, and vagina.
People may undergo pelvic reconstructive surgery to help treat pelvic organ prolapse. This is when the pelvic organs drop and bulge into the vagina due to weakness of the pelvic muscles and ligaments that keep these organs in place.
Potential risk factors of pelvic organ prolapse include:
- pregnancy and vaginal delivery
- chronic constipation and straining on the toilet
- lifting heavy objects
- constant coughing from conditions such as lung disease
The purpose of pelvic reconstructive surgery is to reposition the pelvic organs and help alleviate the symptoms of pelvic organ prolapse.
Doctors usually recommend pelvic reconstructive surgery if lifestyle strategies and nonsurgical treatment options have not successfully alleviated your symptoms.
Some people may receive pelvic reconstructive surgery on an outpatient basis, while others may need to stay in the hospital overnight.
The surgery differs according to the type of procedure you and your surgeon decide on. In some cases, a surgeon performs the surgery through the vagina. In other cases, a surgeon performs the procedure via an incision in the abdomen.
The types of pelvic reconstructive surgeries include:
Native tissue repair
Native tissue repair involves a surgeon stitching the prolapsed organs to your own pelvic muscle or ligament to help suspend the organs in their correct positions. The surgery involves making an incision in the vagina.
A doctor may recommend native tissue repair to help treat uterine or vaginal prolapse.
Colporrhaphy
Colporrhaphy involves a surgeon stitching certain areas of the vagina so they can properly support the bladder or rectum.
Doctors may recommend colporrhaphy to help treat both anterior and posterior vaginal prolapse.
Sacrocolpopexy
Sacrocolpopexy involves a surgeon attaching surgical mesh to the front and back walls of the vagina as well as the sacrum, also known as the tailbone.
A surgeon may perform the procedure via an incision in the abdomen or via a type of minimally invasive surgery called laparoscopy.
Laparoscopy involves a surgeon inserting a device called a laparoscope through a small incision in the skin. A laparoscope is a thin instrument with a camera and surgical tools. It allows the surgeon to perform the procedure without the need for open surgery.
Doctors may recommend sacrocolpopexy to treat vaginal prolapse.
Sacrohysteropexy
Sacrohysteropexy involves a surgeon attaching surgical mesh to the cervix and sacrum to help lift the uterus back into place.
Doctors may recommend sacrohysteropexy to treat uterine prolapse if you do not want a hysterectomy.
Vaginal mesh surgery
Vaginal mesh surgery involves a surgeon placing a surgical mesh, like a sling or hammock, underneath the urethra to help suspend the urethra in its correct position.
This procedure carries a significant risk of severe complications. Because of this, doctors typically reserve vaginal mesh surgery for prolapses that have reoccurred after a previous surgery, or if you’re unable to undergo a longer operation due to medical reasons.
All surgeries carry risks. According to the U.K. National Health Service, some general risks of pelvic reconstructive surgery include:
- risks associated with anesthesia
- bleeding
- blood clots
- damage to other areas, such as the bladder or bowel
- vaginal bleeding and discharge
- infections
The risks of pelvic reconstructive surgery also depend on whether the surgeon:
- performs the procedure through the vagina or via an incision in the abdomen
- places a surgical mesh and where in the pelvic region they place this mesh
According to the American College of Obstetricians and Gynecologists, the benefits and risks of the different procedures are as follows:
Transvaginal surgery
Medical professionals use the term “transvaginal surgery” to refer to surgery performed through the vagina. This surgery typically takes less time to perform and involves a shorter recovery time.
Transabdominal surgery
Transabdominal surgery refers to surgery performed via a surgical incision in the abdomen. Compared with transvaginal surgery, it may result in less pain during sex following recovery.
Transabdominal surgery can increase the risk of certain complications, such as damage to the intestines and adhesions. An adhesion is a band of scar tissue that joins two bodily tissues that are not normally connected.
Surgical mesh inside the abdomen
For surgeries that involve placing surgical mesh inside the abdomen, there’s a small risk that the mesh will erode into the vagina. This can cause scarring and chronic pain, resulting in the need for additional surgery to remove the mesh.
Surgical mesh inside the vagina
For surgeries that involve placing surgical mesh inside the vagina, there’s a significant risk of severe complications, such as:
- mesh erosion
- pain
- infection
- bladder injury
- bowel injury
Doctors reserve this type of surgical approach for cases when the benefits are likely to outweigh the risks.
Some people may need to start or stop taking certain medications before surgery. Your doctor will advise you if this is the case.
It’s a good idea to make arrangements for someone to bring you home from the hospital after the surgery. You may be in some pain or still groggy from the anesthesia.
It may also be helpful to arrange for someone to stay with you at home for a short while after the surgery for extra support.
Medical professionals usually encourage people to move around as soon as possible following pelvic reconstructive surgery. Gentle physical activity helps minimize the risk of postsurgical complications, such as blood clots and lung problems.
The recovery time following pelvic reconstructive surgery varies depending on the type of procedure. A
You may need to take pain medications for the first 1 to 2 weeks after surgery. Your doctor may prescribe opioids or ibuprofen and acetaminophen.
Most surgeons advise a 6-week period of pelvic rest, during which you avoid:
- penetrative vaginal intercourse
- penetrative period products, like tampons and menstrual cups
- douches
- vigorous exercise
- heavy lifting
- straining
Both transvaginal and transabdominal pelvic reconstructive surgery have
Results can vary, however. A surgeon’s skill level and experience may be a predictive factor, especially since different techniques are used based on the type of procedure you receive.
Moreover, surgery may not alleviate all the symptoms of pelvic organ prolapse.
New symptoms may also develop following the surgery, such as:
- pain during sexual intercourse
- pelvic pain
- urinary incontinence
It’s also possible for pelvic organ prolapse to come back sometime after surgery. The following strategies may help reduce this happening:
- avoiding lifting heavy objects
- preventing constipation
- maintaining a moderate weight
Below are some answers to frequently asked questions about pelvic reconstructive surgery.
Is pelvic reconstruction considered major surgery?
Surgeons perform pelvic reconstructive surgery in a hospital. Depending on the surgical approach, the procedure may involve open surgery or minimally invasive surgery.
In either case, most people can return home within about
Is it painful?
General anesthesia is used for the duration of the surgery, so you will not experience any pain during the procedure.
There may be some pain after the surgery. Over-the-counter pain relievers may help. If pain does not subside, doctors may temporarily prescribe additional pain medications, such as low dose opioids.
How long does recovery take?
A
Recovery from laparoscopic surgery may take 6 to 8 weeks, but your recovery timeline may vary depending on the type of procedure.
Pelvic reconstructive surgery is surgery to reposition the pelvic organs. This surgery may be necessary to help treat symptoms of pelvic organ prolapse.
There are several types of pelvic reconstructive surgeries. Talk with your doctor about the different procedures and their associated risks and benefits before deciding on a particular one.
Pelvic reconstructive surgery generally takes 6 to 8 weeks of recovery. During this time, you may need to make some adjustments to your usual activities to promote proper healing and reduce the risk of postsurgical complications.
Some longer-term lifestyle strategies can also reduce the risk of pelvic organ prolapse coming back, including maintaining a moderate weight and eating a lot of fiber to avoid constipation.