Surgical Options For Prolapse
Prolapse surgery is used to repair and reconstruct the support of the vagina and its neighboring organs when there is a prolapsed uterus. The surgeon's goal is to restore normal anatomy, sexual function and human physiologic function (urinating and defecating). Since uterine prolapse is not life threatening, surgery is indicated only if the patient feels that her condition is severe enough that it warrants correction. Mild prolapse need not be surgically corrected for it is rarely symptomatic.
Uterine prolapse is the indication for hysterectomy in approximately 15% of cases in the United States . It is rare for a patient to have a prolapse of the uterus without at least one other type of vaginal prolapse (i.e. Cystocele, rectocele, enterocele, and urethrocele). Therefore it is very important that the physician carefully inspect the vagina for other prolapses. All forms of vaginal relaxation should be treated at the same time as the hysterectomy or uterine suspension. It is possible to have vaginal prolapse surgery without the need for hysterectomy or uterine suspension if there is no prolapsed uterus. Surgery to correct uterine prolapse requires great experience and expertise. Meticulous attention to preoperative evaluation as well as intraoperative technique is essential in repairing all defects present. Failure to do so may result in a second or third surgery for the patient.
Surgical options for patients with uterine and/or vaginal prolapse is dependent upon:
- Degree or severity of prolapse
- Areas specific for prolapse
- Desire to maintain fertility (maintain uterus)
- Desire to maintain sexual function
- Patient's age
- Patient's overall general health
- Patients desire and opinion
Drs. Miklos and Moore have been trained to perform the following uterine prolapse procedures through multiple approaches such as:
Laparotomy (Large abdominal incision)
Vaginally (through vagina)
They choose to perform these procedures through the least invasive way possible for each individual patient.
Click on the following to see their primary approach.
- Uterine Suspension
- Vaginal Vault Suspension
- Laparoscopic Uterosacral Ligament Suspension
- Laparoscopic Sacral Colpopexy
- Sacrospinous Ligament Suspension
- Burch Urethropexy
- Paravaginal (Cystocele) Repair
- Paravaginal Plus Burch Urethropexy
- Anterior (Cystocele) Repair
- Anterior Repair with Mesh (Elevate)
- Enterocele Repair
- Posterior (Rectocele) Repair
- Posterior Repair with Mesh (Posterior Elevate)
- Perineoplasty (Reconstruct Vaginal Opening)
In an attempt to restore vaginal anatomy, maintain sexual function and address urinary leakage, difficulty emptying bladder, and defecatory function, many of the above surgical procedures are performed on the patient during one operation. This is done in an attempt at minimizing vaginal and uterine prolapse recurrence and therefore subsequent surgery.