Pelvic organ prolapse treatment

Martina F. Mutone, M.D., urogynecologist
Urology of Indiana

Pelvic organ prolapse (POP) is a condition in which the pelvic organs - bladder, bowel, or uterus - protrude into the vagina. POP can cause symptoms such as a vaginal bulge, pelvic pressure or discomfort, or difficulty with bladder or bowel function. Many factors are involved in the development of POP, such as weakening of the pelvic muscles, damage to the connective tissue or nerves of the pelvis, and chronic conditions or activities that increase abdominal pressure.

There are different surgical operations for women suffering from symptoms of POP. Some operations are performed through the vagina, whereas others require an abdominal incision. Operations performed vaginally most commonly involve the use of the patient’s own tissues. However, these operations may have failure rates as high as 30-35% due to the weakened nature of the tissues. Sacrocolpopexy is an abdominal operation that uses a synthetic mesh as a substitute for the patient’s tissues, and repairs the prolapse by suspending the vaginal vault to the sacrum. Studies have shown high long-term success rates and low risk of surgical failure with sacrocolpopexy.

In recent years, sacrocolpopexy has been made much less invasive by the development of robotic surgical technology, such as da Vinci Surgical System. Instead of a large abdominal incision, the procedure is performed through several small incisions in the upper abdomen. Studies have shown that robotic sacrocolpopexy may result in decreased blood loss, infection risk, and postoperative pain compared to an open abdominal incision. Most women undergoing robotic sacrocolpopexy can be released from the hospital after a one-night stay, and the recovery period may be as short as 2-4 weeks - also significant advantages over traditional abdominal surgery.

As with all surgical procedures, sacrocolpopexy carries certain risks. These include bleeding, infection, and damage to surrounding structures. There is a risk of complications related to use of synthetic mesh which is approximately 5-10%. A urogynecologist, or physician who specializes in female pelvic medicine and pelvic floor disorders, is uniquely trained to evaluate and treat all forms of pelvic floor disorders - including POP - and can discuss the risks and benefits of surgery and other treatments with you.