Pelvic Organ Prolapse (POP)
This condition refers to the bulging or herniation of one or more pelvic organs into or out of the vagina.
What is Pelvic Organ Prolapse
This condition refers to the bulging or herniation of one or more pelvic organs into or out of the vagina. The pelvic organs consist of the uterus, vagina, bowel and bladder. Pelvic organ prolapse occurs when the muscles, ligaments and fascia (a network of supporting tissue) that hold these organs in their correct positions become weakened.
Exercise – exercises focusing on pelvic floor muscles can help to improve mild cases of prolapse (Kegel exercises)
Vaginal Pessary – A pessary is a rubber or plastic device used to support the pelvic floor and maintain support of the prolapsed organ. A health care provider will fit and insert the pessary, which must be cleaned frequently and removed before sexual intercourse.
Estrogen Replacement Therapy (ERT) – Estrogen may help to limit further weakness of the muscles and other connective tissues that support the uterus. However, there are some drawbacks to taking estrogen, such as an increased risk of blood clots, gallbladder disease and breast cancer.
Surgical options are used to help return prolapsed organs to a normal anatomical position and to strengthen structures around the prolapsed area.
Surgical options can be performed abdominally or vaginally:
Involves making an incision in the vagina, followed by a dissection, separating the prolapsed organ from the vaginal wall and using stitches and/or mesh to strengthen and repair the vagina.
This involves making an incision in the abdomen and using sutures and/or mesh materials to support the vagina, vaginal vault or uterus.
Laparoscopic and robotic approaches
They offer treatment to similar procedures as the open abdominal approach but often with quicker recovery time and smaller scars. In Sacrocolpopexy, done utilizing the laparoscopic approach, a prolapsed vaginal vault is supported by using mesh attached to the sacrum.
Is mesh always necessary?
Not all treatments require mesh.
Traditionally, grafts are used in repeated surgeries and where significant, risk factors for failure exist. You should discuss the pros and cons of the use in detail with your surgeon.
The FDA has established an on-line list of voluntary reports on medical devices which may have malfunctioned or caused death or serious injury. This information is located on the Manufacturer and User Facility Device Experience Database (MAUDE). The FDA issued a safety communication regarding complications related to pelvic organ repair using mesh: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm
Ask your doctor about prolapse repair and if the EndoFast procedure can fit your clinical needs.
Care after Surgery
You can expect to stay in the hospital overnight.
During the next 4 weeks please avoid heavy lifting, exercise and intercourse. Patients can return to other normal daily activities at the physician’s discretion, but not before 7-10 days postoperatively.