Surgical Options for Uterine Prolapse

Surgical Options for Uterine Prolapse

When considering Surgical Options for the treatment of Uterine Prolapse you are often presented with complex and confusing information to base your decision on.

Considering Surgery for the treatment of Uterine Prolapse can be a difficult decision.  Often you are presented with complex, and confusing information in a hurried atmosphere with little time to consider all your options.  It is with this realization that I hope you find the information to follow helpful.

 

When a firm mass is felt or a hard bulge is seen protruding out the vagina it usually a cervix or a portion of the vaginal wall prolapsing past the vaginal opening. This problem Uterine Prolapse may be treated surgically by a number of techniques and approaches.

Sacrocolpopexy

One of the oldest surgical options for treatment of Uterine Prolapse is a procedure called Sacrocolpopexy.  This procedure may be performed abdominally, laparoscopically, or Robotic assisted and attaches the top portion of the vagina to a ligament on the bone in the pelvis called the sacrum.  The uterus is removed and the cervix is left in place.  The procedure uses a synthetic polypropylene mesh material to support the vagina.   As mentioned, this procedure is one of the oldest for the treatment of Uterine Prolapse and has a success rates in the 90 percentile.  The development of Robotics has increased the popularity of this procedure making it less invasive.  Dr. Mathews offers this procedure using the da Vinci Robotic Surgical System, which allows him to perform complex procedures with greater precision and expertise utilizing minimally invasive techniques.

Sacrospinous Ligament Suspension

An older technique to treat uterine prolapse consist of a vaginal hysterectomy, if the uterus is present, followed by the use of sutures to secure the top of the vagina to a ligament in the pelvis called the sacrospinous ligament (sacrospinous suspension). This surgery results this in the vagina being pulled to one side and away from the normal position of the vagina.  This may result in pain with intercourse and is associated with a high rate of prolapse of the bladder.

Transvaginal Mesh or Graft

No doubt you have see the commercials from attorneys concerning the use of polypropylene mesh using a vaginal approach (transvaginal) for the surgical treatment of Uterine Prolapse.  As mentioned above, polypropylene mesh has been used safely and effectively for many years in performing Sacrocolpopexy procedures.  However, Sacrocolpopexy may not be the best operation for certain patients given their location of prolapse, body weight, as well as other considerations.  These factors and unacceptable failure rates for other surgical repairs, led to the use of polypropylene mesh through a vaginal approach.   Unfortunately many surgeons were not adequately trained to perform this technically challenging procedure and less than favorable results occurred in some patients.

Dr. Mathews is one of the most experienced surgeons in North Texas with the use of Transvaginal polypropylene mesh and has success rates in the 90th percentile.  The vaginal approach is the least invasive of all techniques representing the most minimally invasive option for the treatment of Uterine Prolapse.  Removal of the uterus is not usually necessary unless other problems exist. The use of lightweight polypropylene mesh has proven to be safe and effective in the treatment of Uterine Prolapse and is but one option for consideration.  Dr. Mathews encourages patients to consider all their options when considering surgical treatments.

Closing of the Vagina, Partial Colpocleisis

This surgical option for the treatment of Uterine Prolapse represents a minimally invasive vaginal approach that closes the vagina and may be considered by a woman who does not desire future vaginal intercourse.  The procedure may be performed as an outpatient and success rate are high, 95 percentile, with rapid return too normal activity.