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Prolapse (Fallen Vagina) Surgery/Sacrocolpopexy Women often complain of "bulging from the vagina" or "my cervix is coming out of my vagina." This is called pelvic organ prolapse, and occurs when pelvic floor muscles are weak or damaged and can no longer support the pelvic organs. When these organs (e.g., bladder or bowel) slip out of place, they push up against the vaginal walls. Often women will complain of difficulty with emptying stool from the rectum and having to push stool out by pressing on the back of the vagina. Also, many women will complain of loss of bladder control. Prolapse is a result of genetics, vaginal deliveries, years of heavy lifting and environmental factors such as smoking. You cannot repair this problem without surgery or devices that remain in the vagina to prevent droppage (i.e. Pessaries). There are many surgeries to correct this problem depending on your problems. If you have a uterus, this will need to be removed to repair the prolapse. The most effective surgery for prolapse at this time is sacrocolpopexy. This surgery has the best long term results with good vaginal elevation 5-10 years after surgery and longer. No other method has been proven to be a more effective surgical treatment at this time. Now, I perform this surgery with the Da Vinci Robot. In Evansville, I am the first physician and as of January 2009, the only physician to perform sacrocolpopexy with the robot. Over the past 12 years, I have performed several hundred sacrocolpopexies in the Evansville area and have conducted research in the area of pelvic prolapse. However, there are specialists in pelvic organ repair called "urogynecologists" that are located in larger cities like Indianapolis, Louisville, Nashville, etc. that perform these surgeries several times every week. I am always happy to refer any patient for consultation with an urogynecologist should they prefer this approach. Sacrocolpopexy is a surgery that uses artificial mesh called Prolene to reconstruct the vagina. This tissue is very soft but also very strong. I use this tissue along the front and back of the vagina to repair your own damaged tissues and then connect it to your backbone or sacrum. This will elevate the vagina and orient the vagina in its normal position. Sacrocolpopexy has the best results of all the known prolapse repair surgeries for sexual functioning and longevity. This surgery carries the same risks as all surgeries such as: injury to bladder, ureter, bowel and blood vessels; bleeding; infection; anesthetic risk. You will also need a full 6-8 weeks of reduced activity with no heavy lifting greater than 10lbs and no strenuous pulling or pushing over this time. After surgery the mesh is held in place by stitches that I have placed. However, I am counting on your body to heal around the mesh and hold things in place for the remainder of your life. It is very important to not overdo activity after surgery, as you could breakdown the repair before your body has had time to heal it into place. |
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