Prolapse Surgery at the University of Chicago Medical Center Section of Urology
The decision to have prolapse surgery is an important one that should be made only after receiving all the options and facts from your physician. Ultimately, it is up to you to decide when your quality of life could be improved with surgery.
Dr. Gregory Bales has more than eight years experience repairing all types of pelvic organ prolapse and tackling the problems, such as vaginal discomfort and urinary incontinence, that are often caused by prolapse. He is an expert in female reconstructive surgeries such as the sacrocolpopexy and cystocele and rectocele repairs, all procedures that restore the vaginal shape and help alleviate symptoms caused by prolapse. He also has extensive experience in placing pubovaginal slings for the treatment of female stress incontinence, and he takes an active roll in teaching other physicians how to perform these innovative procedures.
Dr. Bales takes a comprehensive approach with each patient, identifying and treating the issues that the patient feels are most bothersome and in need of attention. He seeks solutions that restore both health and quality of life.
The sacrocolpopexy is a common procedure for repairing vaginal vault prolapse and restoring the length and shape of the vaginal canal. Vaginal vault prolapses occur when the uppermost part of the vagina slips downward. They are more likely to occur in patients who have had a prior hysterectomy.
During this surgical procedure, a small entry is created in the lower abdomen so that the vagina can be lengthened back to its natural contour. Then sutures and a durable mesh material are used to fix the vagina to the sacral bone, holding it securely in its restored position.
The sacrocolpopexy procedure is performed in the operating room after a general anesthetic is administered, and the surgery is usually completed in about two hours. Most patients stay two nights in the hospital after the operation. After returning home, patients are asked to take it easy for the first two weeks. They may then return to most daily activities, but they should refrain from heavy lifting and intercourse for about six weeks.
You and your physician may decide that surgery is the best way to treat your cystocele or rectocele. Almost always, these types of prolapse are repaired without making any abdominal incisions. Instead, an opening is made in the vaginal canal that allows the weakened vaginal tissue to be identified and reinforced using a durable mesh material and sutures. In the end, the goal of surgery is to restore natural shape and function to the vaginal canal and prevent the reoccurrence of prolapse.
Very often, patients who have a cystocele also have urinary control issues related to stress incontinence. While urine leakage may occasionally resolve with a cystocele repair alone, many times a pubovaginal sling surgery is performed at the same time to reduce or eliminate leakage that comes with coughing, sneezing, and other such activities. You and your urologist may decide that this combination surgery would be a good option for you.
The cystocele and rectocele surgeries are both performed in the operating room after a general anesthetic is given. These procedures usually take about two hours, and patients can typically go home the same day. As with the sacrocolpopexy procedure, patients must relax for the two weeks following surgery and avoid heavy lifting and intercourse for six weeks after their prolapse is repaired.
Urologists and other surgical specialists have been repairing prolapses and performing pubovaginal sling procedures for many years with variable results. You may know someone who had a past pelvic repair surgery that just did not hold up over the years.
Importantly, new technological advances have allowed surgeons to give patients a more durable solution. Both polypropylene and Teflon meshes can now be used to strengthen and help assure the long-term success of these types of repairs. Such mesh materials are designed specifically for vaginal and pelvic surgeries and have properties that prevent them from becoming infected.