Pelvic Organ Prolapse
Pelvic organ prolapse happens when the tissues and muscles supporting the pelvic organs weaken or loosen. The pelvic organs include the bladder, uterus, vagina, cervix and rectum. POP results in the organs slipping from their normal positions and pressing into or out of the birth canal. Pelvic organ prolapse symptoms may include:
- Discomfort, pressure, fullness or aching in the pelvis
- Seeing or feeling a bulge coming out of the vagina
- Pelvic pressure that worsens with coughing or standing
- Bowel movement problems
- Leaking urine
POP affects almost 3% of women in the U.S., and some may develop other pelvic floor disorders along with POP. Not all cases of POP need surgery. Non-surgical methods such as pelvic floor muscle therapy or pessary (a device to support pelvic organs) may be recommended first. Surgery like sacral colpopexy may come as a next option if these treatments are not effective.
What Are the Types of Pelvic Organ Prolapse?
Here are the types of prolapse depending on the pelvic organ that has dropped:
- Cystocele — bladder dropping into the vagina.
- Enterocele — small intestine bulging into the vagina.
- Rectocele — rectum bulging into the vagina.
- Uterine prolapse — uterus dropping into the vagina.
- Vaginal vault prolapse — the top of the vagina losing its support and dropping.
What Causes Pelvic Organ Prolapse?
Pelvic organ prolapse occurs when the pelvic muscles or connective tissues don’t work properly. Risk factors include:
- Vaginal childbirth
- Long-term abdominal pressure
- Giving birth to an infant weighing more than 8.5 lbs
- Menopausal hormonal changes
- Family genetics
How Common Is Pelvic Organ Prolapse?
Nearly 37% of women with pelvic organ disorders are ages 60 to 79 years old, while about half are 80 years and older. The exact prevalence of POP is unknown, but a study published by the National Library of Medicine revealed that approximately 200,000 POP surgeries are performed every year in the U.S.
Can a Prolapse Be a Sign of Cancer?
A prolapse is not typically a cancer sign, but in some cases, it may be linked to cancer. For instance, a growing cancerous tumor can put pressure on nearby organs, resulting in prolapse. For instance, a rectal tumor may lead to rectal prolapse or uterine tumor may cause prolapsed uterus. Please note that only doctors and thorough medical examination may be able to rule out any underlying cancer or other serious conditions. Seek medical attention if you experience unexplained bleeding, pain or other concerning symptoms. Regular check-ups and screenings are essential for early cancer detection and treatment, especially if you have risk factors or symptoms that raise concerns.
What Is Robotic Sacral Colpopexy?
Robotic sacral colpopexy is a type of pelvic organ prolapse surgery. It aims to put the pelvic organs back to their normal positions using an advanced robotic unit that a surgeon controls in the same room as the patient. Sacral colpopexy is also known as sacrospinous colpopexy or sacrocolpopexy.
Here are some benefits of robotic sacrocolpopexy compared with open surgery or other sacral colpopexy methods:
- Less risk of complications
- Less nerve or tissue damage
- Shorter hospital stays
At Hilton Head Regional Healthcare in Hardeeville, SC, we have board-certified urologists and gynecologists highly capable of performing robotic-assisted sacral colpopexy. In this procedure, the surgeon sits at a console to control the robotic arms carrying surgical tools, which are inserted into small incisions in the patient’s abdominal area. The video captured in a camera in one of the robotic arms allows the surgeon to view the surgical site through a monitor screen.
The patient will be asleep under general anesthesia throughout the surgery. Here’s how the sacrocolpopexy procedure goes:
- The surgeon attaches a surgical mesh to the prolapsed pelvic organs to help keep them in place. The mesh will be stitched and anchored to strong tissue in the pelvic area.
- Some patients may need to undergo hysterectomy (partial or total removal of the uterus) during sacral colpopexy.
- Your surgeon may also repair the rectum or bladder areas if more support is needed for other prolapsed organs.
- A mesh may be placed underneath the urethra to provide support for patients with urinary incontinence or uncontrollable urine leakage.
- The surgeon removes the tools and closes and bandages the incisions after surgery.
What Is the Success Rate of Robotic Sacrocolpopexy?
From a study published in the National Library of Medicine, robotic sacrocolpopexy has a 98.6% success rate, indicating that the procedure is an effective POP treatment. Robotic sacrocolpopexy requires a thorough doctor’s evaluation and consultation to determine whether it’s an appropriate treatment option for you. A range of factors such as your overall health, medical history and medical examination results may affect the success of your treatment. Your healthcare provider will walk you through your treatment options. Here are some questions to ask during your consultation:
- Why is this procedure right for me?
- What are the benefits and risks of this surgery?
- What are possible complications or side effects and what should I do if I experience any?
- What will happen if I don’t have this treatment?
- What can I expect after the procedure?
What Is the Recovery Time for a Robotic Sacrocolpopexy?
Most patients feel better within the first week after robotic sacrocolpopexy. It may take up to six weeks for patients to fully recover.
What To Expect After Robotic Sacrocolpopexy?
After surgery, you will be taken to a recovery room until you wake up from anesthesia and its effects wear off. You may need to stay overnight if your doctor needs additional time to observe your post-surgery condition. It’s normal to experience the following after surgery, so follow your doctor’s instructions about medications and wound care at home:
- Abdominal swelling and gas pains for up to 72 hours
- Whitish-yellow vaginal discharge or light bleeding for the first six weeks
- Constipation due to pain medications
Your doctor may tell you to limit or avoid certain activities after surgery to help you recover properly. Keep in mind the follow-up appointment dates and make sure to show up at all of them. Call your provider right away if you experience any severe symptoms during prolapse surgery recovery such as:
- Severe pain
- Heavy bleeding
- Trouble breathing