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Surgical Procedures to Correct Pelvic Prolapse

Some of the procedures below may involve the use of transvaginal mesh, which has received some recent attention in the media.  We emphasize that each patient has unique medical needs, forming the basis for recomendations that your physician may make.  You will have the opportunity to discuss your surgery with your physician and we encourage you to ask questions about whether or not transvaginal mesh is appropriate for you.  For more information about the use of mesh for the surgical treatment of pelvic floor muscle disorders:

Patient information from the American Urogynecologic Society regarding transvaginal mesh.

Collection of Manufacturers' Literature

Informed Patient Checklist from the American Urogynecologic Society

 

Anterior colporrhaphy

A vaginal procedure to reestablish the supports between the bladder and vagina to fix a cystocele. A synthetic mesh or organic graft material made be placed to reinforce this repair

Bilateral salpingo/oophorectomy

Procedure for removal of the tubes and ovaries (may be performed either abdominally, vaginally or laparoscopically).

Illiococcygeal fascial attachment

A vaginal procedure that attaches the top of the prolapsed vagina to pararectal supportive tissue.

Overlapping anal sphincteroplasty

A procedure which reattaches divided muscle edges around anus to correct fecal incontinence.

Paravaginal repair (vaginal or abdominal approach)

Supports the vaginal wall by attaching it to the pelvic sidewall to fix a cystocele. A synthetic mesh or organic graft material made be placed to reinforce this repair

Posterior colporrhaphy

A vaginal procedure to reestablish the supports between the vagina and rectum to fix a rectocele. A synthetic mesh or organic graft material made be placed to reinforce this repair.

Sacrocolpopexy

A procedure that attaches the top of the prolapsed vagina to the sacrum using either synthetic mesh or cadaveric material, which may be performed abdominally or laparoscopically.

Sacrospinous vaginal vault suspension

A vaginal procedure that attaches the top of the prolapsed vagina to a ligament in the pelvis.

Supracervical hysterectomy

A procedure which removes most of the uterus, but leaving the cervix behind. This procedure can be done abdominally or laparoscopically.

Total colpectomy

A procedure for complete closure of the vagina to correct prolapse, and is only performed when the patient is completely sure that she will never want to have intercourse again.

Total colpocleisis

A procedure for closure of the vagina (similar to colpectomy) while leaving channels at the side for drainage from the uterus (which is not removed)

Total abdominal hysterectomy (with or without bilateral salpingo/oophorectomy)

A procedure to remove the uterus (including the cervix), tubes and ovaries through an abdominal incision.

Total laparoscopic hysterectomy

A procedure to remove the uterus (including the cervix) and possibly the tubes and ovaries through a laparoscopic approach.

Total vaginal hysterectomy (with or without bilateral salpingo/oophorectomy)

A procedure to remove the uterus (including the cervix), tubes and ovaries through a vaginal incision.

Transvaginal enterocele repair

Closes the space between the vagina and rectum through a vaginal incision to prevent the small bowel from pushing the vagina out. This procedure will also resuspend the top of the vagina.

Uterosacral ligament suspension

A procedure that suspends the top of the vagina to the uteroscral ligaments, and can be performed vaginally, abdominally or laparoscopically.

 

For more information on Pelvic Floor Disorders, Pelvic Prolapse and Treatment:

 
Cleveland Clinic’s Pelvic Organ Prolapse and Incontinence Treatment Guide (Cleveland Clinic website)
Pelvic Organ Prolapse (MyPelvicHealth.org)
Reconstructive Pelvic Surgery (MyPelvicHealth.org)
Vaginismus
 

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