Surgery options for pelvic organ prolapse

Pelvic organ prolapse (POP) is a weakening of the support structures that hold a woman’s pelvic organs in place (bladder, uterus, top of the vagina, and rectum). This prolapse is often noticed as a bulging of tissue in or coming out of your vagina.

Read more about pelvic organ prolapse and non-surgical treatment options.

If your symptoms do not resolve with conservative non-surgical options, make an appointment with a urogynecology specialist to see if you are a candidate for surgery.

The goal of surgery is to repair your prolapse and reduce symptoms. Surgery rebuilds the support of the pelvic organs which will help reduce the vaginal bulge. Surgical options vary and depend on your anatomy, how severe your symptoms are, your overall health and lifestyle, your surgical history, and your sexual activity.

Obliterative (vaginal closure) surgery

Obliterative vaginal surgery, also known as a colpocleisis, is minimally invasive vaginal surgery. This surgery is an option for women who are not currently sexually active and who do not intend to be in the future. The surgery is done through the vagina to shorten and narrow the vaginal caliber (diameter of a circular tube) to support the prolapse and reduce the chance of it coming back. This surgery is a same-day, outpatient procedure with full recovery in about six weeks.

Native tissue repair

Native tissue prolapse repair uses a woman’s own tissue to repair the damaged area of the pelvic floor and vagina. Depending on the location and severity of the prolapse, these repairs may be done in combination with a vaginal hysterectomy (removal of the cervix and uterus). Repairs are usually done through the vagina to support the vagina to the deeper ligaments in your pelvis. Sometimes, small incisions (cuts) are made on your abdomen for laparoscopic or robotic assistance during surgery. This surgery requires an overnight hospital stay with full recovery in about six weeks.

An advantage of native tissue repair is that it is less invasive surgery with stitches that dissolve. It does have a higher rate of prolapse happening again over time. 

Sacrocolpopexy

A sacrocolpopexy is surgery that corrects uterine prolapse or vaginal prolapse after a hysterectomy. This surgery is often done with robotic assistance through several small, laparoscopic incisions on your abdomen. If you still have your uterus, a hysterectomy is done first during the same surgery. This surgery requires an overnight hospital stay with full recovery in about six weeks.

During sacrolpopexy surgery the tissue around your vagina is separated from the bladder and rectum. A Y-shaped piece of permanent polypropylene mesh is then attached to the front and back walls of your vagina. The mesh is suspended to the ligament that runs in front of your sacrum (bottom of the spine, near the tailbone) and firmly attached. As you heal, your body tissue grows into the mesh and helps restore your vagina to its normal position.

The mesh used in this surgery has shown to have few complications, but, some mesh complications do occur in about five to six percent of women.

Which pelvic organ prolapse surgery should you choose?

The best pelvic organ prolapse surgery for you is based on your unique needs. Talk with a pelvic medicine and reconstructive surgeon (urogynecologist) if you have symptoms of vaginal prolapse and are interested in learning about treatment options. Make an appointment for evaluation by a urogynecologist to see if you are a candidate for surgery.