What is Pelvic Reconstructive Surgery?

The female body is remarkably resilient, going through extreme transformations throughout a woman’s life. But even still, lasting issues can leave women with debilitating and potentially embarrassing symptoms. Pelvic organ prolapse is a particularly troublesome issue that can lead to incontinence, uncomfortable pelvic pressure, and a host of other problematic symptoms.

Pelvic reconstructive surgery aims to repair those abnormalities, helping women reclaim their bodies and confidence.


Pelvic Organ Prolapse

A urogynecologist in Los Angeles can perform reconstructive surgery to repair pelvic organ prolapse. The pelvis holds many crucial organs like the rectum, bladder, uterus, and cervix. A network of muscles and tissues forms a hammock-like support structure called the pelvic floor.

Unfortunately, the muscles in the pelvic floor can weaken after childbirth or a hysterectomy. Some women will also experience weakened muscles after menopause or significant weight gain or loss. When the pelvic floor becomes compromised, your pelvic organs can prolapse, essentially slipping out of position and pressing into the vagina.

A pelvic organ prolapse typically creates a bulge in the vagina. Pain, discomfort, urinary incontinence, difficulty emptying the bowel, and a lack of bowel control are common symptoms.

Physicians classify pelvic organ prolapse differently depending on the organ that moves out of position.


Vaginal Prolapse

Vaginal prolapse is when the top of the vagina, also known as the vaginal vault, begins to sag into the vaginal canal. In severe cases, the vaginal vault can drop so low that it bulges outside the vaginal opening.

Common symptoms here include a feeling of fullness and unusual pressure in the vagina.


This type of prolapse involves the rectum. Usually, a thick fibrous tissue wall separates the vagina and the rectum. But when prolapse occurs, part of the rectum moves and pushes the back wall of the vagina forward to create a prominent bulge.

In addition to pressure, a rectocele typically increases abdominal gas and emptying the bowel more challenging.


A cystocele is when the bladder drops or sags into the vagina. Like a rectocele, the tissue wall separating the bladder and the vagina weakens, causing the bladder to slip out of place.

A common symptom with a cystocele prolapse is urinary incontinence.

Uterine Prolapse

Uterine prolapse occurs when the uterus drops down into the vagina. Like other prolapses, it causes pressure, vaginal fullness, and bulging. However, it may also cause lower back pain, urine leakage, incontinence, and constipation.


RELATED: Pelvic Floor Disorder Symptoms In Women


Causes of Pelvic Organ Prolapse

There are many potential causes of prolapse that require pelvic reconstructive surgery. While the pelvic floor is resilient, it can only take so much. Anything that causes excessive strain or pressure could cause a prolapse. Here are some of the most common culprits.


Pregnancy and Childbirth

When you become pregnant, the pelvic floor works harder than ever before. It stretches to make room for your growing baby, which often causes the muscles to weaken.

During childbirth, it experiences even more stretching and strain. Even cesarean delivery can weaken those crucial muscles.

Chronic Stress

Patients with chronic constipation, cough, untreated asthma, heavy and prolonged straining movements also can damage the connective tissue support of the organs surrounding the vagina. 


Interestingly enough, genetics can play a part in pelvic organ prolapse. Your genes influence the strength of your bones and muscles. Unfortunately, prolapse becomes a hereditary issue for some women, increasing the chances that they’ll need pelvic reconstructive surgery at some point.


Lastly, obesity can be a significant factor in pelvic organ prolapse. Intra-abdominal pressure strains the pelvic floor muscles and the connective tissue. Women who have a higher BMI are at a greater risk of prolapse.


RELATED: What Causes Urinary Incontinence In Women?


Pelvic Reconstructive Repair Options

If you’re suffering from pelvic organ prolapse, many surgical options are available. Dr. Tahery, a urogynecologist in Los Angeles, can perform a variety of minimally invasive repairs based on your unique needs. These repairs aim to fix the prolapse and rebuild your pelvic floor. Here are some of the ways a surgeon might approach that task.


Native Tissue Repair Surgery

This technique is usually a suitable option for women with healthy workable tissue. It’s a versatile option because it can effectively treat all types of pelvic organ prolapse.

During pelvic reconstructive surgery, a surgeon will use the patient’s existing tissue to fix the damaged portions of the pelvic floor. For a cystocele repair, the surgeon will move the bladder back into place and tighten the front wall of the vagina. For Rectocele, they’ll pull the tissue between the rectum and vagina together to eliminate bulging and promote healing.

In vaginal and uterine prolapse cases, the focus is on damaged ligaments. The surgeon may shorten and tighten overstretched ligaments to ensure that the uterus and vaginal vault stay in place.

Native tissue repair is minimally invasive and typically only involves small incisions in the vagina or abdomen.

Sacrocolpopexy Surgery

Sacrocolpopexy is a pelvic reconstructive surgery that can help women with more advanced cases of prolapse. It’s often the technique of choice for women who experience prolapse after a hysterectomy. Sacrocolpopexy can also correct vaginal prolapse and severe cases of uterine prolapse.

To address the symptoms of pelvic organ prolapse, surgeons utilize surgical mesh. They may attach it to the vagina and sacrum to achieve the correct anatomical support.

There are a few ways to perform sacrocolpopexy. A urogynecologist in Los Angeles can perform it traditionally with a large horizontal incision in the abdomen or with robotics and small incisions. Either way, the goals, and techniques are the same.

Transvaginal Graft Surgery

Transvaginal graft surgery can help patch and reinforce weak areas of the pelvic floor tissue. It may also help with incontinence issues and strengthen the vaginal wall. The procedure is versatile, addressing most types of prolapse.

Surgeons can utilize a synthetic mesh or a biological one. The surgery is relatively straightforward and usually occurs through incisions in the vagina.

Pelvic reconstructive surgery can make a world of difference in your overall health and well-being. Pelvic organ prolapse can be a traumatic experience that dramatically affects a woman’s quality of life. Luckily, there are ways to address the problem and deal with the uncomfortable symptoms.

If you’re struggling with the effects of pelvic organ prolapse or other pelvic floor disorders, reach out to the offices of Dr. Tahery. Dr. Michael Tahery is an experienced urogynecologist in Los Angeles with decades of experience helping women just like you. He’s well-versed in pelvic reconstructive surgery and can help you get the relief you need. Give our offices a call today and schedule your consultation.