Pelvic Reconstructive Surgery

If you have pelvic organ prolapse, you might wonder which treatment is right for you. Other names for pelvic organ prolapse include cystocele, bladder prolapse, vaginal wall prolapse, and rectocele.

At UPMC Magee-Womens, we specialize in helping people regain pelvic floor function. We offer many different treatments, including pelvic floor reconstructive surgery.

Not everyone with a weak pelvic floor or prolapse needs surgery. We’ll walk you through all the options and make sure you know what to expect every step of the way.

What Is Pelvic Floor Reconstructive Surgery?

Pelvic floor reconstructive surgery helps treat pelvic organ prolapse (POP).

Pelvic floor reconstruction is a group of different surgeries, each using a different approach. The goal for all of them is to restore your pelvic organs to their original places.

Types of pelvic reconstructive surgery

Which type of pelvic reconstructive surgery you choose depends on your goals and lifestyle, how severe your POP is, and your future plans.

Pelvic reconstructive surgery options are:

• Native tissue repair — This surgery uses your tissue to better support the falling organs. These surgeries are commonly done through the vagina, although there can be variations. One example is called vaginal colporrhaphy, which is when the surgeon makes stitches to strengthen the vagina. This helps the vagina better support your bladder or rectum and preserves sexual function.
• Sacral colpopexy — This surgery can be done laparoscopically or robotically through the abdomen. Instead of using your own tissue, this surgery uses a safe piece of mesh to support the falling organs. This type of surgery with mesh is known to be very effective and safe. Your provider can discuss the benefits and risks of using mesh for prolapse repair.
• Surgery to narrow the vagina — This surgery involves placing stitches so that the inside of the vagina becomes very short and narrow. This option is only for women who do not plan to have (or who no longer have) vaginal intercourse.

If you’re trying to avoid a hysterectomy, we have options for that, too. Even though many POP surgeries involve hysterectomy (taking out the uterus), be sure to ask your provider if you are a candidate to keep your uterus in place.

Sometimes, prolapse surgeries include urethral sling surgery, which helps treat bladder leakage.

Why Would I Need Pelvic Reconstructive Surgery?

POP can interfere with exercise, sex, going out in public, and other activities of life. While not everyone is bothered by prolapse, surgery may be a good option if your symptoms are getting worse or more bothersome.

Symptoms of POP may include:

• A feeling of pelvic pressure and/or a bulge in your vagina.
• Feeling like something is falling out of your vagina.
• Feeling like you aren’t emptying your bladder completely.
• Tampons not staying in.

Are there alternatives to pelvic reconstruction surgery?

Yes! Alternatives to surgery include:

• Watching and waiting – Not all prolapse requires treatment, and some people choose no treatment.
• Pelvic floor physical therapy — Physical therapy that helps you strengthen your pelvic floor muscles.
• Pessary devices — A fitted device you insert in your vagina to help support your pelvic organs.

What Are the Risks and Complications of Pelvic Reconstructive Surgery?

All surgeries come with risks and potential complications, such as bleeding, infection, and injury to organs.

Your doctor will talk to you about the risks of the specific surgery you’re having. Keep in mind that pelvic reconstructive surgery is generally safe and achieves good outcomes.

What Should I Expect From Pelvic Reconstructive Surgery?

Your doctor will talk with you about steps before and after surgery, including:

• Type of anesthesia.
• Length of surgery and types of incisions.
• Recovery after surgery
• Whether your surgery is outpatient or you’ll need to stay the night.
• How to manage pain after surgery.

Most pelvic reconstructive surgeries are same-day surgeries, and you can go home a few hours after your surgery. Your overall recovery time will depend on which surgery you have.

Your doctor will give you guidelines about when you can return to activity. You’ll be able to do most of your light activity right away. You may need to avoid strenuous exercise and lifting or straining for a few weeks after surgery.

You’ll also need a period of pelvic rest, meaning nothing in the vagina. Your surgeon will give you a specific time frame (usually at least eight weeks). They’ll also need to clear you before you can resume sexual activity.

When to call your doctor about post-op problems

If you've had pelvic reconstructive surgery, call your doctor if:

• Your pain worsens and doesn’t improve with pain medicine.
• You pass large clots of blood or have bright red bleeding that soaks through a pad within one hour.
• You have increased vaginal discharge and/or it has a new odor.
• You feel nauseated and can’t keep anything down (including fluids).
• You have a fever or other signs of infection (pus, redness, red streaks leading from the incision).

Last reviewed by Lauren Elizabeth Giugale, MD on 2024-09-05.