Laparoscopic Pelvic Reconstructive Surgery
All About Pelvic Reconstructive Surgery
What Are Some of the Reasons for Pelvic Reconstructive Surgery?
One of the most common health problems facing women is pelvic floor dysfunction, which affects approximately half of all women. Pelvic floor dysfunction may cause urinary incontinence (strong desire to urinate even if the bladder is not full). or fecal incontinence, vaginal or abdominal pain or discomfort. Many women experience significant changes in their daily activities as a result of pelvic floor dysfunction.
Pelvic floor dysfunction (muscle weakness) results from a variety of medical disorders, as well as normal changes associated with childbirth and aging. Pelvic floor muscles are intended to support the region’s organs, which include the bladder, large intestine and uterus. As result of pelvic floor dysfunction, the pelvic muscles are no longer able to provide necessary support for the urethra and bladder neck, which drops when any downward pressure is applied, thereby causing incontinence.
Proper diagnosis is critical to successfully correct the problem. A urogynecologist – a physician with expertise in conditions affecting a woman’s pelvis, bladder (specifically a loss of bladder control, urination difficulty, a dropped bladder or a prolapsed (fallen) uterus) and rectum – will perform special tests, in addition to a physical examination, to pinpoint the cause(s) of pelvic floor problems related to the vagina, uterus, bladder, urethra and rectum.
Many common causes of incontinence exist, including those which are temporary and treatable such as urinary tract infections, bladder inflammation, vaginal irritation or infection and medicinal side effects. However, incontinence can be caused by other circumstances that are not temporary such as:
- Weak pelvic floor muscles that hold the bladder in place
- A bladder with weak muscles
- Week urethra sphincter muscles
- Bladder muscles that are overactive
- A blocked urethra
- A hormone imbalance in women
- Urinary tract abnormalities
- Neurologic disorders
Cystocele – a hernia-like disorder – occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop and sag into the vagina and can result in urine leaking or incomplete emptying of the bladder.
Some of the most common ways to treat urinary incontinence are:
- Behavioral therapy
- Dietary changes
- Prescription drugs
- Special devices
Reconstructive Surgical Options
Surgical success starts with a good pre-operative evaluation and diagnosis of pelvic floor dysfunction. Laparoscopic reconstructive surgery (small lit fiber optic telescope inserted through tiny abdominal incisions) for pelvic organ prolapse and urinary incontinence has become well-established. These minimally invasive procedures include:
- Bladder augmentation – increases bladder’s holding capacity or decreases its muscle tensing capability
- Sling procedure – involves creating a sling out of tissue or synthetic material, which is attached to an abdominal or pubic area and which holds the bladder and urethra in place
- Burch procedure – involves - through a laparoscope - anchoring with sutures the neck of the bladder to behind the pubic bone
- Vaginal vault suspension: - secures vaginal wall to ligaments laparoscopically
- Uterine suspension: - secures uterus laparoscopically by shortening and strengthening holding ligaments
Most often women suffering from urinary incontinence choose to rely on absorbent pads or make changes in their daily routine, not knowing there are treatments available. However, due to minimally invasive pelvic reconstructive surgery and the increased role of urogynecologists, a woman does not have to sacrifice her quality of life forever.