Pelvic Floor Surgery

What is Pelvic Floor Surgery?

Pelvic organ prolapse (POP) is a condition wherein the bladder, uterus, or rectum drop down and protrude out of the vaginal canal. This can happen due to pregnancy, childbirth, obesity, pelvic organ cancers, and other factors that weaken the pelvic floor muscles. Pelvic floor surgery refers to procedures that repair the pelvic floor and restore the organs to their original place.

Pelvic floor surgery can be performed using various techniques, including anterior vaginal repair, posterior vaginal repair, and vaginal hysterectomy. Anterior vaginal repair corrects the front wall of the vagina, posterior vaginal repair corrects the back wall, and hysterectomy removes the prolapsing uterus. Dr. Bonni prefers performing these procedures using a minimally invasive laparoscope, ensuring an optimal and speedy recovery.

You’re a Candidate for Pelvic Floor Surgery if You…

  • Have a severe prolapse.
  • Have severe symptoms of a prolapse, such as painful intercourse, back pains, constipation, constant bleeding, or urinary problems.
  • Are unresponsive to non-surgical pelvic floor exercises and therapies.
  • Don’t have underlying medical conditions that preclude you from surgery.

Recovering from Your Clitoral Hood Reduction

Anterior Vaginal Repair

Anterior vaginal repair is a surgical procedure that repairs or strengthens the weakened vaginal wall between the vagina and the bladder. The surgery aims to relieve the symptoms of vaginal bulging and laxity, thereby improving urinary control and sexual functions. The anterior vaginal repair has a 70-90% success rate, but there’s a chance that the prolapse might happen again in another part of the vaginal wall.

The anterior vaginal repair is performed under local or general anesthesia. During the surgery, an incision is made along the front wall of the vagina, and the weakened layers are brought together with absorbable sutures. Some of the excess vaginal skin might be trimmed away. In some cases, a vaginal mesh might be used to reinforce the vaginal wall.

The recovery process lasts for around three months, during which you must avoid heavy lifting, strenuous exercises, coughing, constipation, or anything else that puts pressure on your pelvic floor. Most patients can resume normal activities and work in 3 to 4 weeks, but you should avoid sexual intercourse for at least six weeks or longer. Your surgeon will provide the ideal recovery guidelines and timetable.

Posterior Vaginal Repair

Posterior vaginal repair is a surgical procedure that strengthens the vaginal wall separating the vagina from the lower part of the bowel, i.e., the region between the vagina and the rectum. The surgery aims to relieve the symptoms of vaginal bulging and laxity, thereby improving bowel control and sexual functions. The posterior vaginal repair has an 80-90% success rate, but there’s a chance of prolapse recurrence.

The posterior vaginal repair is performed under local or general anesthesia. During the procedure, an incision is made on the center of the back wall of the vagina. The weakened layers of the vaginal wall are reinforced and strengthened with absorbable sutures. In some cases, a vaginal mesh may be used to reinforce the vaginal wall, especially if it’s a repeat procedure.

Recovery after the posterior vaginal repair is similar to the recovery after the anterior procedure. You have to take at least 3 to 4 weeks off social events and work, following which you can resume most low-level activities. You should avoid strenuous workouts for the entire recovery period, which may last for 3 months. And you should wait at least 5 to 6 weeks before resuming sexual intercourse, and only if the surgeon approves.

Vaginal Hysterectomy

Vaginal hysterectomy is a surgical procedure meant for patients with uterine prolapse, i.e., if the uterus drops into the vagina or protrudes out of the vaginal opening. A hysterectomy is a procedure that removes the uterus via the vagina, though, in some cases, the uterus can also be removed laparoscopically via small incisions on the abdomen. Vaginal hysterectomy has an 85% success rate.

Vaginal hysterectomy is performed under general or local anesthesia. The surgeon makes a small incision around the cervix to push the bowel and bladder away from the uterus. The connecting tissues are cut to remove the uterus. Finally, the surgeon closes the vaginal vault using absorbable sutures and supporting stitches.

It takes approximately 3 months to heal completely after a vaginal hysterectomy. Most patients should take at least six weeks off work, though you can resume light activities in 3 to 4 weeks. You’re advised to avoid sexual intercourse and strenuous workouts for at least 5 to 6 weeks. Your surgeon will provide the ideal recovery timeline.

Risks of Pelvic Floor Surgery

You’ll experience some pain/discomfort and spotting after the surgery for a week or two. You can manage the pain and discomfort with prescribed medications. However, you might also experience constipation, rectal damage, incontinence, mesh complications, and painful intercourse. Dr. Bonni uses the latest techniques to ensure a smooth recovery without complications, but surgeries always carry an inherent risk of complications.

Why Choose Dr. Bonni?

Dr. Aram Bonni is double board-certified in female pelvic medicine and reconstructive surgery and obstetrics and gynecology. He also has two fellowships in reconstructive pelvic surgery and cosmetic surgery. As such, he’s one of the country’s leading experts in reconstructive surgery. Please schedule a consultation with Dr. Bonni to discuss your options.