The organs in your pelvic cavity—uterus, vagina, bladder and rectum—are held in place by a web of muscles and ligaments that act like a hammock. When these tissues become weakened or damaged (typically during childbirth, and/or after hysterectomy), one or more of the pelvic organs drop out of normal position and literally fall into the vagina. As a result, the organs may press against the vaginal wall and produce a hernia-like bulge causing discomfort, limiting sexual and physical activity, or impair bladder or bowel function.

As we live longer and remain active during these later years, studies show that about 11% of women will need treatment of their prolapse. The kind of treatment your doctor may suggest for you will be determined by the degree and type of prolapse you have. Mild prolapse will often respond to Kegel exercises. A non-surgical approach of using a Pessary (a plastic device worn in the vagina at all times) may be the best solution for some women.

Women who feel their condition compromises their quality of life may want to consider pelvic organ prolapse surgery to restore normal bladder, bowel, and sexual function. Prolapse repairs can be performed via a minimally invasive approach through the vagina. During the procedure, the surgeon repositions the prolapsed organs and secures them to surrounding tissues and ligaments. The vaginal opening, and the muscles that control it, can also be tightened for better satisfaction during intercourse.

Unfortunately traditional surgery for pelvic organ prolapse has a high failure rate for more moderate to severe cases. This is probably because pulling poor quality tissue together is predisposed to fail once again. The use of mesh “hammocks” dramatically improves the success rates and durability of these repairs. General surgeons learned this lesson two decades ago with repair of groin hernias, where use of mesh has become the standard of care.

The doctors at Women's Health Specialists were the first to use these advanced techniques in our community over eight years ago. With the newer minimally invasive treatments, surgery time is reduced, and most women experience less pain and more rapid return to regular activities.

Over the past decade the evolution of using mesh graphs has revolutionized pelvic organ prolapse surgery. Like most advances in medicine there is some controversy. For example, approximately 1/3 of patients who undergo traditional surgical repair of bladder prolapse will fail and return for a much more difficult second operation. Thus far using mesh graphs to augment this repair has reduced the failure rate to less than 10%. However, in 5 to 10% of these patients the vaginal skin incision will open exposing the mesh, which requires a minor, outpatient corrective procedure. We review the pros and cons of each patient’s treatment options so they become educated to decide what they are most comfortable utilizing.

Learn more about what the FDA wants you to know before you proceed using mesh graphs for prolapse repair surgery. Click here.

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