Pelvic reconstruction is a surgical procedure aimed at restoring the strength and integrity of the pelvic floor. This procedure is designed to address and repair damage to the pelvic floor muscles and ligaments, which can become weakened or damaged due to various factors such as childbirth, chronic disease, heavy lifting, or previous surgeries. Pelvic reconstruction is commonly used to treat pelvic organ prolapse, where organs such as the bladder, uterus, or rectum drop from their normal positions and bulge into the vagina.
Everything You Need to Know About Pelvic Reconstruction
• Procedure
• Treatment
• What to Expect
• Recovery
• Cost
Pelvic reconstruction is typically performed through the vagina. For an anterior pelvic reconstruction, an incision is made along the vaginal mucosa (the lining of the vagina) overlying the bladder. A catheter is inserted into the urethra to allow the vaginal mucosa to be opened and the bladder wall to be exposed.
One common approach involves making an incision along the front wall of the vagina, from near the entrance to almost the top. Surgeons use absorbable stitches to repair the weakened layers of tissue. The surgery usually takes 30 to 60 minutes, or up to 1 to 2 hours if combined with a vaginal hysterectomy.
Pelvic reconstruction treatments can be categorized into non-surgical and surgical approaches:
1. Non-Surgical Treatment
Pessary: The initial non-surgical approach involves inserting a pessary into the vagina to support pelvic organs and manage urine leakage.
Lifestyle and Dietary Changes:
Fluid Intake: Maintain adequate hydration without overloading the bladder.
Fiber-Rich Diet: Incorporate more fibrous foods such as fruits, vegetables, and salads to prevent constipation.
Healthy Weight: Achieve and maintain a healthy BMI to reduce pressure on the pelvic floor.
2. Surgical Treatment
Obliterative Surgery: This procedure involves closing or narrowing the vaginal canal to support prolapsed organs. Note that sexual intercourse will not be possible after this surgery.
Reconstructive Surgery: Aimed at restoring the original positions of pelvic organs through a vaginal incision. Types of reconstructive surgery include:
Native Tissue Repair: Uses the patient’s own tissue to repair weakened areas.
Colporrhaphy: Treats prolapse of the front (anterior) and back (posterior) walls of the vagina.
Sacrocolpopexy: Addresses enterocele or vaginal vault prolapse with mesh support.
Sacrohysteropexy: Treats uterine prolapse without removing the uterus, preserving reproductive potential.
Vaginal Mesh Surgery: Uses mesh placed through the vagina to support various types of prolapse.
This summary provides an overview of non-surgical and surgical treatment options for pelvic reconstruction, along with key aspects of each approach.
Following the surgery, you may experience some vaginal discharge and spotting for up to six weeks. Bleeding typically decreases over time. If bleeding increases, contact your doctor promptly. Dissolving stitches may cause yellowish-white, watery discharge from the vagina.
Recovery time varies based on individual circumstances and overall condition. Generally, it takes about three weeks to resume full activity. Sexual activity should be avoided for three to four weeks, especially if a vaginal incision was made, to prevent discomfort. Additionally, avoid lifting heavy objects, engaging in vigorous exercise, or straining during the initial weeks of recovery.
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