Pelvic floor reconstruction surgery is a specialized procedure aimed at repairing and restoring the strength and function of the pelvic floor, a group of muscles and tissues that support the pelvic organs, including the bladder, uterus, rectum, and vagina. This surgery is often necessary for women suffering from pelvic organ prolapse, incontinence, or other pelvic floor disorders that significantly affect their quality of life.

When Is Pelvic Floor Reconstruction Surgery Needed?

Pelvic floor reconstruction is typically recommended when non-surgical treatments like pelvic floor exercises, lifestyle changes, or pessary devices fail to alleviate symptoms. Common conditions that may require this surgery include:

• Pelvic Organ Prolapse: When one or more pelvic organs, such as the bladder, uterus, or rectum, drop from their normal position due to weakened pelvic floor muscles.
• Urinary Incontinence: Loss of bladder control due to the weakening of the muscles that support the bladder.
• Fecal Incontinence: Inability to control bowel movements, often related to rectal prolapse or damage to the pelvic floor muscles.
• Recurrent Prolapse After Previous Surgery: When previous surgical repairs fail and symptoms return.

Types of Pelvic Floor Reconstruction Surgery

1. Anterior and Posterior Colporrhaphy
   This surgery repairs prolapse of the bladder (cystocele) or rectum (rectocele) by tightening the tissues that support these organs. Anterior colporrhaphy focuses on the front wall of the vagina (bladder), while posterior colporrhaphy targets the back wall (rectum).

2. Sacrocolpopexy
   Often used to treat vaginal vault prolapse, sacrocolpopexy involves attaching the top of the vagina to the sacrum (lower spine) using surgical mesh. This procedure can be performed using open surgery, laparoscopy, or robotic-assisted techniques, providing long-lasting support for the vagina.

3. Hysterectomy and Pelvic Floor Repair
   In cases of severe uterine prolapse, a hysterectomy (removal of the uterus) may be combined with pelvic floor reconstruction. After the uterus is removed, additional repairs are made to support the remaining pelvic organs.

4. Uterosacral Ligament Suspension
   This procedure involves using the uterosacral ligaments (which normally support the uterus) to suspend and support the vaginal apex, preventing prolapse.

5. Mesh Implants
   In some cases, surgical mesh may be used to reinforce weakened tissues. While effective, the use of mesh has been associated with certain risks and complications, so it is typically considered when other options are not viable.