Pelvic Prolapse or Genital Prolapse is the term used to describe a common condition where the support to the uterus, bladder, urethra, rectum or vagina has been weakened with resulting “dropping” “bulging” or “protruding” of the organs. The cause may be due to vaginal birth trauma, aging, menopause, conditions that increase abdominal pressure and even genetic predisposing factors affecting collagen and muscular tissue essential for support and function of the pelvic organs. Loss of support may cause symptoms such as involuntary urine loss when coughing, laughing, sneezing or exercising and problems evacuating stool from rectum along with a pressure sensation and a bulging from the vaginal opening.

Treatments other than surgery include Kegel and pelvic floor exercises and vaginal devices like pessaries.

Bladder Repair (anterior colporrhaphy) is the vaginal repair of dropped or prolapsed bladder. The anterior “skin“of the vagina is opened vertically and dissected laterally to reinforce the weakened support under the bladder using either sutures or mesh graft. This is done under general anesthesia or regional (spinal block). There are no external cuts or stitches.

Vaginal rectal repair or rectocele/enterocele repair (posterior colporrhaphy) is the vaginal repair of the weakened support that causes bulging into the posterior lower and upper part of the vagina using the same technique as the bladder repair, performed with or without mesh graft augmentation. No external incision. Both the anterior bladder and the posterior rectocele repairs can be done to provide a tightening effect of the vagina as well as resolving the pressure and bulge they cause.

Vaginal prolapse repair or vaginal vault suspension is a vaginal procedure that uses minimally invasive techniques to reattach and anchor the upper vagina (vault) to firm ligaments deep in pelvis using mesh grafts or permanent sutures. This is usually done in conjunction with an anterior (cystocele) repair and posterior (rectocele) repair as part of pelvic reconstruction. A concomitant anti-incontinence procedure is often incorporated in the reconstruction.
Click here to view a video of the Elevate® Prolapse Repair System.
Click here to view an animation of the various types of proplapse.

Perineoplasty is the external repair of the posterior vaginal outlet to restore normal form and function and is often done in conjunction with posterior vaginal repair when the anatomy has been distorted or damaged by childbirth trauma. The result is a more cosmetic and functional vaginal introitus.

Suspension of Prolapsed Uterus is a vaginal technique employing permanent vaginal mesh as part of a prolapse repair that attaches to the lower uterus and helps support and prevent further prolapse of the uterus. In cases of extreme prolapse, it may be best to remove the uterus vaginally (vaginal hysterectomy) and the support or suspend the upper part of the vagina with permanent sutures or mesh graft.

Urinary Incontinence Sling is a vaginal procedure that uses a thin permanent mesh under the urethra to control urine loss during coughing, sneezing, laughing or any other activity that increases abdominal pressure and causes bladder leaking. Several techniques exist to introduce the mesh, some using small incisions in the groin and more recently, by small intravaginal (invisible) incision with minimal pain or discomfort. It is usually done as outpatient.
Click here to view a video of the Miniarc® Single Incision Sling System.