Pelvic Reconstruction

Pelvic reconstruction is used to treat pelvic floor problems in women.

These potential issues involve the urinary tract, rectum, vagina, and related structures. This field of medicine is called urogynecology.

• There are non-surgical strategies can be used to strengthen the pelvic floor in some cases. These can include Kegel exercises and pessaries.
• Surgery is pursued when symptoms become too intrusive in women's lives, and non-surgical strategies have not provided relief.

There are a variety of pelvic reconstruction procedures available. Both robotic and traditional surgeries can be used to treat pelvic floor problems. Robotic or robot-assisted surgeries can be less invasive and more precise than traditional surgeries. It can be used in some cases of vaginal prolapse. Surgeries for pelvic organ prolapse can be approached through the vagina, or through the abdomen.

Who is a Candidate?

Women who deal with conditions including urinary incontinence, interstitial cystitis, vaginal prolapse, rectal prolapse, or fistulae may be candidates for pelvic reconstruction. Generally, doctors recommend that women wait until their families are complete before pursuing surgery. There is a risk that further childbearing could cause another prolapse and the need for more surgery. A patient's age and general health are also important factors in determining if she is an appropriate candidate for surgery.

Surgeries for pelvic reconstruction may use surgical mesh, made from polypropylene. This strategy, however, is not the preferred method. Using the body's own tissues for support is preferred. Mesh may sometimes be used if prior surgeries have been ineffective.

What to Expect Before Surgery

Before surgery, patients can expect to have a consultation with the surgeon who will be operating on. This meeting includes a physical exam, and a review of the patient's medical history. The idea is to see if patients are a good candidate for the procedure. The consultation is a good time to ask any questions or raise any concerns that they have.

After the consultation, patients will need pre-operative testing. This includes a physical exam, blood tests and urinalysis. Imaging tests, including X-rays and CT scans of the abdomen, may also be required.

Dietary restrictions in the days before surgery should be respected. These can include clear liquid diets, limited to offerings such as broth, tea and water.

Recovering from Pelvic Reconstruction Surgery

Walking the day after surgery is very important, as it can prevent the formation of blood clots. Walking in the days and weeks following surgery can aid in recovery. Once patients are released from the hospital, they will have to keep sutures clean and pat them dry carefully. Post-operative appointments are a great time to check in with your doctor and make sure that progress is being made as expected.