What it is
The pelvic organs rest on a hammock of muscle and tissue. When that gives way, the bladder, uterus or rectum presses into the vagina.
A repair puts them back and rebuilds the support underneath. Most of it is done through the vagina, with no cuts on the belly.
Which repair you need depends on what has dropped. More than one can be fixed in the same operation.
Why it is done
- A bulge you can feel or see at the opening of the vagina
- Heaviness or dragging that gets worse through the day
- Having to push the bulge back to empty your bladder or bowel
- Leaking urine, or a stream that will not start
- Pain or dryness during sex
- A pessary that is not holding, or that you do not want
What happens, step by step
- 1
The exam
Dr. Mueller examines you lying down and standing. A bulge shows more on your feet.
- 2
Bladder check
Your bladder is tested for leaking that the bulge may be hiding.
- 3
Choosing the repair
The plan covers each wall that has given way, and whether the uterus stays.
- 4
The operation
Working through the vagina, the tissue is brought back together and stitched to stronger support.
- 5
Before you leave
A catheter and a vaginal pack come out first, the same day or the next morning.
- 6
Healing time
Nothing in the vagina and no lifting over ten pounds for six weeks.
Questions people ask
- Is mesh used?
- Not through the vagina. The FDA took that mesh off the market in 2019. Vaginal repairs use your own tissue. Mesh placed through the abdomen is a different operation.
- Do I have to have my uterus removed?
- No. It is often taken out as part of the repair, but keeping it is an option worth asking about.
- Will the prolapse come back?
- It can, especially with heavy lifting, a chronic cough or constipation. Those should be sorted out before surgery.
- Can I have sex afterward?
- Yes, after six weeks. Tell Dr. Mueller if sex hurt before, because it changes which repair she chooses.
- Can a pessary work instead?
- For some women, yes. It is a silicone device that holds the bulge up, with no operation and no anesthesia.