Pelvic reconstructive surgery

Female pelvic conditions, such as pelvic organ prolapse, can cause difficult symptoms to cope with, like urine leakage, vaginal discomfort, and bowel dysfunction. Pelvic reconstructive surgery restores normal pelvic function and helps you feel more like yourself again.

Our experienced surgeons use minimally invasive techniques to repair your pelvic floor, which reduces scarring and quickens your recovery. We also have extensive training in robotic pelvic floor surgery, so you can be confident in our knowledge and expertise.

Penn Medicine offers urogynecology care and thorough pelvic floor assessments to help you decide if reconstructive urogynecological surgery can resolve your pelvic floor issues.

We recommend pelvic reconstruction to people with pelvic organ prolapse, a condition where pelvic organs bulge into your vagina. You may be a candidate for a pelvic reconstructive procedure if non-surgical treatments like physical therapy have been unsuccessful in resolving symptoms such as urinary incontinence, bowel incontinence, or pelvic pain.

We can use several surgical approaches and techniques to repair your pelvic floor. When possible, your surgeon will use the least invasive approach to help you recover faster and reduce the risks of complications.

After an assessment, your provider may recommend a:

• Laparoscopic surgery: We make small incisions (cuts) in your belly. Your surgeon uses a laparoscope (thin tube with a light and camera) to view the pelvic structures and long-handled surgical instruments to repair the pelvic floor.
• Robotic sacrocolpopexy: This procedure also requires small incisions in your belly. But instead of using handheld instruments, your surgeon uses tiny robotic arms to reposition and support pelvic organs. The surgeon moves the tools using a robotic console, which allows for precise movements.
• Vaginal approach: This approach is for anterior or posterior vaginal prolapse. Anterior vaginal prolapse is also known as cystocele or bladder prolapse. Posterior vaginal prolapse is also known as rectocele. To repair these conditions, we make one or two small incisions in your vagina and use stitches to strengthen the vagina and repair the prolapse.

You and your surgeon discuss the optimal surgical approach to restore pelvic function. We’ll go over the procedure and answer any questions you may have.

Before surgery, we give you anesthesia so you’re asleep and don't feel any pain. No matter what approach we use, we make small incisions to reach your pelvic organs. If the procedure is robot-assisted, we insert robotic arms and a small camera through the incisions to see inside your pelvis.

We repair the prolapsed organs using biologic grafts (donor tissue), synthetic surgical mesh, or dissolvable stitches to support your pelvic organs and hold them in place. After attaching the mesh or adding stitches, your surgeon removes all the surgical instruments and closes the small incisions.

Recovery time varies, but it could take up to six weeks before you feel back to normal. Your provider will give you post-operative guidance, such as decreasing your activity and taking prescribed medications. We see you at a follow-up visit within two weeks after surgery to make sure you're healing well.

Side effects of pelvic reconstructive surgery

Pelvic reconstruction side effects can include:

• Abdominal swelling and discomfort
• Anesthesia side effects (nausea, sleepiness)
• Constipation
• Light spotting and vaginal discharge

Pelvic reconstructive surgery has some risks, including pelvic organ damage, blood clots, infection, or continued pelvic prolapse. However, Penn Medicine's urogynecological surgeons use the latest techniques to minimize complications and ease symptoms following surgery. Your provider will speak with you about the risks and benefits of pelvic reconstructive surgery so you can make an informed decision.

We understand how pelvic floor conditions can impact your daily life. Our expert surgeons are here to help when non-surgical treatments aren't working.

We collaborate with other Penn Medicine specialists, including pelvic health physical therapists, colon and rectal surgeons, and gynecologists. You receive care from an expert team focused on restoring your pelvic health before, during, and after surgery.