A Common Problem for Women
Text by Dr. Jeffery Palen, DO, Benefis Obstetrics-Gynecology
Many people find it shocking that your organs can move out of their appropriate place over time, but the shifting of organs, particularly those in the pelvic area is actually quite common, especially for women. This movement of organs from their proper place in the pelvic cavity is known as a pelvic organ prolapse. The organs in this area that can prolapse include the bladder, urethra, uterus, vagina, small bowel, and rectum.
Symptoms of a pelvic organ prolapse can include: a feeling of pelvic pressure or of something actually falling out, lower back pain or a pulling in the groin area, painful intercourse, spotting or bleeding, as well as urinary and bowl movement problems. Symptoms are often worse when standing or doing activities.
Pelvic organ prolapses vary in severity. Some women suffer only mild incontinence, while others experience severe pain, difficult or incomplete urination, and infections. The impact of severe prolapse issues on a woman’s quality of life can be staggering, and sadly, until recently, women were told they just had to “live with it.”
Medical advancements in treating pelvic organ prolapse have come a long way since the introduction of a mesh sling to secure organs in the anatomically correct position. However, many women have seen commercials about lawsuits surrounding the use of “vaginal mesh,” and that has resulted in a lot of fear and misinformation about today’s available treatments. The mesh named in those law suits is no longer used in the treatment of pelvic organ prolapse, and surgical treatment has become less invasive and much more effective, thanks to the introduction of robotics in laparoscopic surgery.
Surgery to treat moderate to severe pelvic organ prolapse is called sacrocolpopexy. Sacrocolpopexy can be done two ways: open or laparoscopic. Open sacrocolpopexy has traditionally been performed by making a large horizontal incision in the abdomen in order to manually access pelvic organs. Success rates for this approach are high, however, recovery time is much longer than with laparoscopic sacrocolpopexy.
Laparoscopic sacrocolpopexy utilizes a surgical robot, allowing the surgeon to access the pelvic cavity through small holes in the abdomen. The surgeon controls the robotic surgical system and is able to perform the same organ repositioning as in a traditional sacrocolpopexy, with significantly less pain, less blood loss, less scarring, shorter recovery, and fewer complications.
Doctors performing laparoscopic sacrocolpopexy undergo extensive initial and ongoing training in the use of the robot. We are very fortunate that advancements, such as laparoscopic sacrocolpopexy, are now available to provide relief and improved quality of life for those who suffer a pelvic organ prolapse. If you are concerned that you may have a pelvic organ prolapse or are considering your treatment options, know that laparoscopic sacrocolpopexy is available and that treatments have come a long way from what you hear in those TV commercials.