Pelvic Organ Prolapse (POP)

A woman’s pelvic organs are held in place by muscles and ligaments. Over time, this supportive structure may weaken and the pelvic organs can drop lower in the pelvis, creating a bulge in the vagina called a prolapse. Women most commonly develop pelvic organ prolapse after a hysterectomy, after menopause, or later in life after several vaginal births.

Treatments vary according to the type and severity of the problems and the patient’s goals. Some problems can be managed without surgery—with medication, pelvic floor therapy, and core-strengthening exercises, or the use of a medical device called a pessary that the patient can insert and remove herself to support areas of pelvic prolapse.

POP Surgery

Most candidates for surgical repair of pelvic organ prolapse (POP) have tried more conservative approaches.

In determining the best surgical approach, a urogynecological surgeon factors in:

  • The patients’ age and general health
  • The patient’s personal preferences, including whether she wants to remain sexually active
  • Whether she has a problem with urinary or fecal incontinence

Types of POP Surgery

  • Reconstructive Procedures
    These surgeries correct prolapse by restoring normal anatomy. They can be performed abdominally or vaginally, depending on the type of repair needed. Some reconstructive surgery may include the implantation of a woven material called surgical mesh. The surgeon anchors the mesh to muscles or ligaments to create a hammock-like support for the prolapsed organs. Over time, the patient’s tissues grow over the mesh, which stabilizes it in its supportive position. Most women with POP have reconstructive surgery.
  • Obliterative Procedures
    These surgeries correct prolapse by removing or closing off a portion of the vaginal canal. This type of surgery is an option for women who can’t tolerate more extensive surgery and/or don’t plan to be sexually active.

Other Pelvic Surgeries

In addition to surgery for prolapse, MarinHealth urogynecologic surgeons perform the procedures below.

Abdominal Procedures

  • Sacral colpopexy/cervicopexy/colpoperineopexy

  • Sacral hysteropexy

  • Uterosacral ligament suspension
  • Paravaginal defect repair
  • Hysterectomy with or without removal of the ovaries and fallopian tubes (salpingo-oophorectomy)

Vaginal Procedures

  • Sacrospinous ligament fixation
  • Uterosacral ligament suspension
  • Anterior and posterior colporrhaphy
  • Perineorrhaphy
  • Levator myorrhaphy
  • Transverse defect repair
  • McCall’s culdoplasty
  • Paravaginal defect repair
  • Total colpocleisis
  • Le Fort colpocleisis
  • Hysterectomy with or without salpingo-oophorectomy

Robotic and Laparoscopic Procedures

  • Sacrocolpopexy/sacrocervicopexy
  • Hysterectomy with or without salpingo-oophorectomy

Other Pelvic Surgeries

  • Reconstructive surgery of the anal sphincter
  • Repair of vaginal and perineal lacerations
  • Fistula repair (A fistula is an abnormal opening between two organs, such as the bladder or urethra and the vagina, or the rectum and the vagina.)