Vaginal Prolapse Repair and
11 % of women will undergo
some surgery in their lifetime for vaginal prolapse or
pelvic floor reconstructive surgeon or vaginal
restorative surgeon, one of the important functions of
the vagina, sexual activity, can not be overlooked. Not
everyone desires to be sexually active, however if you
do and are looking for repair of your vaginal prolapse,
it is important to consider some facts that I will
prolapse is the descent of the bladder, uterus, small
bowel or rectum into the vagina. Often a “bulge” is seen
activity pertains often to intercourse, but obviously
encompasses more than that.
prolapse repairs that will close a vagina. Not only do
they give an unacceptable complication rate of about
30%, I prefer not to take away the option to ever
participate in sexual activity and wil not perform this
who have gone through vaginal childbirth have some
descent of their vaginal walls. Some women choose to
have their vagina tightened for this, which would
classify as cosmetic gynecology. The purpose of the
tightening is to enhance sexual pleasure for the woman
and likely her partner and it often boosts
vaginal walls descend to a degree where they form almost
an obstruction to intercourse. In reality they can
almost always at least temporarily be brought back in,
however it can be uncomfortable for the woman and some
also feel embarrassed about their vagina in prolapsed
though vaginal walls and organs behind it can come down
past the vaginal opening, the organs will not be lost,
the vaginal walls will keep on stretching. You will not
wake up one day with your bladder lying next to you on
considering prolapse surgery there are several options,
mostly limited to laparoscopic/robotic surgery (through
the abdomen with small incisions and camera) or surgery
through the vagina.
does sexual activity have to do with it? When women are
young and sexually active and the bladder, uterus or
vaginal cuff are severely prolapsed, a
laparoscopic/robotic repair is often preferred since the
vagina will remain highly functional. A polypropylene
mesh material is mostly used connecting the vagina to a
ligament on the sacrum (back). There is a very low
chance that this mesh will protrude in the vagina. The
flexibility of the vagina will be better preserved than
with a vaginal mesh insertion.
protrusion in the vagina can give no symptoms to
bleeding or discharge, however if you are sexually
active with a male partner, he may be less enthused.
When mesh comes through the vaginal wall, a male partner
can be ”injured”. Obviously if the partner does not have
a good erection it may go unnoticed.
If a mesh
is implanted vaginally, the chance that it protrudes is
higher than when it is placed through the abdomen,
however if it comes through, also easier to fix.
most urogynecologists would not insert vaginal mesh on
the front and back side of the vagina in a young
sexually active woman, who is in a good medical
condition. A sacrocolpopexy would be preferred.
one side is needed especially if it is the back side of
the vagina, a vaginal repair is often chosen.
everybody needs a repair with a polypropylene mesh,
however if there is significant prolapse to or past the
vaginal opening, pulling weak tissue together will not
create a flexible vagina that will tolerate pleasant
intercourse. Often there is too much tension on these
repairs, and they will not hold up well.
surgical repair with a pessary (support shelf) is an
option, however will have to be removed for sexual
the right repair for your vaginal prolapse is important.
Have a discussion with your urogynecologist about your
Sprock is a fellowship trained urogynecologist,
located in Rockledge FL, who offers laparoscopic as well
as vaginal prolapse repair and pessary placement if
information or to schedule an appointment call
321-806-3929 or leave a message on this website