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Pelvic Floor Surgery Part 1: Treatment Options For Your Pelvic Floor Dysfunction

There are a variety of treatment options for pelvic floor dysfunction, one of which is surgery.

But depending on your condition, the types of surgery can vary. There are even different kinds of surgery options for some of the ailments. 

Let’s explore the surgeries available for the different syndromes that can affect a woman’s pelvic floor.

Endometriosis Surgery

Endometriosis is an often painful disorder that results when tissue similar to that lining your uterus, known as the endometrium, grows outside your uterus. 

If surgery is the prescribed treatment for endometriosis, there are different types:

Conservative surgery: so-called because this attempts to remove the endometriosis implants while preserving your uterus and ovaries, allowing you to still become pregnant. But endometriosis and pain may return. This is most commonly done with laparoscopic surgery.1

Surgery to remove the uterus and ovaries: This procedure, known as a hysterectomy and an oophorectomy, is not done as often anymore, as specialists are instead focusing on removing endometriosis tissue rather than entire organs.1

Incontinence Surgery

Stress urinary incontinence is when you lose control of your bladder, particularly when you exert pressure on it. That can happen when you cough, sneeze, laugh, exercise or lift something heavy.

There are several types of surgery for stress urinary incontinence:

Colposuspension: done with an incision or through laparoscopy, this is when the neck of your bladder is lifted and stitched into position.2

Sling surgery: this time a sling is installed around the neck of the bladder to support it and prevent urine leaking.2

Vaginal mesh or tape surgery: a strip of synthetic mesh is inserted behind the urethra to support it.2

Another type of incontinence is fecal or bowel incontinence, in which you have trouble controlling bowel movements and your stool unexpectedly leaks. The side effects can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.3

There are different surgeries to treat this incontinence too, ranging from a procedure to repair a damaged or weakened anal sphincter;  surgical correction of rectal prolapse or hemorrhoids; or the less common colostomy, which is when stool is diverted through an opening in the abdomen into a special bag to collect the stool. Colostomy is generally considered only after other treatments haven’t been successful.4

Uterine Fibroids Surgery

Uterine fibroids are growths of the uterus that are most often noncancerous, but can grow big enough—or grow in clusters—that they distort and enlarge the uterus. 

Surgery options for fibroids are determined based on the size, number and location of the fibroids, your symptoms, and whether you want to get pregnant.

Non-invasive MRI-guided focused ultrasound surgery: this is performed inside an MRI scanner, where sound waves create heat and destroy small areas of fibroid tissue.5

Myomectomy: the fibroids are removed but your uterus is left in place. This can be done with a laparoscopic procedure if there are few fibroids. If you have multiple or large fibroids, the myomectomy may be done via an open abdominal surgery.5

Hysteroscopic myomectomy: the fibroids are removed using instruments inserted through your vagina and cervix into your uterus.5

Hysterectomy: this surgery removes the uterus, which is a permanent solution for uterine fibroids but also ends your ability to have children.5

Pelvic Floor Lift Surgery

Issues with your pelvic floor can range from pelvic organ prolapse to urinary incontinence. It’s estimated that up to 25 percent of women have one or more pelvic floor disorders. The lifetime risk for women of undergoing surgery for pelvic organ prolapse or stress urinary incontinence by age 80 is roughly 20 percent.6

Pelvic floor repair is a broad term that describes several surgical repairs of the pelvic floor. That can include correcting the front wall or back wall of the vagina, fixing a uterine prolapse, or lifting and supporting a pelvic organ.7

The diagnosis of your condition will result in the correct treatment option if you require pelvic floor lift surgery.

Pelvic Organ Prolapse Surgery

Pelvic organ prolapse occurs when the pelvic floor muscles weaken and one or more pelvic organs drop from their regular position. The dropped organ may create a bulge in the vagina, known as prolapse, and can occur to the uterus, vagina, bladder and/or rectum.

There are various surgery options depending on the organ that’s impacted. There is also a less invasive laparoscopic surgery that involves making small incisions and then resuspending the pelvic organs internally with a combination of sutures and a supportive mesh.8 We explore the prolapse surgery options more in the second part of this series. 

See A Doctor

If you have concerns about your pelvic health, and whether your treatment options include surgery, seek medical advice. 

Use our Physician Finder to find a doctor near you with expertise in women’s health. If you have a pelvic floor dysfunction, a medical expert can help with proper diagnosis and a treatment plan.

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