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Pelvic Organ Prolapse

Procedure overview

Pelvic organ prolapse occurs when a pelvic organ—such as your bladder—drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This is usually the result of weakened or stretched muscles that hold your pelvic organs in place.  This usually occurs through childbirth or surgery.[1]

Many women will experience pelvic organ prolapse, which can be uncomfortable or painful but isn’t usually a significant health problem.

There are different types of prolapse, depending on the organ or organs involved. These include:

  • Uterine prolapse: The uterus and cervix drop down the vaginal canal, sometimes so far that they go past the vaginal opening.
  • Vaginal vault prolapse: The top of the vagina (known as the “vaginal vault”) drops down the vaginal canal. This occurs in women who have previously had a hysterectomy (removal of the uterus).
  • Cystocele: The bladder bulges into the vagina.
  • Rectocele: The rectum bulges into the vagina.
  • Enterocele: The small intestine bulges against the vaginal wall. An enterocele and vaginal vault prolapse can occur together.[2]

Robotic-assisted sacrocolpopexy is one type of surgery used to treat vaginal vault prolapse.[3] This procedure is used to pull up the tissues and move the organs back into place.[4]

During the procedure a graft of tissue or synthetic mesh is sewn onto the pelvic organs that have prolapsed. The graft is then attached to a bony area at the lower part of the spinal column. This helps keep the pelvic organs in place.

It is a minimally invasive method which means it uses smaller cuts (incisions) than a standard surgery. It’s done while you’re asleep under general anesthesia.

Figure 1. Open vs Robotic, Port Placement for Sacrocolpopexy Surgery

Learn more about what robotic assisted surgery is and how surgeons use the technology here.


Potential Benefits​

Studies on Robotic assisted sacrocolpopexy have found the following results:

  • As safe, and as effective when compared to traditional laparoscopic techniques.[5,6]

Additional Patient Resources

Visit the the Canadian Womens Health Network for more informational about the disease, diagnosis, treatment options and support available.

 

Risks & Considerations

 Not everyone is a candidate for robotic assisted procedures, and other treatment options may be available and appropriate. Only a doctor can determine whether robotic assisted surgery is appropriate for a patient’s situation. Surgery of any form contains risks and it is important to discuss risks with your provider. Patients and doctors should review all available information on both non-surgical and surgical options in order to make an informed decision. 

Patients have also developed support areas where they are able to speak with each other about the surgery, their experiences, and any issues that they have faced during their treatment. To learn more check out the additional resources above or visit the community section of this website.

[1] https://www.healthlinkbc.ca

[2] https://my.clevelandclinic.org

[3] https://www.acog.org

[4] https://www.hopkinsmedicine.org

[5]Serati, Maurizio, et al. “Robot-Assisted Sacrocolpopexy for Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis of Comparative Studies.” European Urology, vol. 66, no. 2, Aug. 2014, pp. 303–318, 10.1016/j.eururo.2014.02.053.

[6] Zanten, F, et al. “Robot‐assisted Surgery for the Management of Apical Prolapse: A Bi‐centre Prospective Cohort Study.” BJOG: An International Journal of Obstetrics & Gynaecology, vol. 32, no. 8, 2 May 2019, 10.1111/1471-0528.15696.