What is vaginal prolapse surgery?

Vaginal prolapse surgery includes various procedures to correct weak or damaged muscles, ligaments and tissues that hold a woman’s pelvic organs in place. Problems with this support system, called the pelvic floor, are common in women who have had children. Vaginal prolapse causes protrusion of the pelvic organs into the vagina, which can lead to urinary incontinence and other problems. 

Vaginal prolapse surgery is a major surgery with serious risks and potential complications. You may have less invasive treatment options depending on your circumstances. Consider getting a second opinion about all of your treatment choices before having vaginal prolapse surgery. 

Types of vaginal prolapse surgery

Vaginal prolapse is a condition in which a pelvic organ slips out of its normal place and protrudes into the vagina. Often, two or more pelvic organs are prolapsed, including the bladder, rectum, bowel, uterus, and vaginal vault (upper portion of the vagina). As a result, multiple procedures may be necessary. 

There are many types of vaginal prolapse surgery, also called pelvic organ prolapse surgery and pelvic reconstructive surgery for pelvic organ prolapse. Common examples of vaginal prolapse surgery include:

  • Colporrhaphy treats a prolapsed bladder (cystocele) or rectum (rectocele) by repairing the weakened wall between the vagina and the bladder or rectum. The surgery is performed through the vagina.
  • Hysterectomy treats a prolapsed uterus by removing it. 
  • Uterine suspension treats a prolapsed uterus by shortening stretched-out ligaments that support the uterus. Another version suspends the uterus by supporting it with mesh, which is attached to the pelvis.
  • Vaginal vault suspension treats a prolapse of the upper part of the vagina (vaginal vault) by attaching it to strong ligaments toward the back of pelvis. Another version lifts the vaginal vault by supporting it with mesh, which is attached to the pelvis. 

Vaginal vault suspension can also treat a uterus, bladder, or small bowel that has slipped out of place due to a weakness in the vaginal wall.

Why is vaginal prolapse surgery performed? 

Your doctor may recommend vaginal prolapse surgery to repair or correct weaken or damaged muscles, ligaments and tissues that hold your pelvic organs in place. Problems with this support system, called the pelvic floor, can result in prolapse of the bladder (cystocele), rectum (rectocele), bowel (enterocele), uterus, and vaginal vault (upper part of the vagina). This is common in women who have had children.

Doctors generally recommend vaginal prolapse surgery when your symptoms are severe enough to interfere with your daily life. 

Symptoms of vaginal prolapse include:  

  • A mass or protrusion from the vagina
  • Difficulty having bowel movements
  • Pain with sex
  • Pelvic or back pressure or pain
  • Urinary problems including stress incontinence or difficulty passing urine

Vaginal prolapse is associated with the following conditions:

  • Aging and menopause
  • Hysterectomy
  • Long-term coughing
  • Obesity
  • Ongoing constipation
  • Prolonged labor or having a large baby
  • Repeated childbirth or having a multiple birth, such as twins or triplets
  • Smoking

Your doctor may only consider vaginal prolapse surgery for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on vaginal prolapse surgery.

Who performs vaginal prolapse surgery?

The following specialists perform vaginal prolapse surgery:

  • Obstetrician-gynecologists specialize in women’s health and pregnancy.
  • Urologists specialize in diseases and conditions of the urinary tract and the male reproductive organs.
  • Female pelvic medicine and reconstructive surgeons are urologists or gynecologists who have completed specialized training in women’s pelvic floor disorders.

How is vaginal prolapse surgery performed?

Your vaginal prolapse surgery will be performed in a hospital or surgery clinic. The procedure varies depending on the type and severity of your vaginal prolapse and other factors. Your doctor will perform vaginal prolapse surgery using one of the following approaches: