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Pelvic Floor Stabilization Surgery

Reconstructive surgery to restore pelvic anatomy and support in women with pelvic organ prolapse, including sacrocolpopexy, sacrospinous ligament fixation, uterosacral ligament suspension, and various transvaginal compartment-specific repairs.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Pelvic Floor Stabilization Surgery?

Pelvic organ prolapse (POP) is descent of pelvic organs (uterus, bladder, rectum, small bowel, vaginal apex) into or beyond the vaginal canal due to failure of pelvic support structures; prevalence increases with age affecting up to 50% of parous women.

Surgical stabilization is offered for symptomatic stage II–IV prolapse failing conservative therapy (pessary, pelvic floor physical therapy); approaches divided into apical (sacrocolpopexy, uterosacral, sacrospinous), anterior (anterior colporrhaphy, paravaginal repair), and posterior (posterior colporrhaphy, perineorrhaphy).

Abdominal sacrocolpopexy with synthetic mesh has highest durability for apical and anterior support but requires laparotomy or laparoscopic/robotic approach; transvaginal native-tissue repair has lower morbidity but higher recurrence; transvaginal mesh use restricted by FDA in many countries since 2019.

Symptoms

Vaginal bulge sensation, feeling something coming out, dragging or heaviness in pelvis
Stress or mixed urinary incontinence in 40%, urge incontinence, urinary retention requiring splinting (manual reduction) for voiding
Defecatory dysfunction, splinting for bowel movements, incomplete evacuation, fecal incontinence
Sexual dysfunction including dyspareunia, decreased sensation, partner's awareness, body image concerns
Discomfort with prolonged standing, lifting, or exercise; symptoms worse at end of day
Vaginal erosion or ulceration of prolapsed tissue in advanced procidentia

Risk Factors

Multiparity (especially vaginal deliveries with macrosomia, forceps, prolonged second stage)
Aging and menopause with estrogen deficiency leading to atrophy
Chronic increased intra-abdominal pressure (obesity, chronic cough, constipation, heavy lifting occupations)
Prior pelvic surgery, hysterectomy, prior prolapse repair (especially native tissue)
Connective tissue disorders (Marfan, Ehlers-Danlos), family history
Smoking, race (higher in white and Hispanic women than African American)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bothersome bulge or pelvic pressure not relieved by pessary or physical therapy — gynecology referral for surgical evaluation
  • Recurrent prolapse after prior surgery — specialist urogynecology evaluation
  • Vaginal erosion, bleeding, or ulceration of prolapse — urgent assessment
  • Difficulty emptying bladder or rectum requiring manual reduction — same-week evaluation
  • Concurrent urinary or fecal incontinence with prolapse — combined urogynecology and colorectal evaluation

Treatment Methods

01
Sacrocolpopexy (abdominal, laparoscopic, or robotic) — gold standard for apical/anterior prolapse with mesh attaching vaginal apex to anterior longitudinal ligament of sacrum; recurrence under 10% at 7 years
02
Sacrospinous ligament fixation — transvaginal apical suspension to sacrospinous ligament, unilateral or bilateral, native tissue or with augmentation
03
Uterosacral ligament suspension — transvaginal apex fixation to uterosacral ligaments, often with anterior/posterior colporrhaphy; durable for moderate prolapse
04
Anterior and posterior colporrhaphy — repair of cystocele and rectocele using native tissue plication of pubocervical and rectovaginal fascia
05
Perioperative considerations: pre-op vaginal estrogen for atrophy, urodynamic testing for occult stress incontinence (consider concurrent midurethral sling), anti-thrombotic prophylaxis, post-op pelvic rest 6 weeks, follow-up at 6 weeks, 3, 6, 12 months

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.