Pelvic floor reconstructive surgery has the main objective of replacing the anatomy, repairing the organs, structures and function of the pelvic floor. It can be altered by processes such as pelvic organ prolapse, urethral stricture or urinary incontinence, among others. Any intervention must be individualized and adapted to the patient.
Pelvic Floor Reconstructive Surgery and treatable pathologies
Pelvic floor reconstructive surgery aims to replace the anatomy and function of the pelvic floor altered by processes such as:
– prolapse (protrusion or hernia) of the pelvic organs, alone or in combination: bladder, uterus, bowel, rectum
– stenosis or retraction of the urethra
– lesions in external genitalia
– incontinence of urine
– bladder reconstructions with bowel in genitourinary cancers
– fistulas
– bladder enlargement in neurogenic bladders (neurological patients)
– artificial sphincters
– mesh removal in chronic pain after surgeries…
It is one of the most unknown and complex areas of surgery, despite the fact that some parts, such as prolapse surgery, are more widespread.
In any case, one must know what goes wrong, how it can be fixed and how it can be improved.
The management of pelvic floor reconstruction draws on other specialties, such as plastic surgery, gynecology, general surgery or pediatric surgery, and is constantly evolving.
Patients who can undergo Pelvic Floor Reconstructive Surgery
Being a pathology linked to the quality of life and the function of the pelvic organs, all processes will depend on an individualized assessment adapted to each patient by the urology expert. Thus, the approach to surgery, the type of surgery, the use or not of meshes, even the inadvisability of surgical treatment should be studied. In no case should age be a limiting factor in itself to contraindicate any treatment.
Postoperative period in pelvic floor reconstructive surgery
Each surgery is different and so is each patient. In general, relative rest (no exertion, no lifting or intercourse) is recommended after surgery, to avoid failures or problems in recovery. But, in general, it is not a painful or disabling postoperative period when the approach is vaginal.
Results obtained with Pelvic Floor Reconstructive Surgery
Each problem and each patient is different. In the area of reconstructive surgery it is very important to clearly state the problem, the solution, the possible complications derived from the treatment and to know how to solve them, not to create false expectations.
In the case of the most frequent problems, such as incontinence and prolapse, and in other less frequent ones, such as stenosis of the female urethra, our own series of ten-year results, both in function and in quality of life and sexuality, are excellent.