What is it and why does genital prolapse occur?
The pelvic floor is the set of structures, muscles, fasciae and ligaments that hold intrapelvic organs inside the pelvis. The intrapelvic organs are the bladder, the uterus with the vagina and the rectum, and for their correct function they need to be able to dilate, to be able to contain their structures and then at the right moment when we want to empty it to be able to dilate the sphincters for they leave their products abroad. Therefore it is necessary that there is a correct function of all these muscles, ligaments and fascias. In certain circumstances, for example in childbirth, which is the most frequent reason, or in patients who are overweight, who increase their abdominal activity, patients with chronic chronic constipated or chronic constipation, there may be an injury to these muscles, these fascias or these ligaments and there is an exit to the outside by the vagina of the organs that are inside the pelvic floor. This is what we call genital prolapse, which can affect the anterior face, which would produce an exit to the outside of the vagina and call it cystocele, or in the middle part whereupon the uterus would come out and we call it hysterocele or uterine prolapse, or on the posterior side in which there is an exit to the outside of the rectum and we call it rectocele. In either case an abnormal function of these organs occurs and even sexual dysfunction can occur.
What is the surgical treatment?
When it is decided that a patient needs surgical treatment to correct the prolapse of their pelvic organs we can choose different techniques and different ways. There are abdominal pathways among which the use of laparoscopy is currently prevalent, and there are techniques available vaginally.. There are some classic ones that use own tissues of the patient and more and more they have been imposed in certain circumstances, in very specific cases, the use of meshes. The meshes are non-resorbable tissue prostheses that are inserted in certain structures with harpoon systems that are suitable for holding, for example, in the sacrociatic ligament and that allow a correct positioning of the organs in their situation prior to prolapse.
For what type of patients is the treatment indicated?
It is very important to know that not all types of treatment are useful for all types of patients. It is necessary to reserve the use of meshes for those patients who request it. They are those patients in whom the prolapse is very large, in those who have previously been treated and previous intervention has failed, or in which there are certain defects that can not be corrected with a conventional conventional technique.
What care should be followed after the intervention?
When we perform a vaginal technique, the advantage is that the recovery of the patient is usually faster than with abdominal techniques.. However, the patient must take care. For two to four weeks you should not carry excessive weights, you should not make sudden movements with your abdomen and you should be careful with certain exercises such as climbing stairs or abdominal contractions. After a month, patients can usually lead a completely normal life.