Pelvic Organ Prolapse: Comprehensive Solutions for a Common Problem
Steven Berliner, MD
According to the American Urogynecologic Society, approximately 200,000 procedures for correction of pelvic organ prolapse are performed each year in the United States. Many of these women start out looking at a variety of non-surgical therapy options—from pelvic floor exercises to pessaries. When these options fail to correct the prolapse, these patients explore surgical options.
“By the time many of our patients come to us, they have tried non-surgical approaches and have had prior surgical procedures that failed,” said Samuel S. Lentz, MD.
Lentz and Steven H. Berliner, MD, both urogynecologists at Wake Forest Baptist, repair many prolapse problems using abdominal and vaginal graft augmentation.
“While some institutions prefer an abdominal surgical approach, we perform many of our repairs vaginally,” said Lentz. “We prefer this method because it allows us to more completely address all of the prolapse problems, while avoiding large abdominal incisions.”
In addition, Berliner also performs minimally invasive surgeries that utilize small abdominal incisions. The procedure, robot-assisted sacropexy, uses a polypropylene mesh which attaches to the top and bottom sides of the vagina and is then fixed to the patient’s ligament over the sacral bone.
“This provides a durable and long-term solution for patients who have vaginal vault prolapse. It is ideal in patients who have had previous repair failures,” said Berliner.
Significant pelvic organ prolapse can be painful, resulting in vaginal bulge, lower back pain, and bladder and bowel dysfunction. Factors contributing to prolapse include vaginal deliveries, menopause, chronic straining, smoking and obesity. There are likely genetic-related factors which also predispose a patient to prolapse.
“Our goal is to provide the most comprehensive care for our patients and restore them to a more comfortable and improved lifestyle,” said Berliner.