Do I Need Prolapse Repair Or Vaginal Rejuvenation?

Vaginal rejuvenation and prolapse repair are two different procedures, yet it’s not uncommon for patients seeking out vaginal rejuvenation to discover that they need prolapse repair as well. Fortunately, vaginal rejuvenation and a formal prolapse repair can co-exist. Vaginoplasty, a surgical form of vaginal rejuvenation, if often included in a formal prolapse repair due to the nature of surgery. It’s our expertise: Dr. George Shashoua of Austin Urogynecology and Austin Labiaplasty and Vaginal Rejuvenation is a board-certified urogynecologist with over 25 years of experience, and has performed thousands of pelvic and vaginal procedures.

Pelvic organ prolapse is when the surrounding organs like the bladder, uterus, small intestine, or rectum drop into the vagina. Patients experience varying degrees of prolapse, so it is typically “graded” on a scale from 1-4 depending on how much descent is present. While patients with Stage 1 prolapse have minimal dropping, patients with Stage 4 prolapse have significant descent. Stage 4 prolapse indicates that the prolapsed organ (or organs) have dropped as far as possible outside the vagina. If the bladder, uterus and rectrum are all protruding beyond the opening of the vagina then this is referred to as a total prolapse or complete procidentia. This calls for a formal prolapse repair, and in many cases, a hysterectomy.

There are a host of symptoms caused by pelvic organ prolapse, but it typically starts small and is often asymptomatic. It can be managed conservatively at the start, but if it progresses it can become more bothersome. Prolapse can begin to create a sensation described as vaginal heaviness or pressure and in some cases patients feel as if “something is falling out of the vagina.” When it is at a more advanced stage, prolapse can lead to severe complications like urinary tract infections, urinary incontinence, constipation, pelvic pain, lower back pain and pain during sex. It can also cause vaginal mucosal break down due to thinning and rubbing of the tissue.

Based on the patient’s unique needs, either vaginal or robotic surgery will be recommended to fix pelvic organ prolapse. The technical name for vaginal repair is colporrhaphy, or anterior and/or posterior repair. Patients receiving an anterior repair will have the connective tissue between their bladder and vagina brought together, treating the bulging of the bladder into the vagina (cystocele). A posterior repair is when the connective tissue between the rectum and the vagina are brought together, fixing the bulging of the rectum into the vagina (rectocele). The top of vagina is also elevated. If we discover that the connective tissue is weakened, we’ll also consider a graft which will help provide additional support.

This type of surgery typically requires one overnight stay in the hospital, with patients able to resume their activities within 2-3 weeks. It takes around 6 weeks total for patients to fully heal.

The da Vinci robotic surgery is a less invasive approach for prolapse repair, meaning there are smaller incisions and fewer instruments used. Robotic surgery doesn’t mean a robot performs the surgery but rather we use a robotic platform that is operated by Dr. Shashoua, a specially-trained, board-certified surgeon.

Vaginal rejuvenation can be conducted separately or alongside a formal prolapse repair. Factors like aging, childbirth and genetics can cause the vagina and perineum – the area between the vagina and the anus – to stretch and relax over time. This can change the look and feel of the vagina, leading to disruptive symptoms like decreased sensation during sex. Austin Labiaplasty and Vaginal Rejuvenation offers surgical and laser treatment that can help restore the elasticity of your vagina, repairing your anatomy.

Vaginoplasty is a surgical approach to vaginal rejuvenation that offers lasting, more permanent results. On its own, it typically takes place in a hospital setting, under anesthesia. It usually takes about two hours to perform. During the procedure, the vaginal opening is narrowed using what we called the “wedge” technique. Dr. Shashoua will make an incision within the vaginal wall, reconstruct the opening and then close the area with dissolvable suture. Patients take 6-8 weeks on average to recover.

If you have any further questions about prolapse repair or vaginal rejuvenation, or want to schedule a consultation, contact Austin Urogynecology today.

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