Urogynecology surgeries are procedures that address disorders of the pelvic floor in women — primarily related to the bladder, uterus, vagina, and rectum. These conditions often result from childbirth, aging, menopause, or previous pelvic surgeries.
Here’s an overview of the common urogynecological surgeries and what they treat:
🔹 Common Conditions Treated
- Pelvic organ prolapse (POP) — bladder, uterus, rectum, or vagina "falling" out of place
- Urinary incontinence — involuntary leakage of urine
- Fecal incontinence
- Fistulas — abnormal openings between pelvic organs
- Chronic pelvic pain
🔹 Types of Urogynecologic Surgeries
1. Sling Procedures
Purpose: Treat stress urinary incontinence
Types:
- Mid-urethral sling (most common)
- Pubovaginal sling (using patient’s own tissue or synthetic material)
How it works: A sling is placed under the urethra to support it and prevent leakage during physical activity.
2. Prolapse Repair Surgeries
a. Anterior/Posterior Colporrhaphy
- Anterior repair: Fixes a cystocele (bladder prolapse into the vagina)
- Posterior repair: Fixes a rectocele (rectum bulging into the vagina)
- Done through the vaginal wall
b. Sacrocolpopexy
- Often done laparoscopically or robotically
- Used to treat vaginal vault prolapse (especially after hysterectomy)
- Mesh is used to suspend the vaginal vault to the sacrum
c. Sacrohysteropexy
- Similar to sacrocolpopexy but preserves the uterus
- Uterus is suspended using mesh
d. Uterosacral or Sacrospinous Ligament Fixation
- Vaginal procedures to support the top of the vagina or uterus using pelvic ligaments
3. Hysterectomy (Urogynecologic context)
Purpose: May be performed as part of prolapse repair
Types:
- Vaginal hysterectomy
- Laparoscopic or robotic-assisted hysterectomy
4. Bulking Agent Injections
- For stress incontinence
- Collagen-like materials are injected near the urethra to help it close more effectively
5. Botox Injections into the Bladder
- Used for overactive bladder (OAB) when medications fail
6. Fistula Repairs
- To close abnormal openings, such as:
- Vesicovaginal fistula (bladder-vagina)
- Rectovaginal fistula (rectum-vagina)
- Often require complex surgical techniques
🔹 Surgical Approaches
- Vaginal (less invasive, faster recovery)
- Laparoscopic/robotic (minimally invasive, more precise)
- Abdominal (more invasive, reserved for complex cases)
🔹 Recovery & Risks
Recovery Time: Varies by procedure; typically 2–6 weeks
Risks Include:
- Infection
- Bleeding
- Pain
- Mesh complications (if mesh is used)
- Recurrence of prolapse or incontinence
