Let's learn about Pelvic Organ Prolapse and Sacrocolpopexy surgery.

Do you sometimes feel a constant heaviness in your lower abdomen, a feeling like something is pressing down on you? Maybe you feel like something like a ball is coming out of your vagina? Do you have a problem with urinary incontinence, which is the loss of urine when you laugh, cry, or sneeze? These are problems that many women suffer from in silence, but are a little embarrassed to talk about. But this is not something that only you have. Today we are talking about a condition called Pelvic Organ Prolapse, which causes these symptoms, and a very successful surgery called Sacrocolpopexy .

Simply put, what is pelvic organ prolapse?

Imagine that the organs in your lower abdomen, such as your uterus, bladder, and rectum, are in a hammock. This hammock is made up of what we call the pelvic floor muscles and their associated tissues. These are what hold all of these organs in place.

However, over time, especially after childbirth, due to weight lifting, and as we age, these muscles and tissues begin to weaken and stretch. Then, as if the mesh bed sags, the organs in it also begin to push downwards, that is, towards the vagina. This is what we call pelvic organ prolapse. One treatment for this is a surgery called Sacrocolpopexy. This involves bringing the organs that have fallen back up and using a special surgical mesh to stabilize them in their correct position.

What organs can be degraded like this?

This condition is divided into several types depending on the organ that is affected. To make it easier to understand, let's look at these details.

See if you have these symptoms too...

These are some of the most common symptoms of Pelvic Organ Prolapse:

• The appearance or feeling of something like a lump or ball coming out of the vagina.
• Lower abdominal pain, which means a feeling of heaviness, pressure, or something stuck in the pelvis.
• A small amount of urine leaks spontaneously when laughing, coughing, or lifting a heavy object.
• Difficulty defecating. Sometimes it feels like the stool is not completely expelled.
• Difficulty inserting objects such as tampons into the vagina.
• Pain during sexual intercourse.

Why is this happening? What are the main reasons?

There are several main reasons why pelvic floor muscles become weak.

• Vaginal childbirth: These muscles can be damaged, especially when giving birth to multiple children, having a high birth weight baby, or having a difficult delivery.
• Abdominal surgery: Especially things like hysterectomy.
• Aging: As we age, the body's muscles naturally weaken.
• Frequent heavy lifting: Frequently lifting heavy objects like water buckets and gas cylinders at work or while doing household chores.
• Frequent pressure on the lower abdomen: This condition can also be caused by things like chronic coughing, asthma, and straining due to frequent constipation.
• Genetic causes: Some people are born with weak connective tissues, which puts them at higher risk.

Okay, so how do you fix this with this Sacrocolpopexy surgery?

Sacrocolpopexy is a very advanced and successful surgical procedure for this problem. It is very simple.

The surgeon makes several small incisions in your abdomen and uses a camera (laparoscope) to perform this surgery. This is called laparoscopic surgery . Sometimes robotic technology is also used for this.

In this procedure, a special surgical mesh is attached to the upper part of your vagina, bladder, or rectum that has fallen. The other end of the mesh is then attached to the lowest bone in your spine, the sacrum. This mesh acts like a bridge, pulling all of your lowered organs back up and stabilizing them in their proper place.

Sometimes, depending on your medical history and preferences, a hysterectomy can be performed at the same time as this surgery. This completely eliminates the risk of uterine cancer.

How do you prepare before surgery?

The hospital will give you a set of instructions before the surgery. It is very important to follow them exactly.

• You will be asked to completely avoid eating or drinking after midnight the night before the surgery.
• If you are a smoker, you should stop smoking after midnight the night before the surgery.
• Some medications you take (e.g. blood thinners) may require you to stop taking them for a few days. Talk to your doctor about this.
• You may be allowed to drink fluids such as water, unsweetened tea, or coffee until a few hours before surgery.

How the surgery is performed step by step

Don't be afraid of the surgery. Knowing how it happens will help you overcome your fear.

1. First, you will be put under general anesthesia . So you won't feel any pain and you will be sound asleep.

2. The surgeon will make 4 or 5 small incisions, about one centimeter wide, in your abdomen.

3. The abdomen is then inflated with carbon dioxide gas. This is done to make room inside for the surgery and to see the organs clearly.

4. A camera (laparoscope) and surgical instruments are inserted through these small incisions.

5. While viewing the images from the camera on a monitor, the doctor attaches the aforementioned mesh to the top of the vagina and the sacrum, lifting the organ.

6. If the bladder or rectum is prolapsed, it will also be repaired at this time.

7. At the end of the surgery, a small camera is inserted to check for any damage to the bladder.

8. Finally, all the instruments are taken out, the gas in the stomach is removed, and the small incisions are closed.

This surgery usually takes between 2 and 4 hours .

What happens after surgery? What to expect during recovery

After the surgery, you will be taken to a recovery room. When you wake up from the anesthesia, you may feel a little sleepy or groggy. This is normal.

Next, you will have a voiding trial to see if you can urinate on your own. You may have had a catheter in place before surgery. During this test, it will be removed and you will be tested to see if you can empty your bladder on your own. If you can't, you may be sent home with a catheter to use at home for a few days. Don't worry about that.

It takes between 6 and 8 weeks to fully recover. During this time, you will need to make some changes to your lifestyle.

Don't do these things until you're healed! (Things to avoid)

To ensure a successful recovery period, you must follow these instructions.

• Do not bathe in water for 48 hours after surgery. After that, you can take a shower.
• Avoid being in water (swimming, sitting in a bathtub) for 4-6 weeks.
• Avoid heavy lifting, pushing, or pulling for 4-6 weeks. Do not lift anything heavier than 2-3 kg (e.g. buckets of water, shopping bags, small children, pets).
• Avoid using a vacuum cleaner or pushing heavy doors during this time.
• Do not have sex for at least 6 weeks. Also, avoid using tampons and douching.
• If you are taking the strong painkillers prescribed by your doctor, avoid driving .

How successful is this surgery? Are there any risks?

Sacrocolpopexy is a surgical procedure with a success rate of about 90% . That means the results are very good.

Among the possible risks:

• Damage to surrounding organs such as the bladder and intestines.
• Heavy bleeding.
• Blood clots.
• Infection.
• Problems related to the mesh used (e.g., erosion of the mesh through the vaginal tissue).
• Difficulty urinating or defecating.
• Pain during sex.

These risks are very rare, but it's important to be aware of them.

If you have these symptoms, see a doctor immediately!

If you develop any of these symptoms while at home after surgery, call your doctor or go to the hospital immediately.

• Fever over 38 Celsius (100.4 Fahrenheit) or chills.
• If the cuts are red, swollen, or have a foul-smelling discharge .
• Uncontrollable vomiting or nausea .
• If you have heavy vaginal bleeding that soaks more than one sanitary pad per hour.
• If you have a foul-smelling vaginal discharge .
• If you have severe pain that cannot be controlled even with medication.
• Pain and swelling in the legs.
• Urine that smells bad, is dark in color, or has a burning sensation when urinating.