Pelvic Reconstruction / Prolapse

[ pel-vik ] Noun “hard to function if your organs are coming out of your body”

– Dr. Terri-Ann Samuels

Pelvic Reconstructive Surgery (Vaginal Bulge)

The National Institutes of Health state that nearly 24 percent of U.S. women are affected by one or more pelvic floor disorders. It is projected that the number of US women with pelvic organ prolapse will increase by 46% between 2010 and 2050, from 3.3 million to 4.9 million (Sung et al.) Dr. Samuels offers several different options – both conservative and surgical for vaginal/ pelvic reconstructive surgery. Depending on the precise nature of your situation, she will recommend the treatment that is right for you. Your treatment will always be the one that has the best chance to improve your health, function, and quality of life.

Dr. Samuels understands the effects that pelvic concerns can have on your life. In short, they can prevent you from enjoying your days to the fullest. That is why she works closely with each patient to address their concerns in a compassionate and professional way fully.

    Pelvic Organ Prolapse

    Pelvic organ prolapse is a relatively common condition but can have a big impact on your life. It occurs due to inadequate pelvic support. This is usually caused by:

    • Gravity
    • Age
    • The effects of pregnancy
    • Genetics

    Without proper support, the bladder, uterus, and/or rectum will seem to fall into and out of the vaginal opening. Women often refer to this condition as a fallen bladder or fallen rectum. Most patients describe feeling a bulge in the vagina, and though it is not typically dangerous, it can be highly unpleasant. However, there is hope! Dr. Samuels provides several pelvic reconstruction surgical options and will recommend the best one for you.

    Fistula Repair

    Fistulae can form among a variety of pelvic structures from many different causes. In the US, the incidence of fistula formation can is estimated at 0.1% post-hysterectomy. Fistulae can occur after cancer, radiation, or childbirth. Out of all the complications of OBGYN, the development of a fistula severely and devastatingly impacts the quality of life for the patient involved.

    Dr. Samuels has extensive experience attained by her training and multiple medical missions all over the world in diagnosing and treating vaginal fistula – both bladder (vesicovaginal) and rectal (rectovaginal). These repairs are part of what she does in her annual surgical missions.

    Urethral Diverticulum

    A diverticulum in the urethra is an outpouching similar to the more familiar diverticulum in the colon that gives patients diverticulitis.

    Symptoms of a urethral diverticulum include:

    • Incontinence
    • Urethral/vaginal pain
    • Feeling a bulge in the vagina
    • Vaginal discharge
    • Pain with Sex
    • They are very uncommon but severely affect the quality of life for women that develop them.

    The surgery to treat them is very complex. Fortunately, Dr. Samuels has trained extensively in urethral diverticulum repair.

    Vaginal Rejuvenation / Vaginoplasty

    With age, childbirth, and genetics, our body becomes vulnerable to change. Similar to how external skin, especially facial can loosen/wrinkle, so does the skin of the vagina. For some women, this may appear as if the vagina is turning inside out. In more severe cases, this might look like a fallen bladder or rectum. More commonly, women experience a loss of sensation during sex and a feeling of looseness (described as not as “together” as it used to be).
    Vaginal Rejuvenation procedures have both aesthetic and functional purposes for patients. Unlike most plastic surgeons, Dr. Samuels does a full-depth repair. She expertly incorporates muscle repair and removal of excess tissue for a better cosmetic and functional result.

    Fallen Bladder / Cystocele

    Mesh Placement and Removal in vaginal Reconstruction

    Vaginal Mesh has gotten “a bad rap” over the years. Significant concerns regarding the safety of vaginal mesh have been raised by the FDA with lawsuits for complications. Since then, we have clear data that surgeons with significant annual volume have the least complications (Kelly et al.). In addition, fellowship-trained urogynecologists have even fewer issues.

    As a 3-year fellowship-trained Urogynecologist, Dr. Samuels has the expertise to offer the best outcomes. She has trained extensively in mesh placement and removal when necessary.

    Mesh has been used on abdominal hernias for many years. There are surgical approaches that do not require mesh. But the reality is that for some women, the mesh acts as a necessary scaffolding because their own tissue can no longer hold. This is an extensive discussion with Dr. Samuels to come up with the surgical approach best for you.

    Schedule Your Appointment Today