Laparoscopic Repair of Pelvic Floor Relaxation
and Stress Urinary Incontinence
Pelvic organs, including the bladder, uterus, bowel and rectum are supported by strong, elastic, mesh-like tissue called endopelvic fascia and pelvic floor muscles called levators. When these support structures are strained or weakened, some or all of the above mentioned organs may sag. Such drooping occurs mainly into or through the vaginal space. This process can cause a variety of symptoms, including vaginal bulging/fullness, pelvic pressure/pain, urinary and/or fecal incontinence and more.

Medical terminology describing pelvic relaxation includes cystocele (bladder sagging/prolapse), metrocele (uterine sagging/prolapse), enterocele (sagging/prolapse of the bowel) and rectocele (sagging/prolapse of the rectum).

Pelvic floor relaxation symptoms may cause significant deterioration in quality of life, including social embarrassment (leakage when coughing, sneezing, laughing), humiliation in intimate relationships (incontinence and vaginal bulge affecting intercourse) and avoidance from participating in physical activities (leakage and vaginal protrusion when jumping, running, weight lifting).

Pelvic floor exercises, including biofeedback and electrical stimulation may help patients with mild pelvic floor relaxation. Moderate or severe pelvic floor dysfunction is usually treated surgically. Patients with high surgical risk (heart, lung or other serious illnesses) may get partial relief using vaginal pessary.

Traditional surgical approaches require a several inch long abdominal incision, a two to three day hospital stay and a six week recovery period.The majority of repairs can be accomplished vaginally,with a shorter, one to two day hospital stay and about a four week recuperation phase.

Laparoscopic restoration of pelvic floor is an outpatient surgery requiring only a two week recovery period. A high level of knowledge in laparoscopic surgery is necessary to perform these procedures.

Paravaginal Repair and Vaginal Cuff Suspension are two of the main surgeries which are done to correct pelvic floor relaxation. Both operations can be accomplished using abdominal, vaginal or laparoscopic approach.

Burch Colposuspension is one of the main operations which is used to repair stress urinary incontinence. It can be completed abdominally or via laparoscope.

Laparoscopic procedures are performed using minimally invasive techniques. Three tiny incisions are required: a third of an inch naval access and two or three abdominal openings which are each a fifth of an inch long. Employing zoom cameras, special instruments and permanent sutures the sagging pelvic tissues are transfixed and brought back to their normal anatomic position.

Laparoscopic restoration of continence and elimination of vaginal pressure/bulge generate maximal restitution of quality of life with minimal hospital stay and recovery time.