Pelvic reconstruction refers to procedures done to restore the appearance and function of structures within the pelvis area.
These procedures encompass muscles and organs below the waist or around the abdominal area and thighs. The specific procedure performed will depend on the extent of the damage or abnormality that needs to be corrected. There are many reasons why a urologist may recommend pelvic reconstruction, including:
- A preexisting deformity
- Removal of pelvic bones or muscles during surgery to access and remove a tumor
Why Might Pelvic Reconstruction Be Necessary?
One of the more common reasons for pelvic reconstruction is pelvic organ prolapse, a condition where the pelvic floor tissues and muscles are no longer able to support pelvic organs. As a result, organs that include the vagina, rectum, bladder, cervix, uterus, and rectum may shift position and cause numerous problems.
Other times, pelvic reconstruction may be necessary if there are deformities that are contributing to urinary system issues such as chronic urinary incontinence or recurring bladder and urinary tract infections. Some patients may need pelvic reconstruction surgery due to:
- Significant damage to nerves and connective tissues
- Issues from a previous pelvic or urinary system procedure
- Urinary problems that cannot be successfully treated with non-surgical treatments
How is Reconstruction Performed?
Some pelvic procedures, such as cystocele repair and rectocele repair, involve tightening tissues around the bladder or rectum and the vagina. In women, surgery may be done through the abdomen or vagina, depending on the specific location of the pelvic organs and tissues affected. Vaginally placed mesh is sometimes used with certain reconstruction procedures. Men may require surgery performed through the abdomen to restore the ability of pelvic muscles to support the bladder and bowel.
When possible, a urologist will use minimally invasive techniques that require smaller incisions when performing reconstructive surgery. Some procedures are performed laparoscopically, while some reconstructive surgeries are done with robotic assistance. In some cases, the pelvic bone itself may be reconstructed with the insertion of screws and plates. If pelvic organs have fallen out of place, surgery will also involve restoring the affected organs to their original position and repairing any related tissue damage.
What Happens After Pelvic Reconstruction?
The length of the recovery period following pelvic reconstruction will depend on what procedure was performed, a patient’s overall health, and what specific pelvic organs and tissues were involved. Surgery is sometimes complemented with pelvic floor muscle rehabilitation. Neuromuscular stimulation and pelvic exercises that can be performed at home may also be part of post-surgery recovery recommendations.
If issues within the pelvic region and urinary/reproductive structures aren’t severe, a urologist may recommend pelvic floor exercises to help strengthen muscles that support organs in this area before recommending surgery. Some women may benefit from the insertion of a removable device called a pessary that’s inserted into the vagina to support organs. In some situations, pelvic reconstruction is the only option due to the extent of the damage, deformities, or urinary problems involved. With proper follow-up therapy and observation, many patients are able to enjoy normal urinary and reproductive system functions following pelvic reconstruction.