Pelvic Reconstructive Surgery

Dr. Samuels offers a number of different options for pelvic reconstructive surgery. Depending on the precise nature of your problem, she can recommend the treatment that is right for you; one that has the best chance to improve your health and quality of life.

Pelvic Organ Prolapse

This term refers to a relatively common condition where, due to inadequate support “down below” secondary to gravity, age, and the effects of pregnancy, the bladder, uterus, or rectum will start to “fall” into and out of the vaginal opening. Women often refer to this condition as a “fallen bladder” or “fallen rectum” and describe feeling a “bulge” in the vagina. There are a number of treatment options available, and Dr. Samuels can recommend the one that is best for your needs.

Fallen Bladder Repair (Cystocele)

This term refers to the bulge created by weakening support structures around the bladder. This can happen due to age, childbirth, or genetics. Women will complain of feeling a bulge toward the front of the vagina. It is often accompanied by problems with urination. This is not a life-threatening condition, but it does affect the quality of life of most women who have this condition.

There are good treatment options available. In most cases, a surgical approach is optimal, but in some patients, non-surgical options may help considerably, depending on the extent of the “fallen bladder.”

Fallen Rectum Repair (Rectocele)

This term refers to the bulge created by weakening support structures around the rectum. This can happen because of age, childbirth, or genetics. Women will complain of feeling a bulge toward the back of the vagina, often accompanied by problems with defecation. This is not a life-threatening condition, but it does affect the quality of life of most of the women who have this condition.

Dr. Samuels can offer a number of good treatment options. Often she will recommend surgery, but some patients may find that their condition is helped with a non-surgical option. What is best for a particular patient depends on the extent of the fallen rectum.

Mesh Repair?

Mesh repairs are a very controversial topic at the moment. Mesh in itself is not bad, as it has been used for decades in the body for various repairs. With respect to pelvic floor repair, mesh has caused trouble for some women. Although she is trained in mesh repair, it is not Dr. Samuels’s choice as the first line of treatment. However, in an extreme minority of patients, it can be a good option.

For other women who already have mesh placed and are unhappy with the outcome, Dr. Samuels is trained and happy to remove this mesh with concurrent restoration of the pelvic floor.

Perineoplasty

The perineum is the area between the vagina and the rectum. Due to aging, prolapse, genetics, and childbirth, this area can become mildly or significantly disfigured. This contributes to the size of the opening of the vagina, or the “tightness.” Women complain of “feeling loose” or that sex no longer feels the same. This affects sexual satisfaction and ability to attain orgasm. This repair is often done surgically.

Vaginal Rejuvenation (Vaginoplasty)

This procedure has both aesthetic and functional purposes to the repair. With age, childbirth, and genetics, just as the skin of our hands, legs, and faces becomes more “saggy,” so does the skin of the vagina. For some women, this may appear as if the vagina is turning inside out, or in more severe cases, this might look like a fallen bladder or rectum. More commonly, it results in less sensation during sex and a “feeling of looseness” for women. Unlike most plastic surgeons, Dr. Samuels does a full depth repair when she takes on this procedure, which enables the repair to incorporate muscle repair and removal of excess tissue for a better cosmetic and functional result.