Pelvic Floor Reconstructive Surgery

Team specialising in pelvic floor reconstruction

What is pelvic floor reconstruction surgery?

Pelvic floor reconstructive surgery aims to correct pelvic organ prolapse (bladder, uterus, vagina, or rectum), improve associated symptoms, and restore pelvic floor anatomy and function, always prioritizing the patient’s quality of life.

In our unit, we are specialists in pelvic floor surgery. We prioritize minimally invasive techniques, individualizing treatment based on the type of prolapse, age, symptoms, surgical history, and the preferences of each patient.

Mesh-Free Surgical Techniques

Whenever possible, we prioritize reconstructive techniques without the use of mesh, especially for mild or moderate prolapse:

  • Cystocele correction (bladder prolapse) via anterior vaginal colporrhaphy.
  • Rectocele correction (rectal prolapse) via posterior vaginal colporrhaphy.

These techniques restore pelvic floor support using the patient’s own tissues, yielding excellent functional and anatomical results.

Vaginal Reconstruction and Combined Surgeries

In many cases, pelvic floor surgery can be combined with additional procedures to optimize results

  • Vaginoplasty, for the reconstruction and improvement of the vaginal canal.
  • Apical prolapse correction (descent of the uterus or vaginal vault), with or without uterine preservation.

The choice of technique is personalized following a comprehensive assessment.

Apical Prolapse Surgery and Uterine Preservation

Depending on the clinical case, different approaches may be employed:

  • vNOTES Hysterectomy (minimally invasive surgery performed through the vagina, with no visible abdominal incisions).
  • Subtotal hysterectomy with colposacropexy, using mesh via a laparoscopic or robotic approach, indicated in selected cases of apical prolapse.
  • Reconstructive surgery for post-hysterectomy patients presenting with vaginal vault prolapse, involving the placement of vaginal mesh and reconstruction of pelvic support.

These techniques provide solid fixation of the vagina or uterus through an anatomical and functional approach.

Other Advanced Pelvic Floor Reconstruction Techniques

Depending on the anatomy and the type of prolapse, we also perform specific techniques such as:

  • Laparoscopic pectopexy.
  • Laparoscopic Dubuisson technique.

Both are effective alternatives for correcting apical prolapse through minimally invasive approaches.

Urinary Incontinence Surgery

In addition to prolapse surgery, we treat urinary incontinence, which is frequently associated with pelvic floor issues:

  • Bulkamid Injections: A minimally invasive technique indicated for specific types of incontinence.
  • Suburethral Mesh (TOT in/out): Aimed at correcting stress urinary incontinence.

The indication for each technique is determined following an appropriate urogynecological study.

Admission, Recovery, and Follow-up

  • Hospital stay: Usually between 24 and 48 hours.
  • Initial recovery: Home rest is recommended for approximately 10–15 days.
  • Physical activity: Avoid heavy physical exertion for 1 month.
  • Follow-up: First office consultation between 30 and 45 days after surgery.

Our goal is to offer a safe, progressive recovery tailored to each patient.

Specialized and Personalized Care

We have extensive experience in reconstructive pelvic floor surgery and apply cutting-edge, minimally invasive techniques whenever possible. Every treatment is designed individually, clearly explaining all available options so the patient can make informed and confident decisions.

Book an appointment

Rubèn Baltà i Arandes – Doctoralia.es

Do you need more information or an evaluation?

I am available to evaluate your case and help you make the best surgical decision.

FAQ

It is a set of surgical procedures designed to correct the descent of pelvic organs (bladder, uterus, vagina, or rectum), improve associated symptoms—such as a sensation of a bulge, discomfort, or difficulty urinating or defecating—and restore pelvic floor anatomy and function.

The most common symptoms include a feeling of heaviness or a vaginal bulge, discomfort when walking or exerting yourself, difficulty emptying the bladder or rectum, urinary incontinence, and changes in sexual relations. The surgical indication depends on the intensity of the symptoms and the impact on quality of life.

No. Whenever possible, we prioritize mesh-free techniques using the patient’s own tissues, such as anterior repair for cystocele or posterior repair for rectocele. Mesh is reserved for specific cases, such as certain apical prolapses or vaginal vault prolapses in patients who have already had a hysterectomy.

A cystocele is the descent of the bladder into the vagina. It is usually corrected via anterior vaginal colporrhaphy, a reconstructive technique that reinforces bladder support without the need for mesh in most cases.

A rectocele is the descent of the rectum into the vagina. Correction is performed via posterior vaginal colporrhaphy, which restores the support of the rectovaginal septum and improves associated symptoms.

Yes. It is common to combine prolapse correction with a vaginoplasty, the repair of multiple pelvic floor compartments, or apical prolapse correction in a single intervention, provided it is indicated and safe for the patient.

It is the descent of the uterus or, in women who have had a hysterectomy, the vaginal vault. It requires specific fixation techniques to restore adequate and lasting support.

Not always. In some cases, the uterus can be preserved. In others, a hysterectomy is indicated, which can be performed using minimally invasive techniques such as vNOTES, laparoscopy, or robotic surgery, depending on the clinical situation.

It is a minimally invasive surgical technique performed through the vagina without visible abdominal incisions. It allows procedures like hysterectomies to be performed with a faster recovery and less aesthetic impact.

In hysterectomized patients with vaginal vault prolapse, we perform pelvic floor reconstruction techniques that may include placing a mesh to reinforce vaginal support and restore anatomy.

They are advanced apical prolapse reconstruction techniques performed via laparoscopy, allowing the vagina or uterus to be fixed to solid anatomical structures, offering excellent functional and anatomical results.

In many cases, yes. Furthermore, when urinary incontinence is present, it can be treated using specific techniques such as Bulkamid injections or the placement of TOT (in/out) suburethral mesh.

It is a minimally invasive technique consisting of the injection of a biocompatible material into the urethral wall to improve urinary continence in selected cases.

The TOT technique is a surgery for stress urinary incontinence that uses a suburethral mesh placed through the obturator foramen, with successful results and a quick recovery.

Hospitalization is typically 24 to 48 hours, depending on the type of surgery performed and postoperative progress.

Home rest is recommended for 10 to 15 days. Returning to work will depend on the type of job, and significant physical exertion should be avoided for 1 month.

In general, results are very satisfactory and durable. The proper choice of surgical technique and medical follow-up are key to minimizing the risk of recurrence.

The first office follow-up usually takes place between 30 and 45 days after the intervention.

No. Each case is evaluated individually, taking into account anatomy, symptoms, history, and patient preferences to offer the most appropriate and safest treatment.