Current Advances in Pelvic Organ Prolapse Surgical Treatment

Dear Colleagues,

We cordially invite you to take part in this special issue on female vaginal prolapse correction.

The uterus, vagina, rectum, bladder, and urethra are among the organs that make up the pelvic structures and might regrettably slide out of the vagina. Genital prolapse, which affects many post-menopausal women, gradually damages these organs. Over one-third of women or those who were assigned female at birth (AFAB) will experience pelvic organ prolapse at some point in their lives.

The pelvic floor muscles, which resemble an upside-down umbrella, support these organs. The pelvic organs are held up by the umbrella, however it may eventually start to collapse due to time or other circumstances such as vaginal deliveries. Consequently, there are several kinds of genital prolapse: Uterine Prolapse or Anterior or Posterior Vaginal Prolapse with descent of the bladder, urethra, rectum and small intestine.

The severity of pelvic organ prolapse determines the therapy options available. Vaginal prolapses can be treated surgically or non-surgically. When the prolapse is minor or nonexistent, nonsurgical therapies are usually the first choice.

Surgery to treat vaginal prolapse may be an option in more severe situations.

Among these surgical choices are:

1) The removal of the prolapsed uterus is known as a colpohysterectomy.

2) Repositioning the rectum and small bowel to repair posterior vaginal prolapse and anterior vaginal prolapse (by suspending the bladder and urethra).

3) Vaginal pelvic floor repair, or colpohysterectomy combined with anterior and posterior vaginal prolapse correction.

4) Vaginal vault suspension: This technique entails securing the vagina to the pelvic ligaments for support.

5) Colpocleisis: The vagina is sewn shut during this surgery.

6) Sacrocolpopexy: This operation gives the vagina a lift by connecting a piece of mesh to it and linking it to the sacrum.  Small incisions and a minimally invasive procedure known as a laparoscopy are used to perform this operation. 

Since the first laparoscopy performed by Hans Christian Jacobaeus in 1910, the abdominal surgical technique has undergone a rapid growth, reaching the most modern robotic techniques. The last several decades, in particular, represented an important crossroads for a minimally invasive approach to gynecological and urological pathologies. Technology has gained more utilization in urogynecology. Laparoscopic techniques have become the gold standard in the treatment of pelvic pathologies, increasing operative costs but significantly reducing hospitalization and patient discomfort.

The aim of this Special Issue is to highlight the most recent approaches to pelvic organ prolapse surgery, in particular highlighting the latest surgical approaches in the field of pelvic dysfunction.

Dr. Andrea Tinelli and Dr. Andrea Morciano
Guest Editors

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