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Department of Obstetrics and Gynecology - Robotics

Uterine Prolapse

In the U.S., pelvic support defects are relatively common and increase with age. More than 120,000 women have surgery for uterine and vaginal vault prolapse each year in the United States.  One study of more than 16,000 patients found the rate of uterine prolapse to be 14.2%. The mean age at time of surgery for pelvic organ prolapse was 54.6 years.4
Uterine prolapse ("dropped uterus") is a condition in which a woman's uterus (womb) sags or slips out of its normal position. The uterus may slip enough that it drops partially into the vagina (the birth canal), creating a perceptible lump or bulge. This is called incomplete prolapse. In a more severe case—known as complete prolapse—the uterus slips to such a degree that some of the tissue drops outside of the vagina.

 
Images of various types of uterine prolapse

Prolapse literally means "to fall out of place." In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is generally reserved for organs protruding through the vagina, or for the misalignment of the valves of the heart.

Causes of Uterine Prolapse

Trauma incurred during the birthing process, particularly with large babies or after a difficult labor and delivery, is one of the main causes of the muscle weakness that leads to uterine prolapse. Reduced muscle tone from aging, as well as lowered amounts of circulating estrogen after menopause, may also form contributing factors in pelvic organ prolapses. In rare circumstances, uterine prolapse may be caused by a tumor in the pelvic cavity.

Genetics also may play a role; women of Northern European descent experience a higher incidence of uterine prolapse than do women of Asian and African heritage.2

Finally, increased intra-abdominal pressure, stemming from such diverse conditions as obesity, chronic lung disease and asthma, can be contributing factors in uterine prolapse.3

Surgical Options

Hysterectomy


Uterine prolapse may be treated by removing the uterus in a surgical procedure called hysterectomy. This may be done through an incision made in the vagina (vaginal hysterectomy) or through the abdomen (abdominal hysterectomy). Hysterectomy is major surgery, and removing the uterus means pregnancy is no longer possible.

da Vinci® Sacrocolpopexy: Surgery for Uterine or Vaginal Vault Prolapse

Sacrocolpopexy is a procedure to surgically correct vaginal vault prolapse where mesh is used to hold the vagina in the correct anatomical position. This procedure can also be performed following a hysterectomy to treat uterine prolapse to provide long-term support of the vagina. Robotically-assisted laparoscopic surgery is an effective alternative to traditional surgery for treatment of vaginal vault prolapse, U.S. researchers report.  Robotic surgery involves the use of the da Vinci® Surgical System that helps speed up the repair and simplifies technically difficult aspects of vaginal vault prolapse surgery. A recent Mayo Clinic study of 30 women who had robot-assisted laparoscopic repair concluded that this method has the following advantages over traditional open surgical repair.1

Sacrocolpopexy has traditionally been performed as an open surgery. A 15-30 cm horizontal incision is made in the lower abdomen in order to manually access the inter-abdominal organs, including the uterus.

da Vinci Sacrocolpopexy incision diagram

If your doctor recommends sacrocolpopexy, you may be a candidate for a new surgical procedure called da Vinci Sacrocolpopexy. This procedure uses a state-of-the-art surgical system designed to help your surgeon perform a minimally invasive surgery through small incisions.

For most women, da Vinci Sacrocolpopexy offers numerous potential benefits over a traditional open approach:
  • Significantly less pain
  • Less blood loss and need for transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay
  • Shorter recovery time
  • Quicker return to normal activities

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient- and procedure.

Learn More

If you are a candidate for sacrocolpopexy, talk to a gynecologist who performs da Vinci Sacrocolpopexy. To find a da Vinci gynecologic surgeon, use our surgeon locator .

  1. "Robot Technology Improves Vaginal Prolapse Surgery," U.S. Dept. of Health & Human Services, healthfinder.gov.

  2. "Women's Health: Uterine prolapse," MayoClinic.com.

  3. "Uterine Prolapse," eMedicine from WebMD. www.emedicine.com.

  4. "Uterine Prolapse," eMedicine from WebMD. www.emedicine.com.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci® Surgical System visit www.davincisurgery.com