For women that have had a hysterectomy, apical prolapse refers to the descent of the very tip of the vagina, the portion that was once in contact with the cervix. For women who have not had a hysterectomy, apical prolapse refers to descent of the uterus itself. In women who have had either a cystocele repair, rectocele repair or both in the past, with recurrence of the bulges and discomfort a few years later, apical prolapsed is often the culprit. Support of the vaginal apex is the keystone of any successful reconstruction. However, this type of repair is also the most surgically complex and demanding, often times requiring additional surgical training to perform. Vaginal apex repairs rely on finding suitable tissues in the abdomen or pelvis to anchor the tissue to. Such tissues include ligaments and bony structures and can be accessed vaginally, abdominally or laparoscopic/robotically. El Camino Urology Medical Group is able to offer everything from open abdominal repairs to minimally invasive robotic type repairs because of the many fellowship trained physicians in the group.
Uterine prolpase has traditionally been treated with a hysterectomy followed by vaginal vault suspension by any of the aforementioned techniques. However recent studies have revealed that women do not need to have a hysterectomy when otherwise healthy and this is often in keeping with their personal philosophies. Due to our advanced training, we are able to offer uterus sparing vault suspension (hysteropexy) in addition to the more traditional operations making all options available to our patients.
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