One area gynecologist uses synthetic mesh system
to correct severe cases of pelvic organ prolapse

Sandra Russell, D.O., obstetrician/gynecologist with Meridian Women’s Health, sees some patients who feel and, often see the effects of pelvic organ prolapse – whether it be of the bladder, rectum, or uterus. They describe continuing pressure, tenderness, and pain as intolerable.

Essentially, says Dr. Russell, they have a ‘hernia’ of the uterus, bladder or rectum. "Because it is an elective surgery," notes Dr. Russell, "women who want to tighten up the vaginal plane areas are generally active in competitive sports, hobbies, or work that requires stretching and heavy lifting. Some women have weak collagen tissue in the vaginal area from childbearing, or an inherited genetic propensity toward damaged nerves, leading to muscle weakness. Excess weight, hysterectomy, straining during bowel movements or heavy lifting can contribute to pelvic floor disorders."

"I can usually diagnose a pelvic floor disorder when I perform a pelvic exam, using a speculum to spread the vaginal walls apart. If the prolapse is mild, Kegel exercises often can resolve pelvic floor dysfunction. Depending on the severity, a pessary (shaped like a diaphragm or doughnut) can be used for women I feel would not be good surgical candidates. Essentially we fit a pessary to the woman until the right size is found. A pessary should be cleaned monthly, and I show women how to remove, clean and re-insert their pessary."

For her patients who elect surgery, Dr. Russell uses the Avaulta Solo™ Synthetic Support System. This system provides a nonabsorbable, monofilament, polypropylene mesh with trans-obturator tape to provide a ‘hammock’ to hold the pelvic canal in its original position.

"I’ve found this system to be better than traditional suturing of the vaginal plane to pull up the pelvic canal. The research I’ve read shows a higher failure rate with vaginal plane suturing, perhaps about 50% over five years. The polypropylene synthetic mesh ‘hammock’ has been shown to hold up over time, and still allow women the flexibility to resume their normal work and extracurricular activities.

"For the patient, the most difficult period is the six weeks post-surgery, when I want them to avoid activities that require stretching, straining or lifting."