Prolapses of the pelvic organs are common problems, particularly in elderly and multiparous women, that is, those who have had many children.
Although complaints presented by a patient usually relate to the most affected pelvic organs or compartments – rectum, vagina and uterus or bladder – the association between two or even three compartments is quite common. It’s called “multicompartmental prolapse”.
Because there is an overlap of medical specialties addressing pelvic floor’s diseases, patients may seek a gynecologist, an urologist or a colorectal surgeon, who tend to always consider only their specialties. Treatment directed to only one of the compartments, not considering the others, is a frequent cause of poor surgical outcomes.
The multidisciplinary understanding of the pelvic floor has changed the way surgeons face these problems: there is a tendency to preserve structures such as the uterus and cervix and to approach, in a combined way, all the compartments involved.
The PPS, or Pelvic Prolapse Surgery, was described by Prof. Antonio Longo and, since then, has been increasingly used, particularly in Europe. It proposes the suspension of the uterine cervix or the apex of the vagina, which are fixed to the anterior abdominal wall by using an nonabsorbable mesh. Other procedures may be associated at the same surgical time, or even later.
Preoperative evaluation is crucial for selecting the best candidates and for better planning the procedure.