Minimally invasive robotic surgery offers quick recovery from prolapsed bladder

May 31, 2013

Andy Vu, DO, MHA, FACOG

Those who spend their working day on their feet know a little something about discomfort. Now, imagine adding pelvic pain and incontinence to that discomfort.

Just ask Deborah Boyce, who is a nurse. A quick trip to her doctor led to a referral to Andy Vu, DO, MHA, FACOG, a specialist in urogynecology, female pelvic medicine and reconstructive surgery for UNT Health. His diagnosis? Prolapsed bladder, an uncomfortable but often treatable malady.

Prolapsed bladders are commonly associated with aging. The biggest risk factors for prolapse are age and pregnancy (whether vaginal or cesarean). Other common risk factors are chronic coughing, constipation and obesity.

Symptoms of a Prolapsed Bladder The first symptom that women with a prolapsed bladder usually notice is the presence of tissue in the vagina that many women describe as something that feels like a ball. Other symptoms of a prolapsed bladder include the following: Discomfort or pain in the pelvis Tissue protruding from the vagina (The tissue may be tender and may bleed) Difficulty urinating A feeling that the bladder is not empty immediately after urinating (incomplete voiding) Stress incontinence (urine leakage during sneezing, coughing, or exertion) More frequent bladder infections Painful intercourse (dyspareunia) Low back pain

Symptoms of a Prolapsed Bladder

The first symptom that women with a prolapsed bladder usually notice is the presence of tissue in the vagina that many women describe as something that feels like a ball.

Other symptoms of a prolapsed bladder include the following:

Discomfort or pain in the pelvis
Tissue protruding from the vagina (The tissue may be tender and may bleed)
Difficulty urinating
A feeling that the bladder is not empty immediately after urinating (incomplete voiding)
Stress incontinence (urine leakage during sneezing, coughing, or exertion)
More frequent bladder infections
Painful intercourse (dyspareunia)
Low back pain

In women, the front wall of the vagina supports the bladder. This wall can weaken or loosen with age. Significant bodily stress such as childbirth can also damage this part of the vaginal wall. If it deteriorates enough, the bladder can prolapse, meaning it is no longer supported and descends into the vagina. This may trigger problems such as urinary difficulties and discomfort

Vu and Boyce decided that an abdominal prolapse repair called a sacrocolpopexy was the best option for her because it is a more durable surgery and arguably the gold standard for vaginal prolapse. This surgery is performed with small incisions and robotic arms controlled by the surgeon sitting in a console on the other side of the operating room. This minimally invasive surgery allows patients to recover quickly while enjoying the long term success of the traditional surgery. In the past, this same surgery used to require a large incision on the abdomen.

Since the surgery, Deborah feels 100 percent improved and now is symptom-free. She says of her surgeon, "I love Dr. Vu. He’s wonderful, caring and compassionate. He has made a huge difference in my everyday life and I would recommend him in a heartbeat."

"I want to help patients make an educated decision," said Vu. "Since there are so many surgical and non-surgical options, I try to spend a lot of time explaining the patient’s problem and helping them choose the best option for their situation."

To schedule an appointment with Dr. Vu, call 817-735-DOCS (3627). Visit UNTHealth.org for more information.

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