Feeling pressure or bulging down there? Methodist is first in Nebraska to offer minimally invasive vNOTES prolapse repair

Many women experience symptoms of pelvic organ prolapse but hesitate to talk about them, assuming they’re a normal part of aging after childbirth. While prolapse is common, it’s not something women have to “just live with.”

Today, innovative surgical techniques are giving women more treatment options than ever – including a minimally invasive approach called vNOTES.

What is pelvic organ prolapse?

Pelvic organ prolapse occurs when the muscles and tissues that support the pelvic organs weaken, allowing the bladder, uterus, rectum or intestines to shift downward into the vagina. Women often describe the sensation as a bulge, pressure or feeling that something is “falling out.”

While prolapse can be alarming, it’s important to know that the organs will not suddenly fall out of the body. However, the condition can significantly affect comfort, confidence and quality of life.

Prolapse is extremely common and can affect women of all ages. In fact, it’s seen in roughly 40% of women during pelvic exams, and about 12% of women in the United States will undergo surgery for prolapse during their lifetimes.

Childbirth is a major risk factor, while aging, menopause, chronic constipation, straining and family history can also contribute.

What is vNOTES and who performs it for prolapse repair?

Vaginal natural orifice transluminal endoscopic surgery – or vNOTES – is a minimally invasive laparoscopic surgery performed through the vagina rather than through abdominal incisions.

Outside of pelvic organ prolapse repair, this approach can also be used for hysterectomy, ovary removal, tubal ligation and other gynecologic procedures.

Thanks to Methodist's commitment to innovative care, women with pelvic organ prolapse now have access to a surgical option that was not previously available in Nebraska. I'm grateful to offer this minimally invasive approach to a population whose health concerns have too often been undervalued, and to be part of a team committed to providing women the safest, most advanced treatment options available.

What are some other benefits of this approach?

Improved visualization during vNOTES may help reduce the risk of injury to nearby structures, including the bladder, bowel and ureters. 

Patients may also also benefit from:

• No visible abdominal scars
• Same-day discharge in most cases
• Less time under anesthesia
• Reduced postoperative pain
• Faster return to daily activities

Another important advantage is that some women with uterine prolapse may not need a hysterectomy, as vNOTES may allow them to keep their uterus while still receiving an effective prolapse repair.

Am I a candidate for vNOTES? What’s recovery like?

Most women go home just a few hours after surgery. Pain is typically minimal, and many patients return to their normal daily routines – including work and family responsibilities – within two to three weeks.

For approximately six weeks, patients should avoid heavy lifting, strenuous activity and placing anything inside the vagina while healing occurs.

Most women considering prolapse surgery are candidates for vNOTES. While certain conditions – such as very large fibroids or severe endometriosis – may require another surgical approach, there are few situations where minimally invasive options are not available.

So, I don’t just have to live with it?

For decades, women were often told to accept prolapse or urinary leakage as a normal part of life. Today, we know better.

These conditions may be common, but they’re not normal, and effective treatments are available. If symptoms interfere with your daily activities or quality of life, talk with your provider or seek care from a urogynecology specialist.

Don't be embarrassed. These conversations happen every day, and effective treatment options are available.

To learn more, talk to your provider or call Methodist Physicians Clinic Urogynecology at (402) 815-1700.