Pelvic Floor Reconstruction
Advanced Surgical Treatment for Pelvic Organ Prolapse
Pelvic Floor Reconstruction is a surgical approach designed to restore support to pelvic organs when the muscles, ligaments, and connective tissues of the pelvic floor have weakened or become damaged.
Pelvic floor support may change after pregnancy and childbirth, menopause, previous pelvic surgery, hysterectomy, chronic straining, aging, or other conditions that place repeated pressure on the pelvic floor.
When this support is compromised, one or several pelvic organs may descend from their normal position, resulting in pelvic organ prolapse.
At her Hallandale Beach practice, Dr. Mariana Bubucea provides comprehensive evaluation and individualized surgical planning for women with pelvic floor disorders and pelvic organ prolapse.
The goal of pelvic floor reconstruction is not simply to correct a vaginal bulge. Treatment is planned to restore pelvic support while taking into consideration bladder function, bowel function, vaginal anatomy, sexual health, previous surgeries, lifestyle, and the patient's individual goals.
What Is Pelvic Floor Reconstruction?
The pelvic floor is a complex support system consisting of muscles, connective tissues, fascia, and ligaments that help maintain the normal position of the:
Bladder
Urethra
Uterus and cervix
Vagina
Rectum
Weakness or damage to these supporting structures can cause one or more organs to descend into or through the vaginal canal.
Pelvic Floor Reconstruction refers to surgical procedures used to restore this support and correct the areas affected by prolapse.
Because pelvic organ prolapse may involve several anatomical compartments at the same time, pelvic floor reconstruction is highly individualized. There is no single operation that is appropriate for every patient.
Conditions That May Require Pelvic Floor Reconstruction
Pelvic floor reconstruction may be considered for women with symptomatic or advanced pelvic organ prolapse, including:
Bladder Prolapse — Cystocele
A cystocele occurs when the supporting tissues between the bladder and vagina weaken, allowing the bladder to descend toward the vaginal canal.
Women may experience pelvic pressure, a vaginal bulge, urinary symptoms, or difficulty completely emptying the bladder.
Rectocele — Posterior Vaginal Wall Prolapse
A rectocele develops when the tissues supporting the posterior vaginal wall weaken and the rectum pushes toward the vagina.
Symptoms may include pelvic pressure, constipation, difficulty completing bowel movements, or the need to apply vaginal pressure to assist with bowel evacuation.
Uterine Prolapse
Uterine prolapse occurs when the supporting structures of the uterus weaken, allowing the uterus and cervix to descend into the vaginal canal.
The degree of prolapse can range from mild descent to advanced prolapse extending outside the vaginal opening.
Apical or Vaginal Vault Prolapse
The upper portion of the vagina may lose support and descend downward. This can occur with the uterus present or following hysterectomy.
Restoring adequate apical support is an important component of reconstruction when this area is affected.
Multi-Compartment Pelvic Organ Prolapse
Some women have prolapse involving more than one area of the pelvic floor.
For example, bladder prolapse may occur together with uterine or apical prolapse and posterior vaginal wall weakness.
In these situations, treatment planning requires evaluation of the pelvic floor as an interconnected support system rather than addressing only the most visible area of prolapse.
Symptoms of Pelvic Floor Prolapse
Women with pelvic floor dysfunction may experience:
Vaginal bulging or protruding tissue
Pelvic pressure or heaviness
A sensation that something is “falling out”
Symptoms that become worse after prolonged standing or physical activity
Difficulty emptying the bladder
Frequent or urgent urination
Urinary leakage
Recurrent urinary tract infections
Difficulty with bowel movements
Constipation or incomplete bowel emptying
The need to manually support the vagina during bowel movements
Discomfort or changes during sexual activity
Lower pelvic or vaginal discomfort
Difficulty exercising or performing normal daily activities
The anatomical severity of prolapse does not always correspond directly with symptom severity. For this reason, treatment decisions should be based on both the physical findings and how the condition affects the patient's quality of life.
Your Pelvic Floor Evaluation with Dr. Mariana Bubucea
Before recommending Pelvic Floor Reconstruction, Dr. Mariana Bubucea performs a comprehensive Pelvic Floor Evaluation.
Your consultation begins with a detailed discussion of your symptoms, pregnancies and childbirth history, previous pelvic or abdominal surgeries, bladder and bowel function, sexual health, medical conditions, and treatment goals.
The evaluation may include:
Comprehensive pelvic examination
Evaluation of the anterior and posterior vaginal walls
Assessment of uterine and apical support
POP-Q prolapse measurements
Pelvic floor muscle assessment
Urinalysis or urine culture when indicated
Measurement of post-void residual urine
Cough stress testing
Urodynamic testing when clinically appropriate
Pelvic ultrasound or additional imaging when needed
This evaluation allows Dr. Bubucea to determine which structures have lost support, the stage of prolapse, whether multiple compartments are involved, and whether associated urinary dysfunction or incontinence is present.
Is Surgery Always Necessary?
No.
Pelvic organ prolapse does not automatically mean that surgery is required.
For some women, particularly those with mild prolapse or limited symptoms, conservative Prolapse Management may be appropriate.
Depending on the individual situation, treatment options may include:
Observation and periodic evaluation
Pelvic floor rehabilitation
Lifestyle modifications
Management of constipation and chronic straining
Pessary support
Vaginal therapy when clinically appropriate
Treatment of contributing bladder or bowel conditions
Surgery may be considered when prolapse becomes more advanced, causes significant symptoms, interferes with normal activities, affects bladder or bowel function, or when conservative management does not provide adequate relief.
Individualized Pelvic Floor Reconstruction
When surgery is appropriate, the procedure is selected according to the patient's anatomy and the specific areas requiring restoration.
A reconstruction may involve one or more components.
Anterior Vaginal Wall Repair
Anterior repair may be performed when weakness of the front vaginal wall contributes to bladder prolapse or cystocele.
The goal is to restore support between the bladder and vaginal wall.
Posterior Vaginal Wall Repair
Posterior repair may be considered when weakness between the rectum and vagina results in rectocele.
The procedure is designed to reinforce posterior vaginal support and restore anatomy.
Apical Support Reconstruction
When the uterus or upper vagina has lost support, reconstruction may focus on restoring the vaginal apex to an appropriate anatomical position.
Adequate apical support can be particularly important in women with advanced or multi-compartment prolapse.
Uterine or Vaginal Suspension
Depending on the patient's anatomy, previous surgeries, and treatment goals, surgical suspension may be used to restore support to the uterus or vaginal apex.
Multi-Compartment Reconstruction
When several areas of the pelvic floor are affected, Dr. Bubucea may develop a comprehensive surgical plan designed to address the involved compartments during the same reconstructive strategy when clinically appropriate.
Minimally Invasive Pelvic Floor Surgery
Advances in gynecologic and pelvic reconstructive surgery allow many procedures to be performed using minimally invasive techniques.
Depending on the condition and planned reconstruction, surgery may be performed through a vaginal, laparoscopic, or robotic-assisted approach.
The appropriate surgical route depends on multiple factors, including:
Type and severity of prolapse
Areas of the pelvic floor involved
Previous pelvic or abdominal surgeries
Presence or absence of the uterus
Bladder and bowel symptoms
Urinary incontinence
Overall medical condition
Individual treatment goals
Dr. Bubucea evaluates these factors before recommending a surgical approach.
Robotic Pelvic Floor Surgery
For selected patients, Robotic Pelvic Floor Surgery may be considered as part of pelvic floor reconstruction.
Robotic-assisted techniques allow the surgeon to operate through small abdominal incisions while using enhanced visualization and highly controlled surgical instruments.
This approach may be useful for certain procedures involving restoration of apical or vaginal support.
Potential advantages of a minimally invasive approach may include smaller incisions and reduced postoperative discomfort compared with traditional open abdominal surgery; however, recovery and outcomes depend on the individual procedure and patient's medical condition.
Not every prolapse requires robotic surgery. The surgical approach is selected only after a complete evaluation.
Pelvic Floor Reconstruction and Urinary Incontinence
Pelvic organ prolapse and urinary incontinence frequently occur together.
In some women, significant prolapse can also change the position of the bladder and urethra and may temporarily conceal stress urinary incontinence.
For this reason, evaluation of bladder function is an important part of surgical planning.
Depending on your symptoms and examination findings, Dr. Bubucea may recommend additional testing, including cough stress testing, measurement of post-void residual urine, or urodynamic testing.
If clinically indicated, treatment of urinary incontinence may be incorporated into the overall surgical plan.
What Happens After Your Evaluation?
After your examination and any necessary diagnostic testing, Dr. Mariana Bubucea will review the findings with you.
You will receive an explanation of:
The type of prolapse present
The stage and severity of the prolapse
Which pelvic floor compartments are involved
Whether bladder dysfunction or urinary incontinence is also present
Whether conservative management remains appropriate
Whether surgical reconstruction should be considered
Which surgical approaches may be appropriate for your anatomy
What recovery may involve
Potential benefits, limitations, and risks of the recommended treatment
The decision to proceed with Pelvic Floor Reconstruction is made after discussing the available options and considering your symptoms, medical condition, lifestyle, and personal goals.
A Comprehensive Approach to Pelvic Floor Reconstruction
Successful prolapse treatment requires more than identifying the organ that has descended.
The pelvic floor functions as an interconnected anatomical system.
For women with complex or multi-compartment prolapse, Dr. Mariana Bubucea develops an individualized Pelvic Floor Reconstruction plan designed around the patient's complete pelvic anatomy and functional needs.
The objective is to restore pelvic support while considering:
Anatomy. Bladder function. Bowel function. Sexual health. Quality of life. Long-term pelvic support.
Schedule a Pelvic Floor Reconstruction Consultation
If you have been diagnosed with pelvic organ prolapse or are experiencing a vaginal bulge, pelvic pressure, bladder problems, difficulty with bowel movements, or symptoms that interfere with your everyday activities, a comprehensive pelvic floor evaluation can help determine your treatment options.
Schedule a consultation with Dr. Mariana Bubucea to discuss Pelvic Floor Reconstruction, Prolapse Repair, minimally invasive surgery, and Robotic Pelvic Floor Surgery when clinically appropriate.
Dr. Mariana Bubucea, MD
2500 E Hallandale Beach Blvd, Suite 401
Hallandale Beach, FL 33009 — 4th Floor
Phone: 954-395-2585
Fax: 954-395-2584
Office Hours:
Monday–Friday: 9:00 AM–5:00 PM
Saturday–Sunday: Closed
Languages spoken: English, Russian, and Romanian.
Serving women from Hallandale Beach, Aventura, Hollywood, Miami, Fort Lauderdale, and throughout South Florida.
Schedule your consultation with Dr. Mariana Bubucea to receive a comprehensive pelvic floor evaluation and an individualized treatment plan.