Anterior vaginal wall repair
A/P repair; Vaginal wall repair; Posterior vaginal wall repair; Colporrhaphy - repair of vaginal wall; Cystocele repair; Uterine prolapse - vaginal wall repair; Urinary incontinence - vaginal wall repair
Anterior vaginal wall repair is a surgical procedure. This surgery tightens the front ( anterior ) wall of the vagina.
Anterior
Anterior means "in front of" or "the front surface of. " It usually refers to the front side of the body. For example, your knee caps are on the ant...
Description
The anterior vaginal wall can sink (prolapse) or bulge. This occurs when the bladder or the urethra sink into the vagina.
The repair may be done while you are under:
-
General anesthesia
: You will be asleep and unable to feel pain.
General anesthesia
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...
-
Spinal anesthesia
: You will be awake, but you will be numb from the waist down and you will not feel pain. You will be given medicines to help you relax.
Spinal anesthesia
Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine....
Your surgeon will:
-
Make a surgical cut through the front wall of your
vagina
.
Vagina
The vagina is the female body part that connects the womb (uterus) and cervix to the outside of the body.
- Move your bladder back to its normal location.
- May fold your vagina, or cut away part of it.
- Put sutures (stitches) in the tissue between your vagina and bladder. These will hold the walls of your vagina in the correct position.
- Place a patch between your bladder and vagina. This patch can be made of man-made material (synthetic skin) or commercially available biological material (such as pig skin).
- Attach sutures to the walls of the vagina to the tissue on the side of your pelvis.
Sometimes, the surgeon will also make a surgical cut in your belly. This cut may be up and down or across.
Why the Procedure Is Performed
This procedure is used to repair sinking or bulging of the vaginal wall.
Symptoms of uterine prolapse include:
Uterine prolapse
Uterine prolapse occurs when the womb (uterus) drops down and presses into the vaginal area.
- You may not be able to empty your bladder completely.
- Your bladder may feel full all the time.
- You may feel pressure in your vagina.
- You may be able to feel or see a bulging at the opening of the vagina.
- You may have pain when you have sex.
- You may leak urine when you cough, sneeze, or lift something.
- You may get bladder infections.
This surgery by itself does not treat stress incontinence . Stress incontinence is the leaking of urine when you cough, sneeze, or lift. It may be performed along with other surgeries.
Stress incontinence
Stress incontinence occurs when your bladder leaks urine during physical activity or exertion. It may happen when you cough, lift something heavy, c...
Before doing this surgery, your provider may have you:
-
Learn pelvic floor muscle exercises (
Kegel exercises
)
Kegel exercises
Kegel exercises can help make the muscles under the uterus, bladder, and bowel (large intestine) stronger. They can help both men and women who have...
- Use estrogen cream in your vagina
- Try a device called a pessary in your vagina to hold up the prolapse
Risks
Risks of anesthesia and surgery in general are:
- Reactions to medicines
- Breathing problems
- Bleeding, blood clots
- Infection
Risks of this procedure include:
- Damage to the urethra, bladder, or vagina
- Irritable bladder
- Changes in the vagina (prolapsed vagina)
- Urine leakage from the vagina or to the skin (fistula)
-
Worsening
urinary incontinence
Urinary incontinence
Urinary (or bladder) incontinence happens when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries...
Before the Procedure
Always tell your provider what drugs you are taking. Also tell the provider about the drugs, supplements, or herbs you bought without a prescription.
During the days before the surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
- Ask your provider which drugs you should still take on the day of your surgery.
On the day of your surgery:
- You very often will be asked not to drink or eat anything for 6 to 12 hours before the surgery.
- Take the medicines your provider told you to take with a small sip of water.
- Your provider will tell you when to arrive at the hospital.
After the Procedure
You may have a catheter to drain urine for 1 or 2 days after surgery.
Catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
You will be on a liquid diet right after surgery. When your normal bowel function returns, you can return to your regular diet.
Outlook (Prognosis)
This surgery will very often repair the prolapse and the symptoms will go away. This improvement will often last for years.
References
Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J . 2011;22(11):1445-1457. PMID: 21927941 www.ncbi.nlm.nih.gov/pubmed/21927941 .
Winters JC, Smith AL, Krlin RM. Vaginal and abdominal reconstructive surgery for pelvic organ prolapse. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 83.
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Anterior vaginal wall repair - illustration
Anterior vaginal wall repair is a procedure performed to improve urinary continence. The pubocervical fascia is folded and stitched to bring the bladder and urethra into the proper position.
Anterior vaginal wall repair
illustration
-
Cystocele - illustration
A cystocele is an downward outpocketing or hernia of the bladder towards the vaginal opening. The weakening of the muscular wall in this condition can cause urine to leak from the bladder when there is an increase in internal abdominal pressure such as in sneezing or coughing. Surgery such as an anterior vaginal wall repair may help this condition.
Cystocele
illustration
-
Anterior vaginal wall repair (Surgical treatment of urinary incontinence) - series
Presentation
-
Anterior vaginal wall repair - illustration
Anterior vaginal wall repair is a procedure performed to improve urinary continence. The pubocervical fascia is folded and stitched to bring the bladder and urethra into the proper position.
Anterior vaginal wall repair
illustration
-
Cystocele - illustration
A cystocele is an downward outpocketing or hernia of the bladder towards the vaginal opening. The weakening of the muscular wall in this condition can cause urine to leak from the bladder when there is an increase in internal abdominal pressure such as in sneezing or coughing. Surgery such as an anterior vaginal wall repair may help this condition.
Cystocele
illustration
-
Anterior vaginal wall repair (Surgical treatment of urinary incontinence) - series
Presentation
Review Date: 5/23/2016
Reviewed By: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.