Anterior Vaginal Repair
Pelvic Floor Repair The most common surgery for prolapse is a pelvic floor repair, which is a broad term used to describe simple surgical repairs of the pelvic floor. More specifically, the term anterior repair refers to correction of the front wall of the vagina; and posterior repair . Laparoscopic colposuspension is a minimally invasive surgical technique that provides a safe and durable method for reconstruction of the pelvic floor and its contents without the need for a .
Vaginal Rejuvenation Vs. Pelvic Floor Reconstruction? A recent development in pelvic floor surgery is the advent of Vaginal Rejuvenation Surgery. This may how to get great grades in college different things to different people. As a pelvic floor surgeon it is ehat of the treatment for pelvic floor dysfunction. When the pelvic floor is damaged pelcic childbirth and further affected by hormone changes and gravity, it may become necessary to perform reconstructive surgery of the vagina.
As part of the correction of prolapse and incontinence the overall health of the vaginal support structures must be assessed and corrected. This often results in a return to a more normal vaginal anatomy, a narrowing of the vaginal opening, and a reconstruction of the space between the vaginal and rectal openings. This treats the gaping vaginal opening caused by childbirth. The wall of the vagina between the rectum and vagina recto-vaginal septum is reinforced rectocele repair as is the vaginal wall between the bladder and vagina cystocele repair.
A perineorrhaphy or reconstruction of the episiotomy tissues is the final piece of the puzzle. Reconstructing this area results in dhat sensation during sexual intercourse for the woman and her partner as well as enhanced muscle control in many cases.
Although these procedures result in better anatomy, better sexual function and better physiologic function better urination and sensationthey may also result in better appearance because when our anatomy is more normal, we feel more normal.
All the procedures described above are indicated surgeries although they may be scheduled how to unfreeze motorola droid razr maxx, at a flpor that suits the patient. These procedures are covered by most insurance policies as they are for real diagnoses. This should not be confused with "vaginal lfoor surgery" which is often described as vaginal rejuvenation.
These procedures are frequently not covered by insurance and are not related to the anatomy or function of the vagina but only appearance. Whereas reconstructive surgery can result in better appearance, rejuvenation surgery does not necessarily result in better function.
Labioplasty or surgical adjustment of the lips of the vagina is rarely necessary. I have performed what is a pelvic floor repair surgery in cases where the two lips of the vulva are uneven or exceptionally elongated. Otherwise, normal variations are just that, normal variations and should be left as is. Tampering too much with the labia can lead to scarring, areas of numbness, prolonged swelling, pain, and sometimes no improvement in sexual function.
Vaginal reconstruction is an effective tool in restoring normal sexual function and anatomy as well as improved appearance. Consulting with a urogynecologist will result in the best possible outcome. I recommend discussing your concerns with your gynecologist or requesting referral to a specialist. Learn more about myUCLAhealth. Toggle navigation. Patient Education. Pelvic Floor Reconstruction.
Here is a list of some things PT’s might teach their patients post surgery:
If your pelvic floor disease symptoms do not respond to conservative treatment your consultant may recommend surgery for pelvic floor repair. The muscles, ligaments and connective tissue that hold a women’s internal organs in place are called the pelvic floor. The bladder, bowel, uterus, vagina and rectum are held in place by the pelvic floor. Pelvic floor repair is a broad term used to classify a variety of simple, surgical procedures for repairing the pelvic floor. The three surgeries for pelvic floor prolapse include anterior repair, posterior repair, and a hysterectomy. Below is a general description of a common repair method. An incision is made along the center of the front wall of the vagina starting near the vaginal entrance and finishing near the top of the vagina. The vaginal skin is then separated from the underlying supportive fascial layer.
About 1 in 10 women who have had children require surgery for vaginal prolapse. A prolapse of the front anterior wall of the vagina is usually due to a weakness in the strong tissue layer fascia that divides the vagina from the bladder.
This weakness may cause a feeling of fullness or dragging in the vagina or an uncomfortable bulge that extends beyond the vaginal opening. It may also cause difficulty passing urine with a slow or intermittent urine stream or symptoms of urinary urgency or frequency. Another name for an anterior wall prolapse is a cystocele. Normal anatomy, no prolapse left and Anterior wall prolapse right.
An anterior repair, also known as an anterior colporrhaphy, is a surgical procedure to repair or reinforce the fascial support layer between the bladder and the vagina. The surgery can be performed under general, regional or even local anesthetic. Your doctor will discuss which is best for you. There are many ways to perform an anterior repair. Below is a general description of a common repair method. When you wake up from the anesthetics you will have a drip to give you fluids and may have a catheter in your bladder.
The surgeon may have placed a pack inside the vagina to reduce any bleeding into the tissues. Both the pack and the catheter are usually removed within 48 hours of the operation. It is normal to get a creamy discharge for 4 to 6 weeks after surgery.
This is due to the presence of stitches in the vagina. As the stitches absorb the discharge will gradually reduce. If the discharge has an offensive odor contact your doctor. You may get some blood-stained discharge immediately after surgery or starting about a week after surgery.
This blood is usually quite thin and old, brownish looking and is the result of the body breaking down blood trapped under the skin. There is a chance that the prolapse may come back in the future, or another part of the vagina may prolapse for which you need further surgery. With any surgery there is always a small risk of complications. The following general complications can happen after any surgery:.
In the early post-operative period, you should avoid situations where excessive pressure is placed on the repair, i. It is usually advisable to plan to take 2 to 6 weeks off work. Your doctor can guide you as this will depend on your job type and the exact surgery you have had.
You should be able to drive and be fit enough for light activities such as short walks within 2 to 3 weeks of surgery. You should wait five to six weeks before attempting sexual intercourse.
Some women find using additional lubricant during intercourse is helpful. Lubricants can easily be bought at supermarkets or pharmacies. Anterior Vaginal Repair Introduction About 1 in 10 women who have had children require surgery for vaginal prolapse.
What is anterior repair? Why is it performed? How is the surgery performed? What will happen to me after the operation? How successful is surgery? Are there any complications? When can I return to my usual routine? An incision is made along the center of the front wall of the vagina starting near the vaginal entrance and finishing near the top of the vagina. The vaginal skin is then separated from the underlying supportive fascial layer.
The weakened fascia is then repaired using absorbable stitches, which will absorb over 4 weeks to 5 months depending on the type of stitch suture material used. Sometimes excessive vaginal skin is removed. The vaginal skin is closed with absorbable sutures. These usually take 4 to 6 weeks to fully absorb. A cystoscopy may be performed to confirm that the appearance inside the bladder is normal and that no injury to the bladder or ureters has occurred during surgery.
A pack may be placed into the vagina and a catheter into the bladder at the end of surgery. If so, this is usually removed after hours. The pack acts like a compression bandage to reduce vaginal bleeding and bruising after surgery. Commonly, anterior vaginal repair surgery is combined with other surgery such as vaginal hysterectomy, posterior vaginal wall repair or incontinence surgery. These procedures are covered in detail in other leaflets in this series.
The following general complications can happen after any surgery: Anesthetic problems. With modern anesthetics and monitoring equipment, complications due to anesthesia are very rare. Post-operative infection. Although antibiotics are often given just before surgery and all attempts are made to keep surgery sterile, there is a small chance of developing an infection in the vagina or pelvis. Symptoms include burning or stinging when passing urine, urinary frequency, and sometimes blood in the urine.
Cystitis is usually easily treated by a course of antibiotics. The following complications are more specifically related to anterior vaginal wall repair: Constipation is a common post-operative problem and your doctor may prescribe laxatives for this.
Try to maintain a high fiber diet and drink plenty of fluids to help as well. Pain with intercourse dyspareunia.
Some women develop pain or discomfort with intercourse. While every effort is made to prevent this from happening, it is sometimes unavoidable. Some women also find intercourse is more comfortable after their prolapse is repaired. Damage to the bladder or ureters during surgery is an uncommon complication which can be repaired during surgery.
After a large anterior vaginal wall repair some women may develop stress urinary incontinence due to the unkinking of the urethra tube from the bladder. This can usually be resolved by doing pelvic floor exercises as taught by a specialist pelvic floor physiotherapist or by surgery to support the urethra see the leaflet on stress urinary incontinence. Mesh complications. Occasionally vaginal pain, groin or thigh pain can develop associated with the mesh, requiring part or all of the mesh to be removed.
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