Ambulatory Procedure >>
Vaginal and Minimally Invasive Procedures continued
Table of Contents
Anterior Repair (Colporrhaphy)
Even though the anterior repair is the most commonly utilized operation for correction of a cystocele, anterior vaginal wall repair is probably not the most effective, nor is anterior repair the correct operation for restoring a woman's anatomy and maintaining vaginal length and function. The problem with using anterior bladder or vaginal wall repair in young, healthy, sexually-active woman with a paravaginal defect (cystocele) is the surgeon does not really surgically support the bladder, but instead reduces the bulge by "scrunching " the fascia under the bladder together. The anterior repair for a cystocele should or can be utilized in patients with:
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Midline defects |
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Defects which are not paravaginal defects |
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Cystocele of any type in patient whose vaginal function and length is not important |
Anterior vaginal wall repair operations are performed through the opening of the vagina and can be performed under general, regional (spinal or epidural) or local anesthesia. Dissecting the overlying vaginal skin from the underlying pubocervical fascia begins the anterior repair operation. The defect in the fascia is identified and repaired using suture. The excess vaginal skin is removed. Often the skin stretches and only the excess should be removed. Finally the vaginal skin is closed using suture. The anterior vaginal wall repair operation is one of the least traumatic operations performed in vaginal wall reconstruction.
Anterior Repair Figure: 1 |
Normal Support - side view |
Anterior Repair Figure: 2 |
Cystocele - Midline defect in pubocervical fascia (side view)
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