Definition:
Anterior vaginal wall repair is surgery that tightens the front (anterior) wall of the vagina. It is done to help with the sinking of the bladder into the vagina (cystocele), or the sinking of the urethra into the vagina (urethrocele or urethral hypermobility).
Alternative Names:
A/P repair; Vaginal wall repair; Anterior and/or posterior vaginal wall repair; Colporrhaphy- repair of vaginal wall; Cystocele repair
Description:
This procedure may be done while you are under general or spinal anesthesia. Under general anesthesia, you will be unconscious and unable to feel pain. With spinal anesthesia, you will be awake, but you will be numb from the waist down and you will not feel pain. Usually, an incision (cut) is made through the front wall of your vagina. - Your bladder is moved back to its normal location.
- Your vaginal wall may be folded, or part of it may be cut away.
- Sutures (stitches) are made in the tissue between your vagina and bladder. These sutures will hold the walls of your vagina in the correct position.
- Your doctor may place synthetic (man-made) material between your bladder and vagina.
- If needed, sutures attach the walls of the vagina to the tissue on the side of your pelvis.
Sometimes, your doctor also makes an incision in your belly. This incision may be up and down or across.
Why the Procedure Is Performed:
This procedure is used to repair the sinking of the vaginal wall (prolapse) or bulging that occurs when the bladder or urethra sink into the vagina. Symptoms of prolapse that you may have include: - 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 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 (leaking urine when you cough, sneeze, or lift). It may be performed along with other surgeries. Before doing this surgery, your doctor may have you learn pelvic floor muscle exercises (Kegel exercises), use estrogen cream in your vagina, or try a device called a pessary in your vagina to hold up the prolapse.
References:
Herschorn S. Vaginal reconstructive surgery for sphicteric incontinence and prolapse. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 66. Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2007;3:CD004014.
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