Anterior Posterior Vaginal Wall Repair for Pelvic Organ Prolapse 1
When the muscles and ligaments supporting a woman’s pelvic organs weaken, the pelvic organs can slip out of place (prolapse). Pelvic organ prolapse can worsen over time and you may need surgery to fix it.
This is due to the fact that the muscles of the perineum, the group of supporting muscles located below the low part of the vaginal opening become thin and the mid-line begins to deviate, thus leading to a weakened, poorly supportive, thinned out perennial body.
The cause of pelvic wall relaxation is a weakening of the pelvic support structures (see the illustration below). The pelvic organs include the vagina, uterus, bladder, and the rectum. These organs are kept in place with the help of 3 support systems from muscles, ligament sheets and fascia.
During the course of childbirth, as the baby journeys through the birth canal, these supports become damaged and tend to become weakened. This weakening increasingly worsens, and further on down the line, may cause the pelvic organs to shift from their normal positions.
The underlying cause of pelvic support faults or defects are:
Birth trauma such as multiple vaginal deliveries
Difficult or prolonged deliveries (the use of forceps)
Aging (lack of estrogen resulting from menopause)
Tearing or cutting of the vaginal opening for delivery
Chronic constipation and stress (affecting bowel movement)
After a hysterectomy, as it needs the cutting or damaging various pelvic floor muscles including the ligaments and tissues supporting the upper vagina around the cervix
Every once in a while, the weakening of the muscles and tissues of the vaginal wall can occur to women who have never birthed a child. In these women, the underlying cause(s) may will be:
Anterior Posterior Vaginal Wall Repair is a surgery for the loss of optimal structural integrity of the anterior and the posterior walls of the vagina, resulting in different organs around the vaginal walls pushing and forming a bulge into the vagina or the vaginal opening.
Because of technological advances, gynecology procedures involving the use of laser have been utilized in anterior-posterior vaginal repair. Advantages of laser over old, conventional scalpel procedure include: less blood loss, little or less risk of vessel and tissue damage, precise and accurate surgical wound control, and quicker recovery time and better overall results
There are 4 methods of correcting prolapse of the vagina as follows.
1) The Kegel exercise is safe but would have to take 6 months until results would show, and does not guarantee full effectiveness.
2) The posterior vaginal repair is the procedure to narrow the diameter of the vagina which results to a smaller and tighter vaginal canal and opening. However, this procedure also has its limitations in patients with multiple deliveries.
3) The Anterior and Posterior Vaginal Repair is the surgical repair of pelvic prolapse by entailing the surgical removal of excess anterior and posterior vaginal tissues as well as bladder and rectum prolapse, thereby correcting the prolapse, at the same time tightening the vagina.
4) The Incisionless Laser Vaginal Tightening is a new trend of innovation to the Cosmetic Gynecology for mild to moderate pelvic prolapse, this procedure has limitations and cannot guarantee the results and satisfaction. After the procedure you will experience less pain and no bleeding, compared with the surgical or incision laser method. The post-operative care is only refraining from sexual intercourse for 1-2 weeks after the procedure.
General Notes & Precautions
1) Important points to consider about A-P vaginal repair
- Anterior Posterior Vaginal Repair is a surgical procedure designed for the removal of excess anterior and posterior vaginal wall tissues bulging into the vagina. Consequently, the Pelvic Organ Prolapse or Vaginal Relaxation will be corrected and the vagina will become more tightened.
- Anterior Posterior Vaginal Repair has limitations and cannot absolutely ensure satisfactory results because there are so many factors affecting the surgery’s success. The procedure is not recommended unless the patient has any discussion with her spouse because this may lead to problems and misunderstandings caused by refraining from sexual intercourse for quite a time.
- In case of unexpected surgical results or complications, corrective surgery is an option and will be discussed between the patient and the surgeon. If correction surgery is needed due to the complication of the surgery, all expenses for services and treatment will no longer be charged to you. However, if the unsatisfactory results occur due to the complication from your non-compliance with the doctor’s orders, you will be charged accordingly.
- Anterior-Posterior Vaginal Repair is one of the most complex and meticulous cosmetic surgeries performed today. It requires extensive experience, precision, and accuracy to create the optimal results the patient desires and deserves. Many surgeons have little to no experience with this type of advanced cosmetic surgery. The patient should research and be conscious of the surgeon’s educational background, training, and practical experience.
2) Urinary Stress Incontinence and A-P Vaginal Wall Repair
- In this regard, the A-P Vaginal Repair is not a permanent solution to Urinary Stress Incontinence, which may be experienced by the patient 5 years after the surgery.
3) Before the procedure: Anterior Posterior Vaginal Wall Repair
- Dr. Vitasna will investigate the patient’s health history, conduct a general check-up and internal check-up. Should the patient have vaginal fungal or bacterial infection, she should completely treat it before the procedure to avoid wound infection.
- Anterior Posterior Vaginal Wall Repair is not allowed for women with immunodeficiency. In addition, the patient must not become pregnant nor plan to become pregnant in the next 3 months despite no research about the disadvantage to the pregnancy and the newborn. In case of existing diseases or drug hypersensitivity, please inform the physician or the staff before the procedure.
- Dr. Vitasna will educate the patient with the methods or techniques, processes of the surgery and some potential post-operative complications prior to decision-making.
- The important preparations the patient should know before the surgery are that within 3-5 days after the surgery she should take a rest (refrain from work) and be still to enable the wound to heal faster. Avoid constipation and have a less movement as possible to avoid wound disruption for 1-2 weeks after the surgery. The patient should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for 6 weeks.
Anterior Vaginal Wall Prolapse
Posterior Vaginal Wall Prolapse
The cost of the procedure will include professional fees for the anesthesiologist and the surgeon, all the instruments, medicines used during the procedure, and the home medications as well. However, fees for laboratory work-up for other existing diseases that patient may have and the professional fees for the anesthesiologist and the surgeon for corrective surgery is not included in the package.