Anterior Posterior Vaginal 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 perineal body.
The cause of pelvic wall relaxation is a weakening of the pelvic support structures (see the Figure 1 and Figure 2). 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 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 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 be:
- Abnormal increases in abdominal pressure.
- Inherited weakness of the supporting tissues of the pelvic floor.
- Extraordinary tension placed on the supporting tissues due to a chronic cough.
Anterior Posterior Vaginal 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.
Figure 1: Anterior Vaginal Wall Prolapse
Figure 2: Posterior Vaginal Wall Prolapse
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, less risk of vessel and tissue damage, precise and accurate surgical wound control, and quicker recovery time and better overall results