Anterior Vaginal Wall Repair

What is anterior vaginal wall repair?

Vaginal prolapse is usually corrected by performing a surgery called anterior vaginal wall repair. When something prolapses, it means it is no longer in position. For anterior vaginal wall prolapse, the bladder or urethra moves out of its original position into the vagina. The bladder is the organ responsible for the storage of urine while the urethra transports urine from the bladder. Anterior vaginal wall repair makes the front wall of the vagina tight. It also strengthens the surrounding muscles and soft tissues while helping the bladder or urethra to retain its proper position.

Anterior vaginal wall repair
Photo Credit: ADAM

Symptoms

Majority of cases are devoid of symptoms. For the symptomatic cases, the core presenting features are:

  • Dyspareunia, meaning painful sexual intercourse
  • The vagina feels full and is uncomfortable
  • Pelvic region feels full , like it would come down
  • Low back pain that is relieved on lying down
  • Urinary frequency with associated stress incontinence

Talk to a doctor if these symptoms are noticed as it could be vaginal prolapse requiring anterior vaginal wall repair.

Causes of vaginal prolapse

Various factors contribute to the development of vaginal prolapse. The following conditions serve as risk factors to the development of vaginal prolapse:

  • Cyesis, meaning pregnancy
  • Vaginal delivery
  • Increased body weight
  • Straining during defecation
  • Lifting heavy loads
  • Cough lasting over a month

Prevention of vaginal prolapse

  • Having and maintaining a normal weight
  • Treating cough adequately to prevent progression
  • Taking fruits or applying modalities to prevent chronic constipation
  • Ensure to bend knees when carrying heavy objects as that is the proper way

After effects of vaginal surgery

In general, interventions are carried out provided the benefits outweigh the risks. For anterior vaginal wall repair, the following are likely to occur after surgery:

  • Dysuria, meaning painful micturition
  • Urinary frequency
  • Urinary incontinence
  • Urethral, vaginal or bladder damage

These possible effects are usually discussed prior to performing the surgery.

Preparations for surgery

Surgery is usually performed on a stomach that isn’t full so it doesn’t pose an anesthetic risk thus fasting prior to surgery for at least 8 hours is usually advised. Avoid aspirin to prevent blood clotting issues, ibuprofen and naproxen should also be avoided. In general, medications that possibly cause bleeding are avoided. Blood-thinning drugs are also adjusted if use must be continued.

Surgical procedure

The anesthesia used could be general anesthesia (GA) or spinal anesthesia. In GA, one is asleep and does not feel pain. For spinal anesthesia, numbness is below the waist though one is awake. A cut is made in the anterior wall of the vagina and from there, the bladder or urethra is repositioned in its anatomical site. The organs are held in place by the surgical stiches in the tissues found between the vagina and bladder. More tissue can be removed from the vagina for the sole purpose of tightening the muscles and ligaments.

Post-surgery

Hospital stay for the next few days following surgery is recommended for close monitoring. Bladder may be affected and a catheter should be used for s few days too. A catheter serves for the removal of using from the bladder without actively voiding.

Liquid diet is first recommended then semi-solid before solid foods are then taken.

Outlook

Majority of the surgical repairs are successful. Most women who have undergone surgery show a reduction in prior symptoms. Any complications experienced after surgery should be communicated to the doctor who will offer information about treatment options and longer-term outlook.

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