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Vaginal & Perinial Plastic Surgery

Anterior vaginal wall repair

Anterior vaginal wall repair is a surgical procedure that tightens the front (anterior) vaginal wall to repair the sinking of the bladder into the vagina or the sinking of the urethra into the vagina.

To perform the anterior vaginal repair, the doctor makes a surgical cut through the vagina to release part of the front (anterior) vaginal wall that is attached to the base of the bladder. Tissue between the vagina and bladder is folded and stitched to bring the bladder and urethra into the right position. There are several different versions of this procedure that may be necessary, based on the amount of bulging or sinking.

This procedure is used to repair the vaginal wall sinking (prolapse) or bulging (herniation) that occurs with urethrocele or cystocele. This surgery by itself does not treat stress incontinence.

In mild cases of cystocele, your doctor may recommend trying pelvic floor muscle exercises (Kegel exercises) first, before using surgical treatment. In some women, a device placed in the vagina to hold up the prolapse (pessary) can be used to avoid surgery.

BRIEF ABOUT THE PROCEDURE

This procedure may be performed using general or spinal anesthesia. You may have a foley catheter in place for 1 - 2 days after surgery.

The visible area between the vagina and the rectum is called the perineum. This is the region where episiotomies are cut and where tears during childbirth are most common. Perineoplasty (or Perineorrhaphy) aims to make this region appear normal by excising excess skin, loose skin tags and suturing the underlying muscles or the perineal body closer together to give a more snug feeling in the introitus or vaginal opening. Most plastic surgeons that perform vaginoplasty surgery are actually performing Perineoplasty surgery, a more superficial procedure that does not tighten the entire depth of the vaginal canal. This procedure has been shown to “Enhance Sexual Gratification.” The procedure almost always accompanies vaginoplasty since you are working in the same area. This procedure takes 30 minutes to perform.

Liquid diet will be given immediately after surgery, followed by a regular diet when normal bowel function returns. Your health care provider may prescribe stool softeners and laxatives to prevent straining with bowel movements, because this can cause stress on the area where surgery was performed. A similar procedure can be performed on the back wall of the vagina to repair a rectocele.

Risks as in the case of any surgery are bleeding, infection and injury to surrounding structures.

Possible complications from anterior vaginal repair include:

  • Inability to urinate
  • Injury to the bladder
  • Urinary tract infection

Women treated with this procedure for cystocele have an excellent chance that the prolapse will be cured. This improvement will usually last for years but in some cases the tissue weakens with time and other procedures may be necessary to treat the symptoms.

It is advised to avoid activities that cause an increase in abdominal pressure, such as straining, lifting, sneezing and coughing for several weeks to months after your surgery. Stool softeners or gentle laxatives to prevent constipation and straining with bowel movements amy be given. Sexual intercourse will have to be avoided till proper healing takes place.

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