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Ambulatory Procedure
Ambulatory Procedure Table of Contents
- Anterior Repair
- Posterior Repair
- Elevate Procedures
- Colpocleisis (Lefort)
- Mini-Sling (Incontinence Surgery)
- Tension Free Vaginal Tape (TVT) sling procedure (Incontinence Surgery)
- Transobturator Tape (TOT) sling procedure (Incontinence Surgery)
- Perineoplasty (reconstruct vaginal opening)
- Interstim Therapy
Anterior Repair (Colporrhaphy)
Even though the anterior repair is the most commonly utilized operation for correction of a cystocele, anterior repair is probably not the most effective, nor is it the correct operation for restoring a woman's anatomy and maintaining vaginal length and function. The problem with using anterior repair operation in young healthy sexually active woman with a paravaginal defect (cystocele) is the surgeon does not really surgically support the bladder, but instead reduces the bulge by "scrunching " the fascia under the bladder together. The anterior repair should or can be utilized in-patients with:
- Midline defects
- Defects which are not paravaginal defects
- Cystocele of any type in patient whose vaginal function and length is not important
- Cystocele of any type in sexually inactive patients
Anterior repair operations are performed through the opening of the vagina and can be performed under general, regional (spinal or epidural) or local anesthesia. Dissecting the overlying vaginal skin from the underlying pubocervical fascia begins the procedure. The defect in the fascia is identified and repaired using suture. The excess vaginal skin is removed. Often the skin stretches and only the excess should be removed. Finally the vaginal skin is closed using suture. The operation is one of the least traumatic operations performed in vaginal wall reconstruction.
Midline defect in pubocervical fascia (side view)