Complete reconstruction of the vaginal walls
Combined prolapse is the most common option in women who have given birth: the bladder and rectum sag at the same time, and the genital gap gapes. The surgeon sequentially performs anterior colporrhaphy with strengthening of the fascia under the bladder (in case of incontinence - with support for the bladder neck), then posterior colporrhaphy with restoration of the rectovaginal septum and perineorrhaphy - suturing the levators and forming the perineum. The result is the elimination of protrusion, normalization of urination and defecation, narrowing of the vagina and restoration of sensations. The operation can be combined with a vaginal hysterectomy or fixation of the uterus when it prolapses.
Indications
- prolapse of the anterior vaginal wall with cystocele: foreign body sensation, difficulty or frequent urination, stress incontinence;
- prolapse of the posterior wall with rectocele: difficult defecation, feeling of incomplete emptying, protrusion;
- combined prolapse of the walls, gaping of the genital fissure after childbirth, decreased sensations during sexual activity;
- prolapse and prolapse of the uterus - in combination with uterine fixation or hysterectomy.
The essence of the operation
Prolapse of the vaginal walls occurs due to tears and stretching of the pelvic fascia and muscles after childbirth, with age and during hard work; plastic surgery (colporrhaphy) restores supporting structures with its own tissues: the fascia is sutured with a “duplication”, excess mucous membrane is removed, and during perineal plastic surgery, the muscles are stitched together, narrowing the entrance to the vagina. The operation is performed through the vagina without incisions on the abdomen, eliminates protrusion, improves urination and defecation, and restores anatomy for sexual activity. For severe and recurrent prolapse, mesh implants or laparoscopic sacrocolpopexy are used.
