Cystocele and urination
The prolapse of the anterior wall is manifested by protrusion, difficult or frequent urination, residual urine and cystitis, sometimes incontinence when coughing and exertion. The surgeon dissects the anterior wall, separates the bladder, immerses it with purse-string and interrupted sutures onto the fascia (reposition), forming a strong support, and sutures the mucous membrane. For stress incontinence, surgery is complemented by plication of the bladder neck or installation of a suburethral sling (TVT-O). Catheter for a day; In the first days, the completeness of bladder emptying is monitored. The result is the disappearance of protrusion and normalization of urination; when combined with rectocele, anteroposterior plasty is performed.
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.
