Progress of the operation
The prolapsed mucosa (pink-purple ring around the urethral opening) is grabbed, a catheter is inserted into the urethra as a guide, the excess mucosa is excised circumferentially in separate sectors so as not to lose orientation, and the edge of the healthy urethral mucosa is sutured to the skin of the vulva with 6-8 thin absorbable sutures. Bleeding is stopped by coagulation. The catheter is removed after 1–2 days, urination is free. In girls, the operation is performed under general anesthesia; in menopausal women, after healing, local estrogens are prescribed to prevent relapse.
Two problems of the female urethra
Prolapse of the urethral mucosa - prolapse of the mucosa through the external opening in the form of a ring, more often in girls and women in menopause, with bleeding, pain and dysuria; if ointments are ineffective, excision is performed. Transposition of the urethra is indicated for postcoital cystitis - exacerbations after each sexual intercourse due to the low location or hypermobility of the external opening of the urethra at the entrance to the vagina: moving the opening higher eliminates the reflux of flora and repeated infections.
Results
After excision of the prolapse, symptoms disappear, relapses are rare. Transposition relieves postcoital cystitis in 80–90% of women with correctly established indications (confirmed connection of exacerbations with sexual intercourse, low opening or adhesions during examination). Both operations do not affect urinary continence or sensation.
