Anterior vaginal wall repair

 

Alternative Names

A/P repair; Vaginal wall repair; Anterior and/or posterior vaginal wall repair; Colporrhaphy - repair of vaginal wall; Cystocele repair

Definition

Anterior vaginal wall repair is surgery that tightens the front (anterior) wall of the vagina.

Why the Procedure Is Performed

This procedure is used to repair sinking of the vaginal wall (prolapse) or bulging that occurs when the bladder or urethra sink into the vagina.

Symptoms of prolapse include:

  • You may not be able to empty your bladder completely.
  • Your bladder may feel full all the time.
  • You may feel pressure in your vagina.
  • You may be able to feel or see a bulging at the opening of the vagina.
  • You may have pain when you have sex.
  • You may leak urine when you cough, sneeze, or lift something.
  • You may get bladder infections.

This surgery by itself does not treat stress incontinence (leaking urine when you cough, sneeze, or lift). It may be performed along with other surgeries.

Before doing this surgery, your health care provider may have you learn pelvic floor muscle exercises (Kegel exercises), use estrogen cream in your vagina, or try a device called a pessary in your vagina to hold up the prolapse.

Risks

Risks for this surgery are:

  • Damage to the urethra, bladder, or vagina
  • Irritable bladder
  • Changes in the vagina (prolapsed vagina)
  • Urine leakage from the vagina or to the skin (fistula)

Before the Procedure

Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

  • You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
  • Ask your health care provider which drugs you should still take on the day of your surgery.

On the day of your surgery:

  • You very often will be asked not to drink or eat anything for 6 - 12 hours before the surgery.
  • Take the drugs your health care provider told you to take with a small sip of water.
  • Your health care provider or nurse will tell you when to arrive at the hospital.

After the Procedure

You may have a catheter to drain urine for 1 or 2 days after surgery.

You will be on a liquid diet right after surgery. When your normal bowel function returns, you can return to your regular diet.

Outlook (Prognosis)

This surgery will very often repair the prolapse and the symptoms will go away. This improvement will often last for years.

References

Lentz GM. Anatomic defects of the abdominal wall and pelvic floor: abdominal and inguinal hernias, cystocele, urethrocele, enterocele, rectocele, uterine and vaginal prolapse: diagnosis and management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 20.

Winters JC, Togami JM, Chermansky CJ. Vaginal and abdominal reconstructive surgery for pelvic organ prolapse. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 72.

Maher CM, Feiner B, Baessler K, Glazener CMA. Surgical management of pelvic organ prolapse in women: the updated summary version. Cochrane review. Int Urogynecol J. 2011;22:1445-1457.

Review Date: 6/2/2014
Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.