AP Vaginal Repair

AP Vaginal Repair

What is Anterior-Posterior Vaginal Repair

When the muscles and ligaments supporting a woman’s pelvic organs weaken, the pelvic organs can slip out of place (prolapse). Pelvic organ prolapse can worsen over time and you may need surgery to fix it.

  • This is due to the fact that the muscles of the perineum--the group of supporting muscles located below the low part of the vaginal opening--become thin and the mid-line begins to deviate, thus leading to a weakened, poorly supported, and thinned out perineal body. 
  • Anterior-Posterior Vaginal Repair is a surgery for the loss of optimal structural integrity of the front (anterior) and the back (posterior) walls of the vagina, resulting in different organs around the vaginal walls pushing and subsequently a bulge into the vagina or the vaginal opening.
  • Recently, laser has been applicable to the Anterior-Posterior Vaginal Repair. The benefits of Laser Vaginal Rejuvenation includes: more precision and accuracy as a result of the surgical wound control, less blood loss, lower vessel and lower tissue damages and quicker recovery time thus bringing about better results than using the old conventional scalpel procedure.

 The defect of the anterior and posterior vaginal wall is caused by the following:

  • Multiple vaginal deliveries.
  • Lack of estrogen resulting from menopause.
  • Use of forceps or vacuum extraction for birth.
  • Tearing or cutting of the vaginal opening for delivery.
  • Chronic constipation and stress (affecting bowel movement).
  • After a hysterectomy, as it needs the cutting or damaging various pelvic floor muscles including the ligaments and tissues supporting the upper vagina around the cervix.

Symptoms during sexual intercourse:

  • pain
  • no gratification nor orgasm
  • infrequent sexual intercourse 
  • urinary incontinence while having the sexual intercourse

Bowel or urinary symptoms:

  • chronic constipation
  • pressure on the vagina
  • frequent bladder infection
  • difficulty in emptying the bladder and bowel completely
  • frequent urination and constantly being impelled to urinate
  • urinary incontinence while coughing, sneezing or heavy lifting

The different organ prolapses are the following.

  1. Rectocele (the rectum protrudes into the vagina)
  2. Cystocele (the bladder protrudes into the vagina)
  3. Urethrocele (prolapse of the urethra into the vagina)
  4. Uterine prolapse (uterus protrudes downward into the vagina)
  5. Enterocele (a part of the small intestine prolapse into the vagina)

There are 3 methods of correcting prolapse of the vagina as follows.

  1. THE KEGEL EXERCISE  is safe but would have to take 6 months until results would show, and does not guarantee full effectiveness.
  2. The POSTERIOR VAGINAL REPAIR is the procedure to narrow the diameter of the vagina which results to a smaller and tighter vaginal canal and opening. However, this procedure also has its limitations to the patients with multiple deliveries.
  3. The ANTERIOR AND POSTERIOR VAGINAL REPAIR is the surgical repair of pelvic prolapse by entailing the surgical removal of the excessive anterior and posterior vaginal tissues as well as bladder and rectum prolapse, thereby correcting the prolapse, at the same time tightening the vagina.

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