Anterior Posterior Vaginal Repair for Pelvic Organ Prolapse 1
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 supportive, thinned out perineal body.
The cause of pelvic wall relaxation is a weakening of the pelvic support structures (see the Figure 1 and Figure 2). The pelvic organs include the vagina, uterus, bladder, bowel, and rectum. These organs are kept in place with the help of 3 support systems from muscles, ligament sheets and fascia.
During the course of childbirth, as the baby journeys through the birth canal, these supports become damaged and tend to become weakened. This weakening increasingly worsens, and further on down the line, may cause the pelvic organs to shift from their normal positions.
The underlying cause (s) of pelvic support defects are:
- Aging, occasionally likely in younger women.
- Birth trauma such as multiple vaginal deliveries.
- The use of forceps or other assisted methods of delivery.
- A history of constipation and straining with bowel movements.
- Perineum tears or an episiotomy into the rectum or anal sphincter muscles.
- This problem may be preceded by hysterectomy because it is involved in damaging different structures supporting pelvic organs and ligaments and tissues around cervix supporting the anterior and posterior vaginal wall.
Every once in a while, the weakening of the muscles and tissues of the vaginal wall can occur to women who have never birthed a child. In these women, the underlying cause (s) may be:
- Obesity (increases in abdominal pressure).
- Aging (lack of estrogen resulting from menopause).
- Chronic constipation and stress (affecting bowel movement).
- Inherited weakness of the supporting tissues of the pelvic floor.
- Extraordinary tension placed on the supporting tissues due to a chronic cough.
- After a hysterectomy, as it needs the cutting or damaging the ligaments and tissues supporting the upper vagina around the cervix.
Anterior Posterior Vaginal Repair is a surgery for the loss of optimal structural integrity of the anterior and the posterior walls of the vagina, resulting in different organs around the vaginal walls pushing and forming a bulge into the vagina or the vaginal opening.
Figure 1: Anterior Vaginal Wall Prolapse
Figure 2: Posterior Vaginal Wall Prolapse
Because of technological advances, gynecology procedures involving the use of laser have been utilized in anterior-posterior vaginal repair. Advantages of laser over old, conventional scalpel procedure include: less blood loss, less risk of vessel and tissue damage, precise and accurate surgical wound control, and quicker recovery time and better overall results.