Anterior Posterior Vaginal Repair for Pelvic Organ Prolapse 1

blue-shutterstock_94733821When 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 lower 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:

  • bullet_tickAging (occasionally likely in younger women)
  • bullet_tickBirth trauma (such as multiple vaginal deliveries)
  • bullet_tickThe use of forceps or other assisted methods of delivery
  • bullet_tickA history of constipation and straining with bowel movements
  • bullet_tickPerineum or an episiotomy tears into the rectum or anal sphincter muscles
  • bullet_tickAfter a hysterectomy, because it is involved in damaging different structures supporting pelvic organs such as  ligaments and tissues around cervix supporting the anterior and posterior vaginal wall
Every once in awhile, 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:
  • bullet_tickObesity (increases in abdominal pressure)
  • bullet_tickAging (lack of estrogen resulting from menopause)
  • bullet_tickChronic constipation and stress (affecting bowel movement)
  • bullet_tickInherited weakness of the supporting tissues of the pelvic floor
  • bullet_tickExtraordinary tension placed on the supporting tissues due to a chronic cough
  • bullet_tickAfter 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.


 anterior prolapse 

Figure 1: Anterior Vaginal Wall Prolapse


posterior 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, quicker recovery time, and better overall results.

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