Do you know how to treat anterior vaginal wall prolapse?

The vagina is the most important reproductive organ for women. It is a very important channel and the only way for pregnancy and childbirth. Moreover, menstruation during women's menstrual period must pass through the vagina to be discharged from the body. Therefore, the combination of various effects will inevitably produce great pressure on the vagina. Among them, the pressure from diseases and physiological changes is the greatest. Physiological changes refer to changes in the overall structure of the vagina, which affect the physiological functions of women. For example, anterior vaginal wall bulging is a common symptom that has a great impact on women’s physical health. Let’s take a look at how to treat anterior vaginal wall bulging.

Anterior vaginal wall bulging is actually bladder and urethra bulging, often accompanied by urination dysfunction. Mild prolapse generally causes no symptoms; severe prolapse may cause a feeling of incomplete urination. In order to empty the urine, patients often need to compress the vagina or manually push back the prolapsed tissue.

1. Non-surgical treatment

Mild prolapse does not require treatment. For moderate or even severe prolapse, conservative treatment can be adopted if the patient needs to have children or is elderly with serious medical diseases. Conservative treatment includes the use of pessary, Kegel exercises and estrogen.

2. Surgical repair method

The indications for surgical treatment of anterior vaginal wall prolapse are: ① severe prolapse; ② prolapse leading to urinary retention or recurrent cystitis; ③ accompanied by stress urinary incontinence.

(1) Anterior vaginal wall suture Suburethral plication The purpose of anterior vaginal wall suture is to fold and suture the vaginal muscles and the fascia on the surface of the bladder (pubocervical fascia) or the vaginal side wall tissue to restore the bulging bladder and vagina to their normal position.

(2) Paravaginal repair: The purpose of paravaginal defect repair for anterior vaginal wall prolapse is to restore the separated vagina to the level of the arcuate ligament of the pelvic wall (ATFP) that is normally connected to it. There are two main methods: vaginal approach or retropubic approach.

3. Surgical complications

Complications of anterior vaginal wall prolapse repair are relatively rare, with the most common being hematoma behind the anterior vaginal wall and damage to the urethra or bladder during separation. Repair of bladder damage often requires a urinary catheter to be placed for 7 to 14 days, which is beneficial for the healing of the bladder. Other rare complications include ureteral injury, suture to the bladder or urethra (causing related bladder symptoms), and fistula formation, such as urethrovaginal fistula and vesicovaginal fistula.