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A cystocele protruding through the vagina in a 73-year-old woman. The cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. [1] [5] Some may have no symptoms. [6] Others may have trouble starting urination, urinary incontinence, or frequent urination. [1]
When operating a pelvic organ prolapse, introducing a mid-urethral sling during or after surgery seems to reduce stress urinary incontinence. [13] Transvaginal repair seems to be more effective than transanal repair in posterior wall prolapse, but adverse effects cannot be excluded. [14] According to the FDA, serious complications are "not rare ...
It is the surgical intervention for both cystocele (protrusion of the urinary bladder into the vagina) and rectocele (protrusion of the rectum into the vagina). [citation needed] The repair may be to either or both of the anterior (front) or posterior (rear) vaginal walls, thus the origin of some of its alternative names. [1] [2] [3]
repair of cystocele [3] [6] and rectocele [3] retropubic paravaginal repair [8] the repair of a cystocele using a graft or prosthesis [3] [6] the repair of a cystocele and a rectocele in the same procedure using a graft or prosthetic device [3] [6] the repair of a rectocele using a graft or prosthetic material [3]
Surgery to correct the rectocele may involve the reattachment of the muscles that previously supported the pelvic floor. [1] Another procedure is posterior colporrhaphy, which involves suturing of vaginal tissue. Surgery may also involve insertion of a supporting mesh (that is, a patch). [8]
The Manchester operation, Manchester repair or simply Fothergill operation is a technique used in gynaecologic surgeries. It is an operation for uterine prolapse by fixation of the cardinal ligaments. Its purpose is to reduce the cystourethrocele and to reposition the uterus within the pelvis. The major steps of the intervention are listed below:
If performed without a hysterectomy, the procedure is known as a hysteropexy. Hysteropexy procedures include sacrohysteropexy and sacrospinous hysteropexy. [2] In severe cases of prolapse where the person no longer desires vaginal intercourse and has contraindications to more invasive surgery, vaginal closure procedures may be offered. [10]
[3] [4] Complications may arise from concomitant surgery and inappropriate surgical techniques, while they can also be prevented with uterus preservation. [ 5 ] [ 6 ] Transvaginal mesh was once used widely for nearly 25% of prolapse interventions until the FDA ban, yet approximately 1 out of 15 patients required a mesh removal in the past decade.