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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]
Comparison between the vaginal condition before and after conducting perineoplasty. Perineorrhaphy is a common technique that is involved in the procedure, which aims to repair the perineum (i.e. the area between the vagina and anus) surgically. [24] It can be performed with or without levator ani plication to tighten the pelvic floor muscles. [24]
Posterior view of Sims' position Anterior view of Sims' position The Sims position , or left lateral Sims position, named after the gynaecologist J. Marion Sims , is usually used for rectal examination , treatments, enemas , and examining patients for vaginal wall prolapse .
For posterior vaginal repair, the use of mesh or graft material does not seem to provide any benefits. [14] Compared to native tissue repair, transvaginal permanent mesh likely reduces the perception of vaginal prolapse sensation, the risk of recurrent prolapse, and of having repeat surgery specifically only for prolapse.
A weighted speculum is placed in the vagina during vaginal surgery with the patient in the lithotomy position. The weight holds the speculum in place and frees the surgeon's hands for other tasks. Auvard's speculum: Speculum used in standard vaginal procedures. Cusco's speculum: Bivalved self retaining speculum.
The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female.
Vaginal shrinkage occurred was documented in 2–10% of those treated. Stricture, or narrowing of the vaginal orifice was reported in 12–15% of the cases. Of those reporting stricture, 41% underwent a second operation to correct the condition. Necrosis of two scrotal flaps has been described. Posterior vaginal wall is a rare complication.
The absence of vaginal rugae seen in the normal vagina of a healthy woman may be an indication of a prolapsed bladder (cystocele) or rectocele. [13] [12] An enterocele, or bulging of the bowel into the vagina can also cause vaginal rugae to disappear. [16] The absence of vaginal rugae may also be an indicator of pelvic organ prolapse.