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The most distal prolapse is between 1 cm above and 1 cm below the hymen (at least one point is −1, 0, or +1). 3: The most distal prolapse is more than 1 cm below the hymen but no further than 2 cm less than TVL. 4: Represents complete procidentia or vault eversion; the most distal prolapse protrudes to at least (TVL−2) cm.
Colposacropexy is often used for treating vaginal vault prolapse. A Cochrane Collaboration review [ needs update ] found that limited data are available on optimal surgical approaches, including the use of transvaginal surgical mesh devices, in the form of a patch or sling , similar to its implementation for abdominal hernia .
Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplasty is needed following the treatment or removal of malignant growths or abscesses to restore a normal vaginal structure and function. Surgery to the vagina is done to correct congenital defects to the vagina, urethra and rectum.
A rectocele is a bulge, or herniation, of the front wall of the rectum into the back of the vagina. [16] A cystocele occurs when the wall between the bladder and the vagina weakens. [16] Uterine prolapse. Pelvic floor dysfunction can be assessed with a strong clinical history and physical exam, though imaging is often needed for diagnosis.
Transvaginal mesh, also known as vaginal mesh implant, is a net-like surgical tool that is used to treat pelvic organ prolapse (POP) and stress urinary incontinence (SUI) among female patients. The surgical mesh is placed transvaginally to reconstruct weakened pelvic muscle walls and to support the urethra or bladder.
However, the association between this type of prolapse and vaginal introital laxity is still unclear due to the lack of related data. [2] POP includes (a) the falling out of vagina, bladder and other genito-pelvic structures, (b) vaginal tissue bulging into and through the introitus, or (c) the prolapse of rectal tissues into the vaginal area. [8]
Vaginal surgeries have been around throughout medical history. Even before the invention of modern surgical techniques such as anesthesia and sterile tools, there have been many reports of vaginal surgery to treat problems such as prolapse, vaginal fistula, and poor bladder control.
In older women who are no longer sexually active, a simple procedure for reducing prolapse is a partial colpocleisis. The procedure was described by Le Fort [ citation needed ] and involves the removal of strip of anterior and posterior vaginal wall, with closure of the margins of the anterior and posterior wall to each other.