DR. MAYANK MOHAN AGARWAL
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drmayank.22@gmail.com
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Vaginal Paravaginal Cystocoele Repair

The objective of this surgery is to reattach detached lateral vaginal fascia to its normal point of insertion on the lateral side wall. This firm area of attachment is called as the white line or arcus tendineus fascia pelvis.

Indication

The repair of anterior wall prolapse due to defects of the lateral supporting tissues

Procedure

The procedure can be done under regional or general anaethesia.

Routine anterior repair

The sharp dissection of the vagina from the bladder fascia continues laterally till the pelvic side wall can be recognised.

Permanent or delayed absorbable sutures are placed to the firm pelvic side wall tissue from the lateral vagina (white line or arcus tendineous fascia pelvis). Three to four sutures are placed on each side.

A routine anterior repair with midline plication of the fascia, trimming of excess vaginal skin as needed and closure of the vaginal skin.

Surgery will be covered with antibiotics to minimise the risk of infection and blood thinning agents will be used to decrease the risk of clots forming in the postoperative phase.

In hospital and recovery

You will be instructed to stay in hospital between 3-6 days. The vaginal pack, if used can be removed on the first day and the bladder catheter after the first few days. In the early postoperative period, you should avoid situations where excessive pressure is placed on the repair like lifting, straining, coughing and constipation. Maximal fibrosis around the repair occurs at 3 months and care is required to be taken during this time. If you develop urinary burning, frequency or urgency you should see your local doctor.