These procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for her request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention. Women should be informed about the lack of data supporting the efficacy of these procedures and their potential complications, including infection, altered sensation, dyspareunia, adhesions, and scarring.

Anterior Vaginal Repair

Anterior repair is a surgical procedure to repair or reinforce the weakened layers between the bladder and the vagina. The aim of the surgery is to relieve the symptoms of vaginal bulging/ laxity and to improve bladder function, without interfering with sexual function.

Success rates for anterior repair are 70-90%, however there is a chance that the prolapse may recur or another part of the vaginal wall may prolapse.

Surgery

The surgery can be performed under general, regional or local anaesthetic. There are many ways to perform an anterior repair, but a common method is by an incision being made along the centre of the front wall of the vagina, starting near the entrance and finishing near the top of the vagina. The weakened layers are then repaired using absorbable stitches. Sometimes superfluous vaginal skin is removed.

If you have a severe prolapse or this is a repeat operation, reinforcement material such as mesh may be used to strengthen the anterior vaginal wall.

After surgery

When you wake up from the anaesthetic you will have a drip to give you fluids and you may have a catheter in your bladder. You may also have a pack inside the vagina to reduce bleeding into the tissue. Usually both the pack and catheter are removed within 24 – 48 hours after the operation. Once the catheter has been removed it is normal to monitor how much your bladder holds and whether or not you completely empty your bladder when you go to the toilet. For two or possibly three visits to the toilet your urine output will be collected and measured. Then a small machine which is placed on your tummy will be used to check that your bladder has completely emptied.

Sources: acog.org, bladderandbowel.org

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