Retropubic paravaginal repair

Retropubic paravaginal repair is a surgical procedure used to correct anterior vaginal wall prolapse, often associated with stress urinary incontinence. This condition, where the bladder or urethra descends into the vaginal area, can cause significant discomfort and impact the quality of life. The retropubic paravaginal repair technique aims to restore the normal position of the bladder and urethra by reinforcing the side walls of the vagina.

Indications

Retropubic paravaginal repair is indicated for women suffering from anterior vaginal wall prolapse, especially when it is accompanied by stress urinary incontinence. This condition is often the result of childbirth, aging, or other factors that weaken the pelvic floor muscles and tissues.

Procedure

The procedure is performed under general anesthesia. The surgeon makes an incision in the vaginal wall to access the retropubic space, which is the area behind the pubic bone but in front of the bladder. The goal is to attach the vaginal wall to the lateral pelvic wall using sutures, thus providing support to the bladder and urethra. This can be done using the patient's own tissues or with synthetic materials.

Recovery

Recovery from retropubic paravaginal repair varies among patients, but typically includes a period of rest and limited physical activity to allow the surgical site to heal. Patients may experience discomfort, swelling, and bruising in the treated area, which usually subsides within a few weeks. Follow-up visits are necessary to monitor the healing process and to evaluate the success of the procedure in relieving symptoms.

Risks and Complications

As with any surgical procedure, retropubic paravaginal repair carries risks, including infection, bleeding, and damage to surrounding tissues or organs. There is also a risk of the surgery not fully correcting the prolapse or incontinence, or of these conditions recurring over time.

Conclusion

Retropubic paravaginal repair is a surgical option for women experiencing anterior vaginal wall prolapse and stress urinary incontinence. It aims to improve symptoms and quality of life by providing support to the bladder and urethra. As with any medical procedure, patients should discuss the potential benefits and risks with their healthcare provider.