How to treat postpartum anterior vaginal wall bulging

Every mother and family hopes to have a healthy child. Sometimes women will experience some symptoms during pregnancy, and then there will be many complications after delivery. The simplest is postpartum bulging of the anterior vaginal wall. What kind of disease is this and what causes it? Now let’s take a look at how to treat postpartum anterior vaginal wall prolapse?

1. Non-surgical treatment: Mild prolapse does not require treatment. For moderate or even severe protrusion, conservative treatment can be adopted if the patient needs to have children or is elderly with serious medical diseases.

2. Surgical repair method The surgical treatment indications for anterior vaginal wall prolapse are: ① severe prolapse, ② prolapse leading to urinary retention or recurrent cystitis, ③ accompanied by stress urinary incontinence. Based on the above evidence, Yang Lanyi, an authoritative minimally invasive surgery expert at Baoding Zhenai Obstetrics and Gynecology Hospital, suggested adopting new surgical procedures that are currently recognized internationally as effective, such as:

1. Uterine or vaginal vault sacral suspension

The classic uterosacral suspension technique uses a mesh with its two ends sutured to the biuterosacral ligament or the vaginal vault of a hysterectomy patient and the tough fibrous tissue in front of the sacrum S2S4, namely the anterior longitudinal ligament. The uterosacral suspension procedure lifts the uterus to its normal anatomical position, allowing the cervix and vaginal apex to be on the upper platform of the pelvic floor, maintaining the normal vaginal axis and length, and maintaining the normal pelvic anatomy. A survey showed that the rate of sexual satisfaction after surgery reached 88.8%. It is suitable for those with no uterine lesions and normal cervical cytology, especially those who are unmarried, non-pregnant and want to have children.

2. Sacrospinous ligament fixation

It is suitable for patients with uterine prolapse accompanied by relaxation of the aorta and sacral ligaments. After vaginal hysterectomy, the rectovaginal space is reached through an incision in the perineum or posterior vaginal wall, and the rectal columns are passed to reach the ischial spines and sacrospinous ligaments. Suturing and fixing the vaginal stump to this ligament can better preserve the vaginal function and keep the vagina located in the horizontal axis of the levator ani muscle plate, and the effect is long-lasting and reliable.

3. Iliococcygeal fascial fixation

Similar to the SSLP procedure, only the fixation point is located on the iliocaudal fascia anterior to the ischial spine. Some scholars believe that the fixation point here is easier to approach and less likely to damage blood vessels and nerves, but the depth of the vagina after surgery may be slightly shorter than that of SSLP.

4. Full pelvic floor reconstruction surgery

The entire pelvic cavity is reconstructed from the front, middle and back areas to comprehensively correct pelvic floor defects. The constructed, non-absorbable, thin, porous, single-strand woven polypropylene mesh system includes anterior and posterior joint construction. This surgical method is safe, effective, time-saving and minimally invasive.

5. High sacral ligament suspension

High uterosacral ligament suspension, this operation is performed transvaginally. After hysterectomy, use Allis forceps to clamp the uterosacral ligament from the level of the ischial spine and lift it up. Use 2-3 stitches of non-absorbable sutures to suture and tie the uterosacral ligament to shorten its length.

The above is the treatment method for postpartum anterior vaginal wall bulging. I hope these can be good suggestions or advice for postpartum patients or pregnant mothers, and can effectively prevent the occurrence of these diseases. You can also have a healthy body, a healthy baby, and a happy family.