What to do if the anterior vaginal wall is protruding

Have you ever heard of anterior vaginal wall protrusion? Anterior vaginal wall bulging is actually bladder and urethra bulging, often accompanied by urination dysfunction. Mild prolapse generally causes no symptoms; severe prolapse may cause a feeling of incomplete urination. There may also be a feeling of vaginal fullness, a feeling of pelvic heaviness, stress urinary incontinence or a feeling of incomplete urination, pain in the lumbar region, which worsens after standing for a long time, and difficulty in sexual intercourse. So what should we do about protrusion of the anterior vaginal wall?

First of all, the following examinations should be performed: routine urine test to rule out urinary tract infection; vaginal cytology scraping to estimate the maturity index and evaluate the patient's estrogen level; urine dynamics test Before performing the urodynamic test, a pessary should be placed in the vagina to reduce prolapse. This test is required if you have stress urinary incontinence or voiding problems.

Other auxiliary examinations: Endoscopic examination to evaluate the function of completely emptying the bladder and measure the residual urine in time after urination; Ultrasound examination to measure the residual urine.

1. Non-surgical treatment: Mild prolapse does not require treatment. For moderate or even severe prolapse, conservative treatment can be adopted if the patient needs to have children or is elderly with serious medical diseases. Conservative treatment includes the use of pessary, Kegel exercises and estrogen.

2. Surgical repair method: The surgical 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.

(1) Anterior vaginal wall suture Suburethral plication The purpose of anterior vaginal wall suture is to fold and suture the vaginal muscles and the fascia on the surface of the bladder (pubocervical fascia) or the vaginal side wall tissue to restore the bulging bladder and vagina to their normal position.

(2) Paravaginal repair: The purpose of paravaginal defect repair for anterior vaginal wall prolapse is to restore the separated vagina to the level of the arcuate ligament of the pelvic wall (ATFP) that is normally connected to it. There are two main methods: vaginal approach or retropubic approach.

3. Surgical complications: Complications of anterior vaginal wall prolapse repair are relatively rare, the most common of which are hematoma behind the anterior vaginal wall and damage to the urethra or bladder during separation. Repair of bladder damage often requires a urinary catheter to be placed for 7 to 14 days, which is beneficial for the healing of the bladder. Other rare complications include ureteral injury, sutures to the bladder or urethra (with associated bladder symptoms), and fistula formation, such as urethrovaginal fistula and vesicovaginal fistula

Everyone should know what the protrusion of the anterior vaginal wall is, right? Some precautions need to be taken after the operation. After the anterior vaginal wall repair, urinary retention and difficulty in emptying often occur. This situation is more common in patients who have emptying function disorders before surgery. The treatment is catheter drainage or urinary catheterization. It takes about 6 weeks for the natural emptying function to recover. Everyone must take this seriously! If you have similar symptoms, you must go to the hospital for examination. I wish you good health!