Atlanta Center for Laparoscopic Urogynecology
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Ambulatory Procedure - Anterior Repair
Anterior Repair Surgery (Colporrhaphy)
Anterior repair is a vaginal procedure to repair a cystocele (dropped bladder) utilizing the patients own tissue/fascia for the repair. Even though the anterior repair is the most commonly utilized operation (and the oldest) for correction of a cystocele, anterior vaginal wall repair is probably not the most effective, nor is anterior repair the correct operation for restoring a woman's anatomy and maintaining vaginal length and function in many cases of cystocele. The problem with using anterior bladder or vaginal wall repair in young, healthy, sexually-active woman with a paravaginal defect (cystocele) is the surgeon does not really surgically support the bladder, but instead reduces the bulge by "scrunching " the fascia under the bladder together. Most larger, symptomatic bladders are caused by the anterior vaginal wall tearing away laterally from its support to the pelvic sidewall muscles. This is called a paravaginal defect and this should be repaired laparoscopically (link to paravaginal repair here) when present. The anterior repair for a cystocele should or can be utilized in patients with:
- Midline defects
- Mild anterior wall relaxation
- Defects which are not paravaginal
- Cystocele of any type in patients whose vaginal function and length is not important
fig. 1
Normal Support – side view
fig.2
Cystocele
– Midline defect in
pubocervical fascia (side view)