Surgical Techniques

Surgical correction of anterior vaginal prolapse can be accomplished through a vaginal, abdominal, or laparo-scopic approach. The appropriate route of surgery is determined by several factors including the preoperative evaluation of anterior vaginal support defects, the presence of other vaginal support defects, history of previous reconstructive or anti-incontinence surgery, the patient's surgical risk, and surgeon skill and preference. In the following section, several techniques for correcting anterior vaginal prolapse are described. The procedures discussed all address correction of anterior vaginal support defects. In our experience, it is rare that a patient with advanced anterior vaginal prolapse has an isolated anterior support defect; almost universally, an apical support defect exists when the prolapse is beyond the hymen. For this reason it is essential to include a vaginal vault suspension procedure as part of the surgical correction of anterior vaginal prolapse. Techniques for vaginal vault suspension are detailed elsewhere in this book. Additionally, because of the contribution of anterior vaginal support toward the urinary continence mechanism, preferential support of the bladder neck using a pubovaginal sling, retropubic urethropexy, bladder neck plication, or some similar technique should be performed routinely as part of any anterior vaginal reconstruction.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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