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In some cases, women have a prolapse of the posterior wall of the vagina, which is accompanied by a prolapse of the rectum and a violation of the integrity of the perineal wall. Pathology may be accompanied by a protrusion or rupture of the pelvic floor, fistulas of the rectum, damage to the sphincter. In the absence of effective therapy, the pathology begins to worsen, the vagina is completely everted, and the uterus falls out. This condition threatens with serious consequences for life and health. In particular, blood poisoning and death.
To prevent the development of complications, patients diagnosed with prolapse of the anterior vaginal wall are shown colpoperineoplasty, an operation whose purpose is to strengthen and restore damaged pelvic floor muscles. Additionally, during the operation, the walls of the vagina and perineum are sutured, if necessary, damage to the sphincter and rectum is eliminated.
Causes of pathology
There are several factors that affect the decrease in the elasticity of the pelvic floor muscles, which leads to prolapse and / or prolapse of the pelvic organs. The most common cause is age-related changes or muscle dystrophy against the background of the development of certain diseases in the body. Under adverse living conditions, the body can be severely depleted, which also provokes a decrease in tissue elasticity.
Pathology is diagnosed in approximately 45% of women who have lost a lot of weight in a short period of time. At the same time, the reason for rapid weight loss practically does not play a role – be it a special diet or a disease. Tissues and muscles do not have time to adapt to changes, as a result of which irreversible processes begin.
At increased risk are women who do heavy physical work every day. When lifting weights, a slight protrusion of the pelvic organs occurs, with constant loads, the level of protrusion gradually increases and can reach a critical stage. Another factor that provokes pathology is complicated or multiple births.
The main symptoms of genital prolapse, a woman may suffer from partial urinary incontinence, which is aggravated by sudden movements, running, sneezing. This increases the amount of discharge from the vagina – in some cases, this leads to irritation of the external genitalia.
The elasticity of the sphincter gradually decreases or its integrity is violated. In this case, along with urinary incontinence, partial incontinence of feces and gases is noted.
Indications for holding
All these symptoms bring a lot of suffering to a woman – both physical and moral. Therefore, when identifying signs of the disease, it is important to contact a specialist who can prescribe effective treatment.
Colpoperineoplasty is prescribed in the following cases:
- prolapse of the uterus or its prolapse through the genital slit;
- protrusion of the walls of the rectum into the vaginal area;
- damage or severe stretching (3-4 degree) of the perineal wall;
- prolapse or eversion of the vagina in elderly patients, a strong decrease in the tone of the muscles of the pelvic floor;
- discomfort and pain when walking and during intercourse, caused by the unstable position of the organs.
Features of the operation
Colpoperineoplasty can be prescribed to prevent prolapse of the genital organs during stretching of the pelvic floor and eliminate this pathology.
Colpoperineoplasty is performed exclusively in a hospital setting. The preparatory period consists of two stages. The first is outpatient, during which an accurate diagnosis is established and a comprehensive study is carried out. The second is stationary, during which the patient is shown a control examination. It is recommended to be admitted to the hospital 5 days before the scheduled date of the operation.
Preoperative preparation includes complete bowel cleansing and destruction of the vaginal microflora.
For 12 hours before the procedure, it is recommended to completely exclude food and drink. Especially if the surgery is performed under general anesthesia. In the case of epidural anesthesia, the period of “starvation” is reduced to 8-10 hours. It is important that the pelvic floor muscles are completely relaxed during the operation. Therefore, infiltration anesthesia can be additionally used.
Colpoperineoplasty is an operation that requires transvaginal intervention. In order to prevent accidental injury to the uterus, the cervix is fixed with special clamps before the start of the operation. During the surgical procedure, the doctor excises small flaps from the walls of the vagina that have the correct diamond shape. Then the excision sites are sutured with special sutures. After layer-by-layer suturing of the vaginal tissues, defects and damage to the perineal wall are eliminated.
At the end of the operation, the doctor must completely dry the walls of the vagina in order to identify bleeding wounds. The patient is fitted with a urinary catheter.
In the first 24 hours after the operation, the patient is in the intensive care unit under constant medical supervision. In the absence of complications on the second day, she is transferred to the general ward.
Operation contraindications
General contraindications for colpoperineoplasty are severe cardiac pathologies, blood clotting disorders, infection, kidney or liver failure. In some chronic diseases that are a contraindication for surgery under general anesthesia, the procedure is performed under local anesthesia.
Colpoperineoplasty is not prescribed during the recovery period after childbirth, in the presence of sexually transmitted infections, and in oncological diseases of the pelvic organs.