Name of the Procedure:

Anterior Colporrhaphy, Repair of Cystocele with or without Repair of Urethrocele, including Cystourethroscopy when performed.

Summary

Anterior colporrhaphy is a surgical procedure used to repair a cystocele, which is a condition where the bladder herniates into the vagina. This procedure may also repair a urethrocele, where the urethra sags into the vaginal canal. During the surgery, a cystourethroscopy (a scope to view the bladder and urethra) may be performed to ensure proper placement and functionality.

Purpose

Medical condition or problem:

• Cystocele
• Urethrocele

Goals:

• To provide relief from symptoms such as urinary incontinence or frequent urinary tract infections.
• To restore normal anatomy and function of the pelvic organs.

Indications

• Symptoms such as a feeling of fullness or pressure in the pelvis, urinary incontinence, or recurrent urinary tract infections.
• Diagnosis of cystocele or urethrocele confirmed by pelvic examination and imaging studies.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments may be necessary, particularly blood thinners.
• Pre-operative tests such as urinalysis or cystoscopy to assess bladder function.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made in the anterior vaginal wall.
3. Repair: The prolapsed bladder and/or urethra are repositioned and the supportive tissues are stitched.
4. Cystourethroscopy: A scope may be inserted to view the bladder and urethra, ensuring proper repair.
5. Closure: The incision is closed with sutures.

Tools:

• Surgical instruments for dissection and suturing.
• Cystourethroscopy equipment.

Duration

The procedure typically takes about 1-2 hours.

Setting

Usually performed in a hospital or outpatient surgical center.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Common: Bleeding, infection, pain.
• Rare: Injury to nearby organs, recurrence of cystocele, issues with anesthesia.

Benefits

• Alleviation of symptoms like pelvic pressure and urinary incontinence.
• Improved quality of life.

Recovery

• Patients typically stay in the hospital for 1-2 days.
• Avoid heavy lifting and strenuous activity for several weeks.
• Follow-up appointments will be scheduled to monitor recovery.

Alternatives

• Non-surgical options like pelvic floor exercises or a pessary device.
• Cons: May not provide long-term relief as effectively as surgery.

Patient Experience

• Some discomfort and pain post-surgery, managed with medication.
• Gradual improvement in symptoms over several weeks to months.