Prolapse of neovagina created with labia minora: a case report (original) (raw)
Related papers
Posterior intravaginal slingplasty for vaginal prolapse
International Urogynecology Journal, 2006
Objective: To evaluate the results of the posterior intravaginal slingplasty (IVS). Patients and methods: From a urogynecology database, 42 patients who had undergone posterior IVS procedures were analyzed. All the selected patients had also had a posterior colporrhaphy (88% with mesh inserted into the rectovaginal space). Results: Intraoperatively, there was one complication, a rectum perforation. All patients were followed-up, with a median of 13 months. Recurrent prolapse, grade 3 or 4, developed in 12 patients (29%) which included ten cystoenteroceles (24%), four rectoenteroceles (10%), and three cases of utero/vault prolapse (7%). Repeat surgery was performed in six patients (14%). For utero/vault prolapse, eight patients presented preoperatively with grades 3 and 4 prolapse. On follow-up, three patients had utero/vault prolapse, one of whom did not have utero/vault prolapse on presentation. Therefore, of the eight patients presenting with utero/vault prolapse, only two had repeat prolapse on follow-up, which reflected an improvement of 75%. Conclusion: The posterior IVS delivered satisfactory results for vault and posterior compartment prolapse, with a 75% improvement in vault prolapse. It was not possible, however, to separate the effect of posterior IVS and posterior colporrhaphy on the prevention of recurrent prolapse nor on the improvement of difficulty in defecation. Due to the utilization of the now-abandoned vaginal anterior colposuspension procedure for the treatment of anterior compartment prolapse, no conclusions regarding the impact of the posterior IVS on the anterior compartment can be made.
Labiaplasty with Stable Labia Minora Retraction—Butterfly-like Approach
Plastic and Reconstructive Surgery - Global Open, 2020
Summary: Labiaplasty, referring to a surgical labia minora reduction, is the most commonly requested genital rejuvenation by women. The purpose of this article is to show an innovative maneuver in the technique for this increasingly demanded procedure. In this strategy, labia minora are attached temporarily to the internal thigh with stitches resembling an open butterfly wing. This maneuver stabilizes the redundant labia minora soft tissue, easing the evaluation of asymmetry and aiding precision in the treatment. The study investigated 12 patients, 10 presenting bilateral hypertrophic labia minora and 2 patients with only unilateral abnormal anatomy, n = 22. The mean age was 25 years. The postoperative follow-up was uneventful. All patients presented labia minora with anatomic configuration. In 1 patient, we registered immediate bleeding that needed revision. The butterfly-like maneuver with the labia minora temporarily attached to the inner thigh can ease labiaplasty with central a...
Vaginal surgery for genital prolapse: long-term results in 218 cases
Hernia, 1997
The aim was to assesst he long-term results of vaginal surgery on pelvic support defects and continence by a Prospective study of 218 patients operated on between 1982 and 1992. The mean age was 66 years. Half had stress incontinence of urine (SUI) associated with prolapse, which extended outside the introitus in 78% of cases. The procedure included vaginal hysterectomy, tightening of the round and sacrouterine ligaments' suspension of the bladder neck by the Bologna procedure and myorrhaphy of the levator muscles. The mean follow-up was 69 months. Thirty-two Patients (15%) had recurrent pelvic relaxation, in 84% of these there was vaginal vault prolapse with enterocele. Recurrence was commoner in cases of urge incontinence or pauciparity. Postoperative SUI occurred in 29 Patients with previous SUI (27%) and in 10 without (9%). The recurrence of SUI was commoner when there was sphincter incompetence or SUI grade 2 or 3. The Bologna procedure allows good correction of SUI. Its combination with vaginal hysterectomy, tightening of the uterine ligaments and myorrhaphy of the levators provides a complete treatment for genital prolapse by the vaginal route. So as not to reduce the size of the vagina, the operation should be reserved for maior cystocele or for patients beyond sexual activity.
Aim: To assess the anatomic effectiveness and complications of the Posterior IVS technique for the treatment of pelvic organ prolapse over a period of 3 years. Methods: A retrospective, single-arm, non-comparative study involving routine, standardised, pre-operative assessment, surgery and follow-up care using the Pelvic Organ Prolapse Quantifications score at 1, 2 and 3 years was performed. The Posterior IVS technique was performed in patients with a symptomatic grade 2 or greater prolapse of the apical compartment (i.e. point C and/or D ≥ -1). Concomitant prolapse procedures were allowed. Results: Twenty-nine consecutive patients underwent a Posterior IVS suspension over a period of 2 years. Ninety percent (26/29) of patients required a concomitant prolapse procedure (79% an anterior and 55% a posterior vaginal wall repair). No serious peroperative complications, bladder injuries or rectal perforations were encountered. Overall anatomical success rates (<Stage 2, International ...
Surgical management of vaginal prolapse: current surgical concepts
The Canadian journal of urology, 2021
INTRODUCTION Pelvic organ prolapse (POP) is a condition defined by a loss of structural integrity within the vagina and often results in symptoms which greatly interfere with quality of life in women. POP is expected to increase in prevalence over the coming years, and the number of patients undergoing surgery for POP is expected to increase by up to 13%. Two categories of surgery for POP include obliterative and reconstructive surgery. Patient health status, goals, and desired outcomes must be carefully considered when selecting a surgical approach, as obliterative surgeries result in an inability to have sexual intercourse postoperatively. MATERIALS AND METHODS This review article covers the role of traditional native tissue repairs, surgical options and techniques for vaginal and abdominal reconstruction for POP and the associated complications, and considerations for prevention and management of post-cystectomy vaginal prolapse. RESULTS Studies comparing native and augmented ant...
2014
UNLABELLED The surgical treatment of complete genital prolapse must aim the restoration of the vaginal support structures. All 3 levels of the vaginal support system must be recreated. Ablation of the uterus is not useful for pelvic floor support. Sparing of the uterus offers the advantage of a reduced surgical trauma, and better pelvic floor restoration. We present the case of a 60-year old woman with complete genital prolapse where the uterus was spared, and sacrospinous fixation, anterior mesh repair,perineal body repair and suburethral sling insertion were performed. The results were very good, by means of pelvic floor statics and physiology of micturition. CONCLUSION genital prolapse must be cured by reconstruction of the vaginal support system, not by hysterectomy.
Total vaginal reconstruction with combined ?Split Labia Minora Flaps? and full-thickness skin grafts
Journal of Obstetrics and Gynaecology Research, 2007
Purpose: Vaginal reconstruction with split-thickness skin grafts is the most common method for total vaginal reconstruction. Although it has disadvantages like contraction of the graft, foreshortening, donor site morbidity and long-lasting periods of vaginal standing; its easy surgical technique makes it popular. A new method using split labia minora (LM) flaps and full-thickness skin graft is discussed in this study. Method: A 19-year-old female was presented with amenorrhea. A total absence of vagina was present and the patient underwent a total vaginal reconstruction for possible sexual intercourse. Results: We observed no contraction and no foreshortening with a patent vaginal cavity up to 11 cm and 4.5 cm width. The need for continuous standing period was as short as 4 weeks and for intermittent standing up to 4 months. Sexual intercourse was encouraged after 4 weeks. During sexual intercourse no external lubrication was reported to be needed. There was no need for further reconstructive intervention. Conclusion: Vaginal reconstruction in congenital vaginal agenesis with split LM flaps and full-thickness skin grafts is a simple and effective method, which shortens the standing period and decreases the contraction in neovagina. Total vaginal reconstruction with split LM flaps could also be possible; to achieve this goal, expansion of LM flaps could be a further alternative.
SM Dermatology Journal
Introduction: Vaginismus is defined as recurrent or persistent involuntary spasm of the musculature of the lower third of the vagina, which interferes with coitus resulting in matrimonial disharmony. There are many methods described for the management of the condition. But most of times all methods fail to treat such patients. We have developed a newer approach for management of this condition in which spasmodic muscles are incised and resultant defect is resurfaced with Labia Minora Flaps. Material and method: We have treated fourteen females who were married more than 5 years before and had undergone all types of treatment without success. Results: All of the females could initiate sexual intercourse within 3 weeks of surgery Conclusion: Incision of spasmodic muscles and resurfacing with labia minora flaps is one of good option if other treatment had failed, for management of vaginismus.
Surgical repair of vaginal prolapse: A gynaecological hernia
International Journal of Surgery, 2006
Female pelvic organ prolapse refers to the descent of the pelvic organs towards or through the vagina. The similarities between vaginal prolapse and herniae in their aetiology and treatment make this an interesting area for all those operating in the pelvis.