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Vaginectomy
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Iatrogenic Vaginal Constriction
Vaginal stricture may occur secondary to inflammatory conditions of the vagina, vaginal surgery, episiotomy repair, or radiotherapy. The surgical approach to the stenosis depends on its anatomic location, underlying cause, and severity. For introital or vaginal stenosis, the procedure can…
Congenital Vaginal Abnormalities
Labial Fusion/Agglutination Filmy adhesions of the labia can be a common finding in the newborn and are usually left alone. Fusion of the labia is commonly associated with congenital adrenal hyperplasia, and further evaluation and testing may be warranted, especially…
Benign Lesions of the Vaginal Wall
Under normal circumstances, the vagina does not contain any glands. However, when the condition of adenosis exists (i.e., occurs spontaneously or as the result of antenatal diethylstilbestrol [DES] exposure), mucosal and submucosal mucus-secreting glands may be identified ( Fig. 58.1A…
Pubovaginal Slings for the Correction of Stress Incontinence
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Avoiding and Managing Synthetic Mesh Complications After Surgeries for Urinary Incontinence and Pelvic Organ Prolapse
In 1998 synthetic midurethral slings became commercially available in the United States. These procedures were robustly compared with suspension procedures, and pubovaginal slings were found to be much less invasive with comparable long-term outcomes. These slings have stood the test…
Synthetic Midurethral Slings for the Correction of Stress Incontinence
In 1996, Ulmsten and colleagues introduced the first synthetic midurethral sling, which they named the tension-free vaginal tape (TVT) procedure. This procedure introduced the concept of placing a synthetic material (polypropylene) under the midportion of the urethra in a tension-free…
Obliterative Procedures for the Correction of Pelvic Organ Prolapse
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Vaginal Native Tissue Suture Repair of Vaginal Vault Prolapse
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Native Tissue Vaginal Repair of Cystocele, Rectocele, and Enterocele
Anterior Vaginal Wall Prolapse Anterior vaginal wall prolapse, or cystocele, is defined as pathologic descent of the anterior vaginal wall and overlying bladder base. The cause of anterior vaginal wall prolapse is not completely understood but is probably multifactorial, with…