Posterior vaginal bulge repair

1. Old perineal laceration, vaginal opening, rectal bulging. 2. Uterine prolapse with vaginal posterior wall bulging. Treatment of diseases: rectal bulging uterine prolapse Indication 1. Old perineal laceration, vaginal opening, rectal bulging. 2. Uterine prolapse with vaginal posterior wall bulging. Preoperative preparation 1. Vaginal rinse for 3 consecutive days before surgery. 2. Oral antibiotics were taken 3 to 5 days before surgery. 3. Clean the enema 1 time before the operation and the morning of the operation. 4. 1 day before surgery, the vulva is prepared for skin. Surgical procedure 1. Position and disinfection: the stone removal position. Routine disinfection of the vulva, vagina. 2. Incision: A transverse incision is made at the joint skin after the perineum, with a width of the vaginal opening. A longitudinal incision is made at the midpoint of the incision to the posterior wall of the vagina to form a "" shaped incision. 3. Separation of the posterior wall of the vagina: Separate along the incision against the vaginal wall, and the lower part of the perineum is placed on the upper third of the vagina to reach the rectal column. 4. Stitching the rectal column and the middle and upper mucosa of the vagina: suturing the rectal tissue and the rectal column which have been peeled off from the top and the bottom from top to bottom, and suturing the rectal wall while suturing. At the same time, the upper middle vaginal wall is sutured intermittently, so as to avoid difficulty in suturing the upper part of the vagina. After each suture, it is necessary to check the width of the vagina to accommodate more than two fingers. 5. Stitching the levator ani muscle: exposing the levator ani muscle on the right side. Suture the left and right levator ani muscles together. When suturing, check the width of the vagina and cut off excess vaginal mucosa. 6. Reconstruct the posterior wall of the vagina and the perineum: suture the vagina and perineum continuously with the absorbable suture. When suturing, pay attention to the perineum can not face the vaginal cavity, otherwise it will cause vaginal stenosis

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