urethral folding

Urethral folding surgery, also known as vaginal anterior wall repair, is mainly through the repair and tightening of the anterior wall of the vagina to enhance the strength of the bladder neck and the posterior wall of the urethra to achieve the purpose of treating stress urinary incontinence. Treating diseases: uterine prolapse Indication Urethral folding is suitable for urethral folding for patients with stress urinary incontinence with vaginal anterior wall prolapse and uterine prolapse. Preoperative preparation 1. Patients with bladder urinary tract infection should be treated first, and surgery should be performed after the inflammation subsides. 2. Strengthen the exercise of the pelvic floor muscles and enhance their tension. 3. Patients with chronic cough should be treated after surgery. 4. Patients with perineal dermatitis, eczema, erosion, should be actively treated to keep the skin dry. 5. Apply soapy water and water to clean the inside of the thigh and vagina before use, then rinse the vagina with 1:2000 benzalkonium solution or 1:5000 liters of mercury solution. Surgical procedure 1. Incision: The labia minora is fixed on the labia majora with a thin wire, and the gravity hook pulls the vagina. The urethra is placed in the balloon catheter to expand the balloon. Make a median longitudinal incision in the anterior wall of the vagina, starting from about 1 cm below the urethral opening, extending up to the neck of the bladder, about 4 cm long. 2. Free vaginal anterior wall: The depth of the anterior wall of the vagina should be cut so as to expose the bladder neck and the posterior wall of the urethra, about 0.3 to 0.5 cm. The wound edge is lifted with a tissue forceps, and the vaginal wall is peeled off to the sides along the plane, and the peeling range depends on the degree of vaginal bladder swelling. Large wounds should be sutured to stop bleeding, and blood seepage can be temporarily suppressed by wet gauze. 3. Folding the urethra: recognize the position of the urethra and the bladder, and use the silk thread to make a horizontal folding suture on both sides of the posterior wall of the urethra. The proximal suture should be located in the bladder neck, a total of 4 needles. Then knot one by one to tighten the back wall. 4. Repair the anterior wall of the vagina: close the front wall of the vagina and cut off the excess vaginal wall so that the anterior wall of the vagina does not bulge after suturing. 5. Stitching the vagina: The vaginal wall should be sutured intermittently with a 1-0 absorbable line. The middle part of the suture should pass through the deep fascia layer, so that there is no dead space after suturing. Do not over-tighten the suture to prevent tissue necrosis and affect the healing of the incision. After the operation, the vagina is filled with a sterile gauze block, the catheter is indwelled and the catheter is properly fixed.

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