Transvaginal anterior repair

Anterior colporrhaphy.
(A) With the patient in the dorsal lithotomy position, the anterior vaginal wall is clearly visualized. Using Allis clamps to grasp the anterior vaginal wall, a transverse incision is made using a knife at the proximal aspect of the defect. Sharp dissection in a vertical manner is then performed as superficial as possible using Metzenbaum scissors along the midline of the anterior vaginal wall, staying at least 1 cm away from the external urethral orifice.
(B) Sharp dissection is performed bilaterally to clear the mucosa from the underlying muscularis and adventitia to the level of the pubic symphysis.
(C) Plication of the remaining muscularis and adventitia is then performed with a delayed absorbable suture, thereby repairing the anterior wall support defect.
The vaginal mucosa is then trimmed and closed in a running manner.