Transposition of the urethra in women: training, methodology
Plastic surgery used to bias the external passage of the urethra at 1-1,5 cm above the vaginal entrance, is called «transposition of the urethra». This surgical intervention is that professionals increase the distance between the urethra and the vagina, and reduce mobility of the bladder, resorting to moderate sprain.
Indications for performing surgery:
- chronic or post-coital cystitis;
- dystopia of the urethra;
- hypermobility of the urethra.
Cystitis, dystopia and hypermobility of the urethra
Cystitis is an inflammatory processes that occur in the urinary cavity of women. Often the appearance of this disease bacteria is to blame. Infection in the bladder often cause acute pain, moreover, can give complication and navigate to the kidneys. In the case where the therapy of cystitis was incorrect, the inflammation takes the chronic form is called chronic cystitis.
Postcoital cystitis is a type of cystitis, deteriorating after sexual intimacy and revealed itself after 24-48 hours. This disease is aggravated by almost any sexual act, regardless of whether there was use of a condom. The cystitis is accompanied by severe pain.
Dystopia is the external opening of the urethra is an inherited disease, it is characterized by a low location of the outer passage of the urethra, based almost on the front wall of the vagina. Dystopia almost always acts as a causative agent of cystitis, which subsequently develops into chronic cystitis.
Urethral hypermobility excessive mobility of the far Department of the urethra, so it leaves the area of the manometric depression during physical exertion or sexual intercourse. Because of this during sex the urethra that moves into the vagina, and due to the reciprocating movements, unusual for urinary tract microflora gets into the urethra, then to bladder, causing inflammation.
Contraindications to transposition of the urethra in women
Note the following contraindications to surgery:
- acute inflammation in the urethra or in the vagina, and the presence of thrush;
- cases when the woman has not yet undergone birth, because the decrease in mobility of the urethra is often detrimental to the future of childbirth and increases the likelihood of injury to the urethra.
Preparing for surgery
Transposition of the urethra includes standard training and another surgery. The doctor prescribes examination, which includes General analysis of blood and urine, biochemical blood analysis, which shows the functional status of all organs and a blood test for hepatitis. In situations where there are other pathology, the patient will need to consult with another doctor.
Method of operation
Surgery for transposition of the urethra is carried out as outpatients and in day care. When the operation is applied and the local, and General anesthesia, however, many experts agree that to carry out surgery need under local anesthesia. For anesthesia performed catheterization of the bladder cavity, after which surgeons attach the drainage bag to the catheter. The technician then produces the section and customize the outer passage of the urethra slit up, fixing his special stitches. With surgery the rejected hole rises to 1-1,5 cm above the vaginal entrance, because this manipulation occurs elongation and compression in the urethra.
At the end of the transposition introduced into the vagina with a cotton swab soaked with an antiseptic, which will help prevent various inflammatory processes and decay. The catheter often stays in the bladder cavity for up to 7 days, until the wound heals, in order to prevent contact of the wound with urine. In circumstances where the operation took place under local anesthesia, the patient leaves the surgery for 2 hours after the transposition of the urethra. If the transposition of the urethra was carried out under General anesthesia, the patient will need to remain under observation in hospital until the morning. It is important to say that the surgical intervention is better to move, if the operation comes at a time of critical days or for a period of 1-2 days before or after menstruation.
The effectiveness of transposition of the urethra and complications
Surgery every year proves its effectiveness as the best method of treatment in case of a displacement of the external opening of the urethra. A huge number of clinical studies that show that approximately 80% of women subjected to transposition of the urethra, the number of recurrences of this disease is reduced in 7-10 times.
Despite the fact that this operation is not difficult and lasts from 30 to 60 minutes, it may be postoperative complications. The most frequent infectious-septic complications, as well as injury to the integrity of the urethra. There are measures for the prevention of postoperative inflammation, which doctors usually recommend taking antibacterial drug called «Monural».