Lateral cross section of female reproductive system, illustrating the vesicovaginal and rectovaginal areas As pelvic organ prolapse and stress urinary incontinence can be present separately or simultaneously, surgical<unk>  is implanted into vesicovaginal and rectovaginal region through the vaginal route in different approaches, to manage patients’ condition properly. Pelvic organ prolapse (POP) surgery The goal of POP repair with<unk>  is to increase longevity in patients by reconstructing organ position and preventing pelvic organs from bulging into the vagina. Generally, the position and incisions for<unk>  are determined by the corresponding pelvic muscle defect, which differs from patient to patient. The implantation usually starts with anterior colpotomy, which is an incision on the anterior vaginal wall to assess the vesicovaginal space in front of the vagina. For patients who have undergone hysterectomy or will be preserving their uterus, only longitudinal anterior incision can be performed. For patients who are also receiving a concomitant hysterectomy, an anterior colpotomy, a Cross-T-shaped incision that cuts around the cervix, or a single incision around the cervix and across the vagina will be performed. Tissue Fixation System (TFS) invented in Australia, an example of<unk>  implant to repair pelvic organ prolapse and stress urinary incontinence. In consideration of the patient's specific conditions, the<unk>  can be positioned in front of the vaginal wall (cystocele correction), behind the vaginal wall (rectocele correction), or on top of the vagina (uterine prolapse correction). For cystocele corrections, horizontal arms will be inserted on the lateral bladder walls through the obturator foramen by an Emmet needle. Meanwhile, vertical straps will be placed onto the fibrous thickenings of pelvic fascia anteriorly and posteriorly in order to reposition the bladder. Alternatively, an incision on the posterior vaginal wall will be needed to place the<unk>  through the perineal skin for rectocele correction. To hold the rectum upright, the horizontal straps are inserted into space surrounding the rectum, brought out of the body and pulled below the anus. If both corrections are required,<unk>  can be cut into two pieces before operation and adjusted for accurate reconstruction. After putting the prolapsed organs back to its original position and reinforcing the vaginal wall, the incision is closed with sutures.<unk>  surgery is expected to show improved pelvic support after the first few weeks, particularly for non-absorbable<unk> es which have a higher biocompatibility and permanent outcome. For absorbable<unk> es, longer recovery time and lower durability are expected as native tissues need to grow into the pores to support the weakened organs. Stress urinary incontinence (SUI) surgery<unk> , also known as midurethral or bladder neck sling for SUI repair, can be used to support the urethra or the neck of the bladder in two surgical approaches, namely the retropubic and transobturator. In the retropubic approach, two incisions above the pubic bone and one incision in the vagina are performed. The<unk>  is then placed under the urethra through the retropubic space, which is anterior to bladder and posterior to pubic symphysis, and brought out to the suprapubic area. In the transobturator approach, two incisions in the groin area and one incision in the vagina are performed. The<unk>  is inserted through the obturator foramen to avoid damage of pelvic organs, and brought out to the skin in the groin area. Since 2008, mini-slings with single vaginal incision have been introduced to reduce complications without comprising the successful rate.
Transvaginal mesh
Cervical pessary
Macy catheter
Vaginoplasty
Perineal dilator
Vaginal dilator
Hymenorrhaphy
Progesterone vaginal ring