Transvaginal paravaginal defect repair

Transvaginal paravaginal repair - After complete sharp dissection of the anterior vaginal mucosa, the endopelvic fascia is sharply incised using Metzenbaum scissors, thereby entering the retropubic space. Medial retraction allows visualization of the pelvic sidewall and the arcus tendineus fascia pelvis (Image A). The lateral vagina is then reattached to the pelvic sidewall with a series of interrupted permanent sutures through the lateral vagina and arcus tendineus fascia pelvis (Image B). The interrupted sutures are not tied until all have been placed (Image C). Tying of the sutures results in closure of the lateral vaginal support defect.