✦ Pelvic Floor Repair Treatment

Paravaginal Repair

Q: What is the arcus tendineus fasciae pelvis?

The arcus tendineus is a thickened band of fascia running along the pelvic sidewall from the pubic symphysis to the ischial spine — the natural anchor point for vaginal support.

Q: Will paravaginal repair fix my leaking?

Paravaginal repair corrects the support defect beneath the urethra, which resolves stress leakage from urethral hypermobility in 60–80% of patients.

Q: Can paravaginal repair be done laparoscopically?

Yes — laparoscopic and robotic paravaginal repair achieves equivalent anatomical outcomes to open retropubic repair with significantly smaller incisions and faster recovery.

Surgical correction of lateral vaginal wall detachment to restore pelvic floor anatomy

60–120 min PROCEDURE

1–3 Days HOSPITAL STAY

>80% SUCCESS RATE

3–4 Weeks RECOVERY

What is Paravaginal Repair?

Paravaginal Repair corrects a paravaginal defect — detachment of the lateral vaginal walls from the arcus tendineus fasciae pelvis (the "white line") on the pelvic sidewall. This defect causes anterior vaginal wall prolapse (cystocoele) and contributes to stress urinary incontinence by disrupting the hammock-like supportive layer beneath the urethra. The repair reattaches the pubocervical fascia to the arcus tendineus, restoring the support layer and correcting both the prolapse and incontinence simultaneously. It can be performed vaginally, laparoscopically, or robotically. The procedure is performed under general or spinal anaesthesia with a hospital stay of 1–3 Days.

Women with anterior vaginal wall prolapse (cystocoele) caused by paravaginal defects, particularly those with lateral sulcus defects identified on examination or urodynamic assessment, and stress urinary incontinence from urethral hypermobility.

How the Procedure Works

Space of Retzius Entry

Under general anaesthesia, the retropubic space of Retzius is entered through a Pfannenstiel or laparoscopic approach.

Defect Identification

The paravaginal defect is confirmed by direct palpation — the surgeon's finger in the vagina and direct vision confirm the detachment site.

Suture Placement

Three to five permanent or long-lasting absorbable sutures are placed through the full thickness of the pubocervical fascia and tied to the arcus tendineus.

Bilateral Repair

After completing one side, the same suture sequence is placed on the contralateral side.

Combined Procedures & Closure

If a Burch colposuspension or mid-urethral sling is planned, it is completed at this stage through the same access.

Outcomes

60–120 minDURATION

1–3 DaysHOSPITAL STAY

>80%SUCCESS RATE

3–4 WeeksFULL RECOVERY

Who Needs This Treatment?

→Women with anterior vaginal wall prolapse (cystocoele) where a lateral paravaginal defect is the cause.
→Those with stress urinary incontinence caused by urethral hypermobility from loss of lateral support.
→Patients in whom anterior colporrhaphy alone has failed — paravaginal defects are not corrected by central plication.
→Women seeking combined prolapse and incontinence correction through the same retropubic approach.
→Those undergoing laparoscopic or robotic sacrocolpopexy where paravaginal repair adds anterior compartment correction.
→Patients who wish to avoid synthetic vaginal mesh — paravaginal repair uses native tissue sutures.

"Paravaginal repair addresses prolapse at its anatomical origin — the detachment of the vaginal support from the pelvic sidewall. By reattaching fascia to the arcus tendineus, we restore the natural supportive architecture of the anterior compartment."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

What is the arcus tendineus fasciae pelvis?+

Will paravaginal repair fix my leaking?+

Can paravaginal repair be done laparoscopically?+

Not sure which treatment is right for you?

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