These form because of a problem with pelvic support tissues (eg, fascia, ligaments, and muscle).
Reasons for Procedure
These repairs are done to stop symptoms like problems going to the bathroom, urine leakage, or pain during sex. Most often, this type of surgery is not done until other treatments have been tried. Other treatments may include muscle exercises and the insertion of a pessary device (a device put into the vagina to try to push the bladder or rectum back into place). If you have tried these treatments and experienced no relief, your doctor may suggest surgical repair.
Complications are rare, but no procedure is completely free of risk. If you are planning to have this type of repair, your doctor will review a list of possible complications, which may include:
Adverse reaction to anesthesia
Accidental damage to vagina, rectum, and bladder
Accidental damage to nearby organs
What to Expect
Prior to Procedure
Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
or other anti-inflammatory drugs for up to one week before surgery
Do not have anything to eat or drink after midnight on the night before the procedure.
If you are having a rectocele repair, you may need to have an enema the night before the surgery.
You will often have your choice of either
With general anesthesia, you will be asleep. Regional anesthesia will numb your lower body, but you will be awake.
Description of the Procedure
A bladder catheter will be inserted in the urethra to decrease pressure on the bladder.
A cut in the skin will be made to expose the involved muscle and tissue. In some cases, the muscles and tissue will be sewn back onto itself. This will make it stronger. In other cases, a mesh-type material will be used to strengthen the tissue. Any tissue that has been weakened by previous surgeries, pregnancies, or age will be removed. Excess vaginal lining will be removed as well.
In some cases, a suspension or elevation procedure may be done to provide extra support to the bladder.
How Long Will It Take?
45 minutes to two or more hours
How Much Will It Hurt?
You will likely experience vaginal discomfort for 1-2 weeks following the surgery. You will be given medicine to help relieve this.
Average Hospital Stay
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if complications arise.
At the Hospital
A medicated vaginal packing is usually left in the vagina overnight.
If you had a rectocele repair, the bladder catheter will be removed as soon as you are able to use the restroom on your own. If you had a cystocele repair, the bladder catheter often needs to stay in longer (sometimes 2-6 days). This will allow the bladder time to begin working normally again.
You may notice a smelly, even bloody, discharge from the vagina for 1-2 weeks.
When you return home, do the following to help ensure a smooth recovery:
Avoid lifting anything that weighs more than 10 pounds for about six weeks.
Avoid sexual intercourse for about six weeks.
Avoid inserting anything into the vagina (eg, tampons) for about six weeks.
Have someone to help you at home for a few days following the surgery.
Drink plenty of fluids and eat a healthy, high fiber diet to keep stools soft.
Be sure to follow your doctor’s
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
Signs of infection, including fever and chills
Excessive bleeding, or any discharge from the incision site
Unusually heavy vaginal bleeding, or foul-smelling discharge from the vagina
Nausea or vomiting
Pain that you cannot control with the medicines you have been given
Inability to pass urine into catheter
Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
Agarwala N, Hasiak N, Shade M. Graft interposition colpocleisis, perineorrhaphy, and tension-free sling for pelvic organ prolapse and stress urinary incontinence in elderly patients.
J Minim Invasive Gynecol
DeLancey JO. Functional anatomy of the female pelvis.
. Philadelphia, PA: JB Lippincott;1994:3-16.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a