Pronounced: SIS-toh-SEEL or RECK-toh-SEEL
A cystocele occurs when part of the bladder wall bulges into the vagina. The bulge happens through a defect in the tissue between the bladder and vagina.
A rectocele occurs when part of the wall of the rectum bulges into the vagina. The bulge happens through a defect in the tissue between the rectum and vagina.
These form because of a problem with pelvic support tissues (eg, fascia, ligaments, and muscle).
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:
You will often have your choice of either general or regional anesthesia . With general anesthesia, you will be asleep. Regional anesthesia will numb your lower body, but you will be awake.
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.
45 minutes to two or more hours
You will likely experience vaginal discomfort for 1-2 weeks following the surgery. You will be given medicine to help relieve this.
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if complications arise.
When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, CALL 911 .
RESOURCES:
American Congress of Obstetricians and Gynecologists
http://acog.org/
National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov/
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org/
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/
References:
ACOG Education Pamphlet. American College of Obstetricians and Gynecologists. Available at: http://www.acog.org/publications/patient_education/bp012.cfm . Accessed July 21, 2008.
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 . 2007;14:740-745.
DeLancey JO. Functional anatomy of the female pelvis. Female Urology . Philadelphia, PA: JB Lippincott;1994:3-16.
Kobashi KC, Leach GE. Pelvic prolapse. Journal of Urology . 2000;164(6):1879-90.
Richardson AC. The anatomic defects in rectocele and enterocele. Journal of Pelvic Surgery . 1995;1:214-221.
Last reviewed October 2009 by Adrienne Carmack, MD
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 medical condition.
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