is when part of the bladder wall bulges into the vagina. The bulge happens through a defect in the wall between the bladder and vagina.
Copyright © Nucleus Medical Media, Inc.
is when part of the wall of the rectum bulges into the vagina. The bulge happens through a defect in the wall between the rectum and vagina.
Copyright © Nucleus Medical Media, Inc.
These form because of a problem with the fascia, ligaments, and muscles of the pelvis.
Cystocele and rectocele can cause problems going to the bathroom such as frequent urination, urine leakage, and difficulty urinating. Pain during sex may also occur. This surgery is done to help relieve these symptoms.
Most often, this type of surgery is not done until all other treatments have been tried. Other treatments may include muscle exercises and the insertion of a supportive device called a pessary. If you have tried these treatments and have had 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: Reaction to anesthesiaInfectionBleedingAccidental damage to vagina, rectum, and bladderAccidental damage to nearby organsDifficulty with bowel movements
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinkingChronic disease such as diabetes or obesity
Prior pelvic surgery may increase the risk of complications.
Talk to your doctor about your current medications. Certain medications may need to be stopped before the procedure.
Eat a light meal the evening before the 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 have either
With general anesthesia, you will be asleep. Regional anesthesia will numb your lower body, but you will be awake.
You may be given an antibiotic just before surgery. A tube called a catheter will be inserted in the urethra. This will allow urine to drain and decrease pressure on the bladder.
A cut will be made in the skin 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. These are special sutures that provide extra support to the bladder.
45 minutes to 2 or more hours
You will likely experience vaginal discomfort for 1-2 weeks following the surgery. You will be given medication to help relieve this.
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if complications arise.
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 more time to begin to work normally.You may notice an odor and/or bloody discharge from the vagina for 1-2 weeks.
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
When you return home, do the following to help ensure a smooth recovery: Avoid lifting anything that weighs more than 10 pounds for about 6 weeks.Avoid sexual intercourse for about 6 weeks.Avoid inserting anything into the vagina, including tampons, for about 6 weeks.Be sure to follow your doctor’s
After you leave the hospital, contact your doctor if any of the following occur: Signs of infection, including fever and chillsExcessive bleeding or any discharge from the incision siteUnusually heavy vaginal bleeding or foul-smelling discharge from the vaginaNausea or vomitingPain that you cannot control with the medications you have been givenInability to pass urine into the catheterPain, burning, urgency or frequency of urination, or persistent blood in the urineCough, shortness of breath, or chest pain
In case of an emergency, call for emergency medical services right away.
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.
Bladder prolapse (cystocele/fallen bladder). Urology Care Foundation website. Available at:
http://www.urologyhealth.org/urology/index.cfm?article=118. Accessed November 24, 2015.
Kobashi KC, Leach GE. Pelvic prolapse.
Journal of Urology.
More about surgery. The Royal Women's Hospital website. Available at:
. Accessed November 24, 2015.
Last reviewed November 2015 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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