Repair of cystocele
Under normal conditions in women, the bladder is held in place by a layer of tissues (fascia) between the bladder and uterus and cervix and supporting pelvic floor muscles. When these tissues are stretched and/or become weak, the bladder can drop and bulge through this layer and into the vagina. This results in bladder prolapse, also called cystocele. In severe cases, the prolapsed bladder can be seen and felt at the opening of the vagina. Sometimes it can even protrude (drop) through the vaginal opening.
How is the surgery done
Surgical repair of the cystocele is done by making an incision in the vaginal wall over the bulging bladder. The bladder is dissected off the vagina and from the uterus and cervix. Once freed, the bladder is replaced in position. The tissues (fascia) between the bladder and the vagina are strengthened by application of multiple sutures which also improves the tone of the vaginal walls. The cut edges of the vagina are repaired. All sutures absorb over time and do not removing. Surgical mesh and grafts are not used, since research suggests no benefit from these materials.
After surgery
You’ll probably need to stay in hospital overnight or for a few days following surgery. You are likely to have a thin flexible tube, a urinary catheter, to help you pass urine as you may find it difficult to do that yourself. The catheter is removed 12 -24 hours later following which you should be able to pass urine satisfactorily.
You may also have a long piece of gauze placed inside the vagina to put pressure on the vaginal edges to help stop any bleeding. This can be uncomfortable and is removed after 12 hours.
Recovery
For the first few days or weeks after the operation, you may have some vaginal bleeding or discharge, and during this time you would use sanitary towels and not tampons.
You should be able to have a shower and bathe as normal once you have left hospital, but you may need to avoid swimming for 6 weeks.
It’s best to avoid having sex for around 4 to 6 weeks, until you have healed completely.
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