A cystocele 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. A rectocele 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. 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.
A cystocele and rectocele repair is an operation that lifts and tightens the tissue around the bladder and rectum so these organs no longer push against the vagina. This procedure is also known as an Anterior and Posterior Repair.
The procedure should allow easy, effective, and complete urination and better bowel control. It helps to be more active. You might be able to resume your normal level of activity without leaking urine. Bulging and pressure sensations in the vagina will be relieved.
Perineoplasty (also perineorrhaphy) denotes the plastic surgery procedures used to correct clinical conditions (damage, defect, deformity) of the vagina and the anus. Among the vagino-anal conditions resolved by perineoplasty are vaginal looseness, vaginal itching, damaged perineum, incontinence, genital warts, dyspareunia, intraoital stenosis, vaginismus, vulvar vestibulitis, and decreased sexual sensation. Depending upon the vagino-anal condition to be treated, there are two variants of the perineoplasty procedure: the first, to tighten the perineal muscles and the vagina; the second, to loosen the perineal muscles.
Surgery is done to relieve bulging into the vagina that may be caused by a cystocele and rectocele. Surgery is usually used only after you have tried other treatments such as:
Doing muscle-strengthening exercises, called Kegel exercises.
Placing a pessary in the vagina (a device that supports the vaginal walls). A pessary does not help a rectocele problem, but it can help with a cystocele.
Ask your doctor about these other treatment choices.
Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.
Follow instructions provided by your doctor. You may be asked to take an enema or medicine to clean out your bowel the day before surgery. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight or the morning before the procedure. Do not even drink coffee, tea or water.
You are given a regional or general anesthetic. A regional anesthetic numbs part of your body while you remain awake. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.
The doctor will make two cuts in the wall of the vagina, exposing the tissue between the vagina and the bladder and the tissue between the vagina and the rectum. The doctor will try to support these organs by bringing tissue around them. He or she will remove any tissue from the vaginal wall that has stretched from aging or pregnancy. If incontinence is a significant symptom, the doctor may also perform an elevation or suspension procedure on the bladder. Cuts in the vagina will be sewn closed.
The doctor may place a catheter (a tube for urine passage) in your bladder and lead it out through a cut made in your lower abdominal wall. This makes urinating easier during recovery and decreases the pressure inside the bladder.
You may stay in the hospital anywhere from 2 to 6 days. The catheter may remain in your bladder 2 to 6 days or until your bladder starts working normally again. You may be constipated during this time.
During the first 4 weeks after the operation, there may be some smelly, sometimes bloody drainage from your vagina.
After you leave the hospital, avoid all heavy activity such as lifting for the first 6 to 8 weeks. Then gradually increase your activity during the next 4 weeks.
Ask what other steps you should take and schedule checkups with the doctor 2 and 4 weeks after the operation.
This procedure should allow easy, effective and complete urination and better bowel control. It should help you to be more active. You might be able to resume your normal level of activity without leaking urine. Bulging and pressure sensations in the vagina also will be relieved.
There are some risks when you have general anesthesia. Discuss these risks with your doctor.
The regional anesthetic may not numb the area quite enough and you may feel some minor discomfort.
There may be damage to the bladder and rectum. If damage occurs and the doctor is aware of it, he or she will try to correct it during the operation.
There may be infection or bleeding.
You should ask your doctor how these risks apply to you.
Call the doctor immediately if:
The catheter becomes plugged and makes it hard to urinate.
You develop a fever.
You have heavy bleeding from your vagina.