Vaginal Repairs - Overview
A vaginal repair aims to provide a long term cure for vaginal prolapse. A cut is made in the vaginal wall and stitches are used to hold up the bladder, the top of the vagina and the lower bowel. Different procedures are performed, depending on what type of prolapse you have:
- Anterior Repair - Repairs the front wall of the vagina, supporting the urethra and ladder.
- Posterior Repair - Repairs the back wall of the vagina, which supports the lower bowel (rectum). This can be combined with a perineoplasty, to tighten the skin between the vagina and the anus.
- You may also have this treatment in conjunction with a hysterectomy - removal of the womb.
Who will this treatment be recommended to?
You will often be recommended pelvic floor exercises before offered this treatment. If these are unsuccessful surgery may be required. Alternative treatments will also be discussed with your urogynaecologist.
How do I perform these exercises?
Your pelvic muscles can be strengthened with kegel exercises, helping to reduce the extent of vaginal prolapse. To perform these exercises, tighten your pelvic muscles as if you are trying to hold back urine. Hold the muscles tight for a few seconds and then release. Repeat this 10 times. You can do this up to four times a day and these exercises can be done anywhere.
Risks of Vaginal Repairs:
- Continuing Symptoms
- Recurring Prolapse - This may be a different type of prolapse and happens in around 30% of women who undergo a vaginal repair.
- You may have difficulty passing urine immediately after the surgery and require a catheter to drain the bladder.
- Bladder Injury - There is a low risk that the bladder could be damaged during operation. However, this can usually be repaired during the same operation, and you need a catheter to drain the bladder for ten days so it can heal properly.
- Narrower Vagina following surgery - this may make sex more difficult
Pre/Post Procedure Instructions:
What happens before my surgery?
A pre-assessment appointment, a few days prior to your procedure, may also be required. This can involve having blood tests and a general health check-up. This is also a good opportunity to ask any questions about your surgery.
What should I expect following my procedure?
You should be able to go home the same day as your procedure, before this:
- A pack (gauze) is sometimes placed inside the vagina to prevent excess bleeding - this is removed the following day.
- Catheter - You may need a catheter to drain the bladder - you can go home with a catheter for up to a week.
Recovery:
- Bath or shower as normal
- Do not use tampons for 6 weeks and avoid douching the vagina.
- You will probably feel tired during the day for a month or so, this will gradually improve.
- Avoid constipation and heavy lifting to reduce strain on the stitches. To avoid constipation, drink plenty of water and eat fruit and green vegetables.
- After 6 weeks you should start to slowly increase your level of activity. You should be back to your normal level after 3 months.
- You can return to work in a light job after 6 weeks, and a busy job in 12 weeks. Avoid unnecessary heavy lifting.
- You can start having sexual intercourse again after 6 weeks but you may wish to use lubrication to reduce pain.
