Cystocoele Repair (Natural)

Repair of an anterior / bladder prolapse using natural tissue and repair of introitis

This procedure is done under a spinal / general anesthetic, as decided by the anesthetist.

An incision is made along the center of the front wall of the vagina starting near the vaginal entrance and finishing near the top of the vagina.
The vaginal skin is then separated from the underlying supportive fascial layer.
The weakened fascia is then repaired using absorbable stitches, which will absorb over 4 weeks to 5 months depending on the type of stitch (suture) material used.
Sometimes excessive vaginal skin is removed, and the vaginal skin is closed with absorbable sutures, these usually take 4 to 6 weeks to fully absorb.
Reinforcement material in the form of biological (absorbable) may be used to repair the anterior vaginal wall.
Mesh is no longer used
A cystoscopy may be performed to confirm that the appearance inside the bladder is normal and that no injury to the bladder or ureters has occurred during surgery.
A pack may be placed into the vagina and a catheter into the bladder at the end of surgery.
If so, this is usually removed after 3-48 hours. The pack acts like a compression bandage to reduce vaginal bleeding and bruising after surgery.
You will have a vaginal pack to reduce any bleeding.
Both the pack and the catheter are usually removed within 48 hours of the operation.

Quoted success rates for anterior vaginal wall repair are 70-90%.
There is a chance that the prolapse may come back in the future, or another part of the vagina may prolapse for which you need further surgery.
Recurrence rates are as much as 50% in the next 3 years.

With any surgery there is always a small risk of complications.
Anesthetic problems. With modern anesthetics and monitoring equipment, complications due to anesthesia are very rare.
Bleeding. Serious bleeding requiring blood transfusion is unusual following vaginal surgery (less than 1%).
Post operative infection. Although antibiotics are often given just before surgery and all attempts are made to keep surgery sterile, there is a small chance of developing an infection in the vagina or pelvis.
Bladder infections (cystitis) occur in about 6% of women after surgery and are more common if a catheter has been used. Symptoms include burning or stinging when passing urine, urinary frequency and sometimes blood in the urine. Cystitis is usually easily treated by a course of antibiotics.
Constipation is a common postoperative problem.
Pain with intercourse (dyspareunia). Some women develop pain or discomfort with intercourse.
Damage to the bladder or ureters during surgery is an uncommon complication which can be repaired during surgery.
Incontinence. After a large anterior vaginal wall repair some women develop stress urinary incontinence due to the unkinking of the urethra.
This is usually simply resolved by placing a supportive sling under the urethra section.

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Wes Cystoscoele Repair Natural