E F Nigel Holland
Consultant Gynaecologist and Obstetrician

Patient Leaflet 10 - Anterior and Posterior Repair of the Vagina - Back to List

This leaflet has been designed to help you prepare for your operation. It does not contain all the known facts about your operation or complaint. Some of the risks associated with your operation will depend on your medical condition and, as any operation can be life threatening, these risks will vary from person to person. Your doctor will be available to discuss these with you.

What is an Anterior and Posterior Repair of the Vagina?

This operation is done when you have a prolapse. This is a weakness in the muscles supporting the uterus (womb), bladder and rectum (back passage).
The two most common repairs are:-
Anterior (front) repair or Cystocele. - This is an operation which is done when the bladder prolapses or "drops" into the front wall of the vagina.
Posterior (back) repair or Rectocele. - This is an operation which is done when the rectum prolapses or "drops" into the back wall of the vagina.
You will be in hospital for approximately 5-10 days.

Why do I need an operation?

Symptoms may include a feeling of fullness or heaviness with a lump felt in the vagina that may or may not feel as though it is getting bigger over the course of the day.
Benefits of the operation:

  • No incision (cut) on the abdomen
  • No sutures (stitches) to remove
  • The symptoms of pressure will improve

Risks accociated with the operation

No operation is without risk. Those associated with this operation include

  • Damage to nearby organs
  • Haemorrhage (difficulty in controlling bleeding)
  • Infection
  • Difficulty passing urine
  • Recurrence of the prolapse
  • If any of the above occurs further surgery or treatment with antibiotics may be needed.
  • Risks associated with a general anaesthetic
    A general anaesthetic (you will be asleep) also carries a small risk. These risks are greater for women who smoke or are overweight. It is advisable, if either of these apply, to reduce or stop smoking and try to lose some weight. In addition there may be special risks for women with certain medical problems such as heart or lung disease.

You will be able to discuss any concerns you may have with your anaesthetist before your operation.

What happens before the operation?

You will be admitted to the ward either on the day before, or, on the same day as your operation. If you have not attended a pre operative assessment clinic you will need to have some investigations performed e.g blood tests, E.C.G (heart tracing). These will be done on the day of admission. It may be necessary to wear special stockings and/or have a series of small injections which help lower the risk of blood clots developing. You will have the opportunity to ask any questions concerning your operation or your anaesthetic. You may be seen by the physiotherapist.

What happens during the operation?

The operation is normally done under general anaesthetic and takes between one - one and a half hours. You will be away from the ward for approximately two - three hours depending on your recovery time. Your operation is done through the vagina so there will be no incision on your abdomen. There will, however, be sutures inside the vagina which will slowly dissolve. You may need a catheter (a narrow, hollow tube) to drain the urine from your bladder. This is normally removed after 24 - 48 hrs depending on the doctors decision and providing everything is satisfactory. You may have a drip (intra venous infusion, I.V.) usually in the back of the hand. This will help to give you fluids and/or drugs until you start to eat and drink. There is a possibility that you will have a gauze dressing put inside your vagina. This will be removed after 24 - 48 hours depending on the doctors' decision

Will I have any pain?

Any operation can produce pain. This can be mild in some patients and more severe in others. Always tell a member of staff if you are in pain, there is no need to suffer!

There are several methods of pain relief (analgesia) available. Before your operation the anaesthetist will discuss and explain to you which is the best method of analgesia for you. These methods can include:-

  • Epidural analgesia - an infusion (drip) around the spinal cord to numb the nerves and help prevent pain.
  • Patient Controlled Analgesia (PCA) - you control how much pain relief you need by pressing a hand held button attached to a pump (similar to a drip).
  • Intra muscular analgesia - a pain killing injection usually given into the muscle of either your bottom or thigh.
  • Suppository - this is for pain relief. It is given, with your permission, into your back passage (rectum).
  • Tablets taken by mouth when you feel able to drink.
  • It may be necessary to take some form of analgesia when you go home.

Will I feel sick?

Some patients may feel sick. This can be caused by anaesthetic or operation. Some of the drugs used for pain relief can also cause nausea and sickness. An anti sickness preparation can be given to help control this.

What happens after the operation?

On your return to the ward the nurse will check your blood pressure, pulse and wound at regular intervals. The amount of urine you pass through the catheter will also be monitored. On the first day after your operation you will be given help with your personal hygiene and encouraged to sit out of bed for short periods. If you have a gauze dressing inside your vagina this will be removed after 24 hours or when the doctor advises.

Depending on how you feel on your second day, you will be given help to wash yourself or have a bath or shower. Providing you are eating and drinking your drip should be able to be discontinued. By day three, if everything is satisfactory, your catheter will have been removed and the nurses will be monitoring how much and how often you are passing urine. You will be encouraged to move around more and be able to bath or shower without assistance. Please tell a member of staff if you have difficulty opening your bowels. You may need to have some form of medication to help with this. Do not force yourself to open your bowels.

Please remember not to compare your recovery with other patients. Not every one has had the same operation and all patients are different.

Going home

You will probably be tired when you go home. It is be advisable, if possible, to arrange for someone to stay with you for your first few days at home

  • Rest whenever you feel tired
  • Drink plenty of fluids and empty your bladder regularly
  • It is advisable to bath each day but avoid bubble bath and other perfumed bath products
  • You may still have some bleeding or discharge from your vagina. This should be decreasing. To help prevent any infection please use sanitary towels, not tampons.
  • After about 10-14 days you may find small pieces of suture material on your pad. Do not worry about this, the internal sutures are beginning to dissolve.When this occurs, bleeding from the vagina may increase slightly. If this becomes heavy or you are passing clots then you need to contact your doctor and rest.
  • Continue to rest whenever you feel tired but remember to do some form of gentle exercise each day.
  • Gradually increase your activities. After about six weeks you should be able to do most of the things you were doing before your operation. However, it is important not to do any lifting or heavy housework until after approximately 10 weeks or until you have seen the doctor at your follow up appointment.

The best advice you can have is to listen to your body. If you feel tired then rest.

How soon can I resume driving?

It is advisable to wait at least six weeks after your operation or until after your follow up appointment. You need to be able to do an emergency stop and you may not have the strength to do this. It can also be painful. Please check this situation with your insurance company.

When can I start sporting activities?

Check with your doctor at your follow up appointment

What about sex?

Sexual activity can normally be started after your check up which is usually about six weeks. After your operation please be sure that both mentally and physically you feel ready to start having sexual intercourse.

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all content © Nigel Holland 2005-2010