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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Cystocele Repair
What is a cystocele repair?
A cystocele is a type of hernia in which the urinary bladder
pushes against weakened tissue in the front wall of the
vagina. It causes a bulging into the vagina. Common causes
of a cystocele are aging and pregnancy with vaginal
delivery.
A cystocele repair is an operation that lifts and tightens
the tissue around the bladder so that it no longer pushes
against the vagina.
When is it used?
Surgical repair is done to relieve symptoms that may be
caused by a cystocele.
Symptoms of a cystocele may include the following:
- If the urethra (the tube through which urine drains from
the bladder) is pulled out of position, you may leak
urine when you cough, laugh, or lift a heavy object.
(This is called stress incontinence.)
- Your bladder may not empty completely after you urinate.
The urine remaining in the bladder may then become
infected, causing frequent and very painful urination.
- You may have bulging and pressure sensations in the
vagina.
Examples of alternatives to cystocele repair include:
- doing muscle-strengthening exercises, called Kegel
exercises, which help some women
- placing a pessary in the vagina (A pessary is a device
that can be put into the vagina to support the vaginal
walls. Your doctor can help you choose an appropriate
one.)
- choosing not to have treatment, recognizing the risks of
your condition.
You should ask your doctor about these choices.
How do I prepare for a cystocele repair?
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. Eat a light
meal, such as soup or salad, the night before the procedure.
Do not eat or drink anything after midnight and the morning
before the procedure. Do not even drink coffee, tea, or
water.
What happens during the procedure?
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 a cut in your vagina and expose the
tissue between the vagina and the bladder. He or she will
try to support the bladder by bringing more tissue around
it. The doctor 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. Then the
cut 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 either through a cut made in
the abdominal wall or through the urethra (the tube through
which urine normally flows). This will help you pass urine
while you are recovering and decrease the pressure inside
your bladder.
What happens after the procedure?
You may stay in the hospital about 2 to 6 days. The
catheter may stay in your bladder 2 to 6 days or until your
bladder is working again.
During the first 4 weeks after the operation, there may be
some smelly, sometimes bloody drainage from your vagina.
After you go home from the hospital, avoid all heavy
activity such as lifting for the first 2 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.
What are the benefits of this procedure?
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 will be
relieved.
What are the risks associated with this procedure?
- 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.
- Your bladder could be punctured. If this happens (and
your doctor sees it), the doctor will try to correct it
during the operation.
- You may develop an infection or bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- The catheter becomes plugged and you stop passing urine.
- You develop a fever.
- You have heavy bleeding from your vagina.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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