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Medications

Pelvic Organ Prolapse: Surgery for Cystocele

Cutaway view of pelvis
Cystocele

Cystocele is when the bladder sags into the vagina. The goal of surgery is to repair the problem and relieve your symptoms. Your surgery may include one or more repairs.

Cutaway view of pelvis
Anterior Repair

The Surgical Procedure

A cystocele can be treated with an anterior repair. This type of surgery is done through the vagina. The prolapsed bladder is moved back into its normal position. Sutures (stitches) are placed in tissue between the bladder and the vagina. In some cases, another type of surgery is done to correct weakness in the front wall of the vagina. The vagina is attached to strong tissues in the side wall of the pelvis.

Your Incisions

During surgery, the doctor reaches your pelvic organs through the vagina or the abdomen. An incision may be made in the vaginal wall. If incisions are made on the abdomen (lower belly), they can be vertical (up and down) or transverse (across).

Possible Risks and Complications of this Surgery

  • Infection

  • Bleeding

  • Risks of anesthesia

  • Damage to nerves, muscles, or nearby pelvic structures.

  • Blood clots

  • Prolapse of the pelvic organ or organs occurring again

Site of incision
Incision made in the vaginal wall

Site of incision
Abdominal incisions

 

 

 

 

 

Pelvic Organ Prolapse: After Surgery

You may go home the day of surgery, or you may stay in the hospital for 1 or more days. The length of your stay is based on the surgery you had.

Cutaway view of bladder
A suprapubic  catheter carries urine out of your bladder through an incision in your abdomen.

Cutaway view of bladder
A Foley catheter carries urine out of your bladder through your urethra.

Catheter, Drain, and IV

After surgery, it may be hard for you to urinate for a few days or weeks. A catheter (thin tube) helps drain your bladder. You may have a Foley catheter, which is put into the bladder through the urethra, or a suprapubic catheter, which is put into the bladder through a small incision in your abdomen. The catheter may be removed while you are in the hospital, or it may stay in place for a few days after you go home. Tubes may drain fluid from your incision. Intravenous (IV) lines give you fluids and medications. If you have a vaginal incision, you may have gauze packing in your vagina for 24 hours.

Managing Pain

A nurse can give you medication to control pain. Or, you may have a PCA (patient-controlled analgesia) pump attached to your IV line. This pump lets you give yourself pain medication. It is normal to feel some pain. But if the pain bothers you, tell your nurse right away. If you go home soon after surgery, you will have a prescription for pain medication to take with you. Call your doctor if this medication does not relieve your pain.

Returning Home

Your doctor will tell you when you can leave the hospital. An adult friend or family member should drive you home. When you get home, care for yourself as instructed and schedule any needed follow-up visits with your doctor.

 

Going Home with a Catheter

If you are still using the catheter when you leave the hospital, you may be told to:

  • Keep the catheter and the skin around it clean.

  • Clamp a suprapubic catheter to see whether you can urinate on your own. Then, measure the urine that drains from the catheter after you urinate.

Getting Out of Bed

You may be asked to get up and walk a little before you leave the hospital. Walking keeps your blood moving and helps prevent blood clots. Once you can get out of bed, you may be helped to the bathroom to see if you can urinate on your own. When you can stand on your own, you may be able to take a shower.

Recovering at Home

Your recovery at home will take some time.  You may need 6 to 8 weeks to recover fully.  The guidelines below will help you heal.  Be sure to follow any other instructions that your healthcare provider gives you.

Avoid Lifting or Straining

Lifting or straining can damage your healing pelvic floor muscles. 

  • For the first 6 weeks after surgery, do not lift anything over 5 pounds.  This includes children, grocery bags, and briefcases.  Also, avoid pushing and pulling heavy items, such as a vacuum cleaner.

  • After the first 6 weeks, you can start to lift heavier things.  But don't lift anything over 10 to 15 pounds until your doctor says it's OK.

  • While you heal, drink at least 8 glasses of fluids each day.  Eat food high in fiber.  This helps prevent constipation, which may lead to straining.  Ask your doctor whether you should take laxatives. 

Care for Your Incisions

Follow your doctor's instructions to care for your incisions.  Here are some guidelines:

  • Put nothing into your vagina for the first 6 to 8 weeks.  This includes tampons and douches.

  • You may have light vaginal bleeding or discharge for about a week.  Use sanitary pads.  Do not use tampons.

  • Take showers instead of baths.  Getting into and out of the tub can strain an incision.

  • If Steri-strips were used to close an incision, leave them in place for a week.  After that, you may wet and remove them.

  • Avoid having sex for as long as your doctor suggests (often 6 to 8 weeks).

Be Active

Follow any advice you doctor or other healthcare provider gives you to help you be active.  This may include the following:

  • Take walks often to help your body heal and regain strength after surgery.  Ask your doctor how often you should walk and for how long.

  • Do not lift weights, jog, or run until your doctor says that you can.

  • Ask you doctor whether you should avoid climbing stairs and, if so, for how long.

  • Don't drive until your doctor says it's OK and you are no longer taking prescription pain medications.

Your Return to Work

When you can return to work depends on the type of job you have.  Most people won't be able to go back to work for at least 3 to 6 weeks after surgery.  Your doctor can tell you when it's safe for you to return to work.  When you do start working again, be sure to avoid lifting and straining. 

When to call your Doctor (303)825-8822

Call your doctor if you have any of the following:

  • Pain that is severe or seems to be getting worse

  • Fever over 100.4'F(37.7'C), or chills

  • Heavy vaginal bleeding

  • Lots of blood in your urine

  • Difficulty urinating

  • Swollen, very red, or tender incision

  • Vomiting that won't stop

  • Chest pain

  • Shortness of breath

  • Symptoms of a bladder infection (fever, pain, or burning feeling when urinating, needing to urinate but not being able to)

Back in Control

If you worry about urine leakage, surgery can help you get back in control.  Be sure to take care of yourself by exercising, eating right, and seeing your doctor regularly.  If you have any questions or concerns, call your doctor.  Once you have healed from surgery, you can start enjoying life again.

 

 

 

© 2000-2020 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.