Anterior and posterior repair

If the wall between the vagina and bladder becomes weak it is called a cystocele. If the wall between the rectum (bowel) and the vagina becomes weak it is called a rectocele. If the wall between the pelvis and vagina becomes weak it is called an enterocele. If the main ligaments holding the uterus and top of the vagina in place becomes weak, it is called uterovaginal prolapse, as the womb comes down. It is graded according to the amount of prolapse (grade 1 = the prolapse comes down but does not reach the outside, grade 2 = the prolapse comes out but goes back up, grade 3 = the prolapse stays outside the vagina).

The operation

The operation can be performed under general (asleep) or regional (awake) anaesthetic and takes about 1 hour.

The vagina is opened and the bladder or bowel reflected (moved out of the way). Sutures (stitches) are placed on either side and brought together to strengthen the wall. During the operation, a catheter will be passed into the bladder to drain off the urine (so the bladder doesn’t get in the way of the operation).

If there is uterovaginal prolapse it will be necessary to perform a vaginal hysterectomy at the same time. Although there will be some discomfort following the surgery, this will be controlled with pain killers. The average length of stay in hospital is 1 – 4 days and normal activities can be resumed within 2 – 6 weeks. There should be no problem with sexual intercourse once fully recovered from the operation.