Description

The anterior vaginal wall can sink (prolapse) or bulge. This occurs when the bladder or the urethra sink into the vagina..

Your surgeon will:  Make a surgical cut through the front wall of your vagina

    Move your bladder back to its normal location.

    May fold your vagina, or cut away part of it.

    Put sutures (stitches) in the tissue between your vagina and bladder. These will hold the walls of your vagina in the correct position.

    Place a patch between your bladder and vagina. This patch can be made of commercially available biological material (cadaveric tissue). The FDA has banned use of synthetic material and animal tissue in the vagina to treat anterior vaginal wall prolapse.

    Attach sutures to the walls of the vagina to the tissue on the side of your pelvis.

complication

With any surgery there is always a small risk of complications. The following general complications can happen after any surgery:

• 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.

The following side effects are more specifically related to anterior vaginal wall repair.

• Damage to the bladder or ureters during surgery is an uncommon complication which can be repaired during surgery.
• After a large anterior vaginal wall repair some women may develop stress urinary incontinence due to the unkinking of the urethra (tube from the bladder). This can usually be resolved by doing pelvic floor exercises (as taught by a specialist pelvic floor physiotherapist) or by surgery to support the urethra (see the leaflet on stress urinary incontinence).
• Some women develop pain or discomfort with intercourse (dyspareunia). While every effort is made to prevent this from happening, it is sometimes unavoidable. Some women also find intercourse is more comfortable after their prolapse is repaired.
• Constipation is a common post-operative problem, and your doctor may prescribe laxatives for this. Try to maintain a high fiber diet and drink plenty of fluids to help as well.