A cystocele is when part of the bladder wall bulges into the vagina. The bulge happens through a defect in the wall between the bladder and vagina.
A rectocele is when part of the wall of the rectum bulges into the vagina. The bulge happens through a defect in the wall between the rectum and vagina.
These form because of a problem with the fascia, ligaments, and muscles of the pelvis.
Cystocele and rectocele can cause problems going to the bathroom such as frequent urination, urine leakage, and difficulty urinating. Pain during sex may also occur. This surgery is done to help relieve these symptoms.
Most often, this type of surgery is not done until all other treatments have been tried. Other treatments may include muscle exercises and the insertion of a supportive device called a pessary. If you have tried these treatments and have had no relief, your doctor may suggest surgical repair.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Prior pelvic surgery may increase the risk of complications.
You may be given an antibiotic just before surgery. A tube called a catheter will be inserted in the urethra. This will allow urine to drain and decrease pressure on the bladder.
A cut will be made in the skin to expose the involved muscle and tissue. In some cases, the muscles and tissue will be sewn back onto itself. This will make it stronger. In other cases, a mesh-type material will be used to strengthen the tissue. Any tissue that has been weakened by previous surgeries, pregnancies, or age will be removed. Excess vaginal lining will be removed as well.
In some cases, a suspension or elevation procedure may be done. These are special sutures that provide extra support to the bladder.
45 minutes to 2 or more hours
You will likely experience vaginal discomfort for 1-2 weeks following the surgery. You will be given medication to help relieve this.
The usual length of stay is 1-2 days. Your doctor may choose to keep you longer if complications arise.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
When you return home, do the following to help ensure a smooth recovery:
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
If you think you have an emergency, call for emergency medical services right away.
National Institute of Diabetes and Digestive and Kidney Diseases
The American Congress of Obstetricians and Gynecologists
Canadian Urological Association
The Society of Obstetricians and Gynaecologists of Canada
Agarwala N, Hasiak N, Shade M. Graft interposition colpocleisis, perineorrhaphy, and tension-free sling for pelvic organ prolapse and stress urinary incontinence in elderly patients. J Minim Invasive Gynecol. 2007;14(6):740-745.
Bladder prolapse (cystocele). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/bladder-prolapse-(cystocele)?article=118. Accessed December 18, 2017.
Pelvic organ prolapse. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114467/Pelvic-organ-prolapse. Updated March 23, 2015. Accessed December 18, 2017.
Vaginal prolapse surgery. The Royal Women's Hospital website. Available at: https://thewomens.r.worldssl.net/images/uploads/fact-sheets/Vaginal-prolapse-surgery-131217.pdf . Accessed December 18, 2017.
6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
6/9/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114467/Pelvic-organ-prolapse: Sung VW. Rardin CR, et al. Changes in bowel symptoms 1 year after rectocele repair. Am J Obstet Gynecol. 2012;207(5):423.e1-e5.
Last reviewed November 2018 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 12/20/2014