Surgical Repair of Pelvic Support Problems

Pelvic support problems may be corrected by surgery. The type of support problem you have will influence whether surgery is done through the vagina or abdomen.

Enterocele: This is usually repaired through the vagina, but may also be done through the abdomen (Moskowitz Repair).

Rectocele: This repair is done through the vagina.

Cystocele: This repair is done through the vagina.

Vaginal Suspension (Marlex): This repair is done through the abdomen, using a synthetic mesh to the sacral area.

Burch Bladder Suspension: This repair is done through the abdomen restoring the normal angle between the bladder and urethra to correct urinary stress incontinence.

 

What do I need to do prior to the surgery?

You will need to meet with the Advanced Admission Preparation department for lab work and x-rays. These tests could include blood test, urine test, chest x-ray, and x-rays of your kidneys. You will receive instructions for a bowel prep to do prior to your surgery. You will not be able to eat or drink anything after midnight the night before your surgery.

What risks or complications could occur?

The surgery may relieve some, but not all, of the symptoms caused by pelvic support problems. In a few cases, symptoms may return. The factors that caused you to have prolapsed in the first place can lead to recurrence if not corrected. After surgery, you should continue to not smoke, control your weight, avoid constipation, and avoid activities, such as heavy lifting, that put pressure on these muscles.

If you are having abdominal surgery, you may be given an anti-coagulant to help prevent blood clots. To help prevent pneumonia, you will be shown how to do exercises such as coughing and deep breathing.

What can I expect after the surgery?

After the surgery you will spend a few hours in the recovery area. If abdominal surgery is done, you will be moved to your hospital room where you may stay 2-4 days.

  • You will have an IV for hydration and pain control.
  • You will be able to take fluids by mouth after your bowel function returns.
  • If abdominal surgery is done, your incision may be sutured or stapled.
  • You will have had a catheter placed in your bladder during surgery. Depending on your surgery, this will be kept in place for 1-3 days and you may be taught to self-cath for a few days after surgery.
  • Your vagina may be smaller after surgery but not necessarily shorter.
  • Bladder spasms can occur after surgery. You may be given prescription for medication to help relieve these spasms.
  • Discomfort may be relieved by sitz baths.

What should I expect during my home recovery?

Generally most women return to normal activity in a few weeks. It is very important that you do not lift more than 20 pounds for 4-6 weeks after surgery. If you have had vaginal surgery, refrain from sexual intercourse, using tampons, vaginal douching, tub baths, public pools and hot tubs to aid healing.

You will need to make a follow-up appointment with the doctor 3-4 weeks after your surgery for a pelvic exam to check healing process.