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by Dameron A

Definition

A cystocele is when the bladder wall bulges into the vagina. A rectocele is when the rectum wall bulges into the vagina. These bulges form because of problems with the pelvic muscles and tissue. These procedures fix the bulges.

Cystocele
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Rectocele
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  • Having to urinate (pee) often
  • Urine leakage
  • Not being able to urinate
  • Pain during sex
  • This type of repair is usually not done until all other treatments have been tried. Those may be muscle exercises and inserting a device in the vagina to support it.

    Possible Complications

    Problems are rare, but all procedures have some risk. Your doctor will go over problems that could happen, such as:

    • Problems with anesthesia
    • Infection
    • Bleeding
    • Damage to vagina, rectum, bladder, or other nearby organs
    • Problems with bowel movements (pooping)

    Things that may raise the risk of problems are:

    • Smoking
    • Drinking too much alcohol
    • Chronic disease such as diabetes
    • An earlier pelvic surgery

    What to Expect

    Prior to Procedure

    The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Anesthesia

    The doctor may give

  • General anesthesia—you will be asleep
  • Regional anesthesia—pain will be blocked without causing sleep
  • Description of the Procedure

    A tube will be inserted to drain the bladder. This will relieve pressure in the area.

    An incision will be made so that the doctor can see the muscle and tissue. The muscle and tissue may be sewn to themselves to make them stronger. Tissue weakened by previous surgeries, pregnancies, or age may be removed. Excess lining of the vaginal wall may also be removed. The doctor may also put extra sutures in to support the bladder.

    .

    How Long Will It Take?

    45 minutes to 2 or more hours

    Will It Hurt?

    There may be some pain in the vagina for 1 to 2 weeks. Medicine and self care can help ease the pain.

    Average Hospital Stay

    Some people can go home after the surgery. Others need to stay 2 to 6 days. You may need to stay longer if there are problems.

    Post-procedure Care

    At the Hospital

    For a rectocele repair, the bladder catheter will be removed when you can use the bathroom on your own.

    For cystocele repairs the bladder catheter needs to stay for up to 6 days to give the bladder more time to work normally.

    During your stay, staff will take steps to reduce your chance of infection, such as:

    • Washing their hands
    • Wearing gloves or masks
    • Keeping your incisions covered

    There are also steps you can take to reduce your chances of infection, such as:

    • Washing your hands often and reminding visitors and staff to do the same
    • Reminding staff to wear gloves or masks
    • Not allowing others to touch your incisions
    At Home

    There will be some limits to physical activity for a few weeks. It may affect working, daily habits, and sexual activity.

    Problems to Look Out For

    Call your doctor if you are not getting better or you have:

    • Signs of infection, including fever and chills
    • Excessive bleeding or any discharge from the incision site
    • Very heavy vaginal bleeding or foul-smelling discharge from the vagina
    • Nausea or vomiting
    • Cough, shortness of breath, or chest pain
    • Problems urinating (peeing), such as:
    • Pain, or burning
    • Blood in the urine that will not go away
    • Having to urinate often
    • Not being able to urinate at all

    If you think you have an emergency, call for medical help right away.

    RESOURCES

    National Institute of Diabetes and Digestive and Kidney Diseases  https://www.niddk.nih.gov 

    The American Congress of Obstetricians and Gynecologists  https://www.acog.org 

    CANADIAN RESOURCES

    Canadian Urological Association  http://www.cua.org 

    The Society of Obstetricians and Gynaecologists of Canada  https://www.sogc.org 

    References

    Bladder prolapse (cystocele). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/bladder-prolapse-(cystocele)?article=118. Accessed March 10, 2022.

    Cystocele and rectocele repair. Charleston Area Medical Center website. Available at: https://www.camc.org/cystocele-and-rectocele-repair. Accessed March 11, 2022.

    Cystocele (fallen bladder). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder#management-and-treatment. Accessed March 11, 2022.

    Fathy, M., Elfallal, A.H. et al. Literature review of the outcome of and methods used to improve transperineal repair of rectocele. World Journal of Gastrointestinal Surgery, 2021; 13(9): 1063-1078.

    Pelvic organ prolapse. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T114467/Pelvic-organ-prolapse  . Accessed March 10, 2022.

    Surgery for pelvic organ prolapse. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/womens-health/faqs/surgery-for-pelvic-organ-prolapse. Accessed March 11, 2022.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
    • Review Date: 11/2018
    • Update Date: 00/31/2022