Minimally Invasive Surgery & Procedures Pelvic Floor Repair

A repair operation is performed when you are suffering from some form of vaginal wall prolapse with or without prolapse of the womb. A cut is made in the vagina and the pelvic floor muscles are tightened.

The type of pelvic-floor repair operation you are having, or have had, may be:

  • an anterior vaginal repair – if the front wall of your vagina has prolapsed
  • a posterior vaginal repair – if the back wall of your vagina has prolapsed.
  • You may be having, or have had, a pelvic-floor repair operation in conjunction with a hysterectomy – if your uterus (womb) has prolapsed into your vagina.

An absorbable mesh (a small piece of tissue type material) may be inserted at the time of your operation for the repair. Your surgery choices will depend on your personal circumstances and will be discussed with you and Dr McMurray before your operation.

Complications

A repair operation is usually straightforward with a low chance of complications. However, any operations may be associated with complication which could be an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT) or rarely in the lungs (pulmonary embolism). Infection is also a risk and antibiotics will be given at the start of the surgery to minimise this risk.

The complications specific to repair operations include – Injury to womb, bowel, bladder or blood vessel. The injury may, very rarely, have to be repaired through a cut on the tummy. Painful intercourse may be a complication after the operation. Many women will go on to have either a recurrence of a prolapse or develop another prolapse.

What to expect after the operation:

  • You will have intravenous fluids until you can drink.
  • You will have a catheter to empty your bladder – this may remain 24hrs or longer.
  • Usually you will have a pack in the vagina to put pressure at the site of operation for about 24 hours to stop any bleeding from the site.
  • You will have a daily injection to try and prevent any blood clots. You will be given medication for pain relief. It is not unusual not to open your bowels for a couple of days after the operation.

If it is causing discomfort you will be given medication to help you.

  • When the catheter is removed it is very important that you pass urine regularly.
  • If you are unable to empty your bladder properly you may have to go home with the catheter. This is very rare.

Advice after operation:

You will feel tired when you go home – take it easy. Gradually build up your daily activities. Listen to your body.

Avoid any heavy lifting as this puts pressure on the repair and may weaken it. You may have some vaginal bleeding or discharge for 10 -14 days.

To avoid constipation have plenty of fibre in your diet and drink plenty of water.

Avoid intercourse for about 6 weeks.

Avoid driving until you feel that you can do an emergency stop without any pain.

Return to work and normal daily activity varies from 6-12 weeks – depending on the type of your work.

Always remember to do pelvic floor exercise throughout your life.

You will receive an appointment to be seen in the gynaecology outpatient department in 6-12 weeks.

Please contact us if you have the following symptoms:-

  • Heavy vaginal bleeding
  • Offensive vaginal discharge
  • Severe pain in the vagina or abdomen
  • Diarrhoea or vomiting
  • Any difficulty in passing urine.
  • High temperature

Prolapse can recur in 15-20% cases. The risk of recurrence is higher if you are overweight, if you suffer from chronic cough (usually caused by smoking), constipation or involved with regular weight bearing jobs.