Vaginal Prolapse

Definition of prolapse:

Weakness in the pelvic supporting structures that allow the pelvic organs to descend into the vagina. One or more of the following may also accompany a prolapse of the womb (uterus):

  • Cystocele; prolapse of the bladder into the vagina.Cystocele
  • Enterocele; is a protrusion of the intestine through the back of the vaginal wall.Enterocele
  • Rectocele; is prolapse of the rectum through the vaginal wall.Rectocele
  • Vaginal Vault Prolapse; (roof of vagina) – after hysterectomy.Vault Prolapse

Why is the operation performed?

Operations for prolapse may be recommended when the sensation of the prolapse is troublesome. A prolapse which is not bothersome to the patient probably does not require any surgical intervention.

Symptoms which can be caused by prolapse include:

• incomplete emptying of the bladder;

• a sensation of vaginal fullness, pressure, dragging or “falling out”;

• increased urinary frequency;

• discomfort during sexual intercourse;

• difficulty emptying the lower bowel caused by material becoming trapped with   the  rectal bulge.

Following your Surgery:

Expect to stay in hospital two to three nights. You will have an intravenous drip for 24 hours. The degree of pain experienced is not usually severe after this form of surgery. You may have a catheter in your bladder after returning from the operating theatre but this is not routine. Drink plenty of fluids to flush your bladder and assist return to normal bowel actions. Expect a small amount of vaginal bleeding and possibly some spotting for up to 4 – 6 weeks after the operation.

Possible Risks and Complications

Risks increase with obesity, smoking, heart or lung disease, or diabetes. Complications which may occur include excessive bleeding (haemorrhage) during and after surgery. Blood transfusion may be required (approx. 1:100)

  • Post operative infections.
  • Thromboembolism (blood clots) of the deep veins of the leg which may spread around the body.
  • Accidental injury to the blood vessels, bowel, bladder or ureters (the tubes leading from the kidneys to the bladder).
  • The incidence of a fistula (an injury that creates a link between the vaginal wall and the bowel or bladder) is rare.
  • Severe complications are extremely rare, and very rarely life threatening. These events are managed according to their severity.

Expected Outcome:

No operation for prolapse can be guaranteed to cure prolapse forever. Stitches can come loose, structures can tear and, over time, ligaments can stretch again.

Post-Operative instruction:

Pain should be relieved with Panadol, Neurofen or Solpodeine (remember if you take Solpodeine this increases the risk of constipation so ensure you have an adequate intake of fibre and fluids in your diet). Commence gentle exercise on your return home. Start with short walks twice daily. Recovery from surgery is characterised by up and down days, both physically and emotionally. Some days will be good, others will not be. This is to be expected.

When you go home you must not lift objects heavier than 5kgs or do strenuous work for about six weeks.

  • Do not drive an automatic car for 1 week*
  • Do not drive a manual car for 2 weeks*
  • Do not make a bed for 2 weeks
  • Do not stretch upward for 6 weeks
  • Do not do any lifting for 6 weeks

Remember to rest, if you are tired and uncomfortable you have been doing too much and need to slow down.

You will generally see Dr Kamal at two and six weeks for post-operative checks. Should you have any concerns post-operatively you may contact Dr. Kamal during office hours on 087-3625010 for advice. After hours please attend to your local GP.

* It is important to check with your insurance company, re driving your car as each company  has different policies on driving and surgery.