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Prolapsed vagina - Anterior Repair

This page will provide you with information about an anterior repair procedure. For further details, you should speak to your GP or other relevant health professional.

An anterior prolapse is a bulge in the front wall of your vagina which has been caused by your bladder dropping down (prolapsing) from its normal position. It is caused by a weakening of the support tissues between your vagina and bladder (figure 1). 

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An anterior prolapse can cause a dragging or aching sensation, the need to pass urine more frequently and the feeling of not having fully emptied your bladder. It can also cause discomfort when having sex and lead to difficulty keeping a tampon in.

An anterior prolapse is usually caused by childbirth but can also happen to women who have never been pregnant.

It is possible to have more than one type of prolapse at the same time. For example, the support tissues of your womb or back passage may also be weak.

What are the benefits of surgery?

The aim is to tighten the support tissues of your bladder and remove the bulge in your vagina.

The surgery can also help treat stress incontinence and a feeling of bladder fullness.

Are there any alternatives to an anterior repair?

An anterior repair is a major operation so should only be considered after simpler, alternative treatments have failed.

For example, if you have only a mild prolapse, your doctor will usually recommend treatments such as pelvic floor exercises to strengthen your pelvic muscles or placing a pessary in your vagina (a soft plastic ring which pushes the prolapse back up into place).

What does the operation involve?

Your surgeon will make a cut on the front (anterior) wall of your vagina. They will then be able to push your bladder and urethra back into its normal position.

Your surgeon will then stitch the support tissues (fascia) between your vagina and bladder together in order to provide better support. They will cut away a small part of your vaginal wall to remove tissue left over from the repair.

The operation is usually performed under a general anaesthetic. The operation usually takes about 30 minutes. The stitches the surgeon used will eventually be absorbed by your body and will not have to be removed.

What complications can happen?

As with any surgical procedure, there is the possibility of complications, no matter how many precautions are taken. General complications include pain, feeling or being sick, bleeding, blood clots (including deep vein thrombosis, DVT), or the risk of infection at the wound site.

Specific complications include overactive bladder symptoms, incontinence, urine infections, developing a haematoma (a collection of blood outside the blood vessels), or damage to your bladder or uterus.

How soon will I recover?

You should expect a slight discharge or bleeding from your vagina. Let the healthcare team know if this becomes heavy.

You will usually be able to go home after two to three days but you should rest for two weeks and continue to do the exercises that you were shown in hospital. Light activity will be good for you but do not sit or stand for too long and avoid heavy lifting or physical strain.

Do not have sex for six weeks or at least until any bleeding or discharge has stopped.

You can return to work once your doctor has said you are well enough to do so (usually after six to eight weeks).

If you experience an increase in pain, considerable swelling around your abdomen or are suffering from excessive fatigue after the operation you should contact your doctor.

You should continue your pelvic-floor exercises as soon as possible and keep doing them for life. This will help to prevent the prolapse from coming back and reduce the risk of you becoming incontinent.

 

References: EIDO Healthcare Limited - The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.

The information should not replace advice that your relevant health professional would give you.

 

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