Anterior Vaginal Repair procedure

Uses:

1. Prolapse of the bladder or urethra
2. Occasionally used to treat urinary stress incontinence

Procedure

The procedure is usually performed under general anaesthesia but can be done with spinal or epidural anaesthesia.

The vaginal skin is opened in the midline directly over the bladder. The vaginal skin is dissected off the bladder to expose the damaged supporting fascia. Using delayed absorbable sutures, the fascia is repaired. The vaginal skin is then closed over the repair with absorbable sutures.

A vaginal pack and urinary catheter are inserted to minimise the risk of post-operative bleeding. These are usually removed the following morning. Antibiotics are given during the procedure to minimise the risk of infection.

Due to the risk of deep vein thrombosis (clots in leg veins) and pulmonary embolism (clots in the lungs) you will have anti-thrombotic stockings fitted prior to surgery. During and after surgery, you will also be given blood thinning injections and have compression devices fitted.

Complications
In the short term you may experience:

  • Urinary tract infection (2 in 100)
  • Constipation (1 in 5)
  • Urinary retention (1 in 100)
    • May require a catheter for a longer period
    • Rarely needs re-operation
  • Injury to bladder or urethra (1 in 300)
    • Usually detected and repaired during the operation
  • Late detection of injuries may result in fistula formation (1 in 1000)
  • Excessive bleeding at/after surgery requiring transfusion (1 in 200)
  • Deep vein thrombosis and pulmonary embolism

You should not expect any change in sexual function. If anything, this should improve with treatment of the prolapse.

Recovery

Your hospital stay is expected to be 2 days, give or take a day or two.

It is important to avoid any form of straining initially and also in the future

  • For example, coughing, lifting, constipation
  • Limit lifting to less than 5kg weights

You need to be watchful of any complications in the first 6 weeks after surgery.

  • For example, urinary burning and frequency may suggest infection
  • See your general practitioner if there are any symptoms
  • Most things can be easily fixed by your GP
  • Dr Stamatiou will see you between 2 and 6 weeks after your surgery.

Other concerns
Things to avoid

  • Washing and house cleaning for 6 weeks
  • Driving for 4 weeks
  • Sexual intercourse for 6 weeks
  • Baths and swimming pools for 2 weeks
  • Work for 2 – 6 weeks depending on the physical nature of the work and ability to do light duties