Yes, cystocele (bladder prolapse) repair is major surgery. Even if your surgery is done through a less invasive way, surgeries to repair prolapse tend to be major surgery. Any surgery that requires general or regional anesthesia, overnight stay at the hospital and removal or repair of an organ is classified as major surgery.
Other things to note about these surgeries are as follows:
- Failure rate: None of these procedures has a 100% successful rate. According to studies, 5-15% of women may have to face failure even after a prolapse repair surgery. Usually, there is a partial failure in these cases and requires no treatment or sometimes pessary (device placement in the vagina) or less extensive surgery than originally may help.
- Risk of the graft material: Grafts used in prolapse repair are made up of medical-grade polymer called polypropylene, which is also used for hernia repair. Around 90% of women do very well with this material. However, 5-10% of women may experience exposure of the material into the vagina and vaginal discharge or spotting. Then the mesh material will be removed.
- Other risks: Other less common complications associated with these mesh grafts include infection that can be well managed with antibiotics. Sometimes, another surgery may require removing the graft. Smoking tobacco may increase the risk of mesh exposure in women. Every woman has a different risk or benefit response to graft repairs.
The good thing is that bladder prolapse (cystocele) is generally not life-threatening, and it can be fixed with many non-surgical methods.
If you are bothered enough by your symptoms and now want surgery to fix them, then you should follow the recommended restrictions and instructions given by your doctor after the surgery even if you feel okay so that the chances of achieving permanent success can increase. Currently, women with severe or recurrent prolapse who want to retain sexual function are highly benefited by mesh reinforcement procedures.
What does cystocele mean?
Cystocele means a prolapsed or dropped/fallen bladder (urine pouch). It is the bulging or dropping of the bladder into the woman’s vagina (the tube that connects the womb to outside the woman’s body).
It mostly occurs when the wall between a woman’s bladder and her vagina weakens due to
- Constant straining during defecation.
- Chronic constipation.
- Chronic or violent coughing.
- Heavy weight-lifting.
- Excessive weight gain.
- Straining during childbirth.
- Weakened vaginal muscles during menopause.
Mild prolapse often may not show any symptoms. However, if you have severe bladder prolapse, then you may experience
- A bulge in the vagina.
- Heaviness or fullness in the pelvic (groin) area.
- Difficulty starting a urine stream.
- Frequent or urgent urination.
- Urine leakage during sneezing or coughing.
- Incomplete emptying of the bladder.
- Discomfort while walking and standing for a long time.
Mild bladder prolapse can be treated with conservative therapies such as
- Dietary changes and laxatives.
- Physical therapy with Kegel exercises (pelvic floor muscle exercises).
- Pessary (insertion of a device into the vagina).
Surgery is the last option for women who are bothered by prolapse.
What does cystocele repair mean?
Cystocele repair is a surgical procedure that is performed to repair the sinking of the vaginal wall or bulging of the bladder into the vagina.
The surgery may help to restore the normal position of your bladder and may reduce the pressure caused due to the bulging bladder onto your vagina. These surgeries are generally recommended in severe prolapse cases when physical therapy and medications do not resolve the condition. Surgery is generally done by taking a cut on the vagina or belly with basic three methods:
- Anterior colporrhaphy: In this, the prolapsed bladder is repaired by making a cut on the vaginal surface and stitching the internal surface to strengthen the area.
- Paravaginal repair: It repairs the prolapsed bladder by attaching it to the pelvic sidewalls.
- Anterior colporrhaphy with graft: In this, a tissue graft is placed (if the tissue lining is very thin) along with stitches on the internal surface of the vagina.
What happens during the procedure?
Before the surgery,
- Your gynecologist (women’s specialist)/urologist (urine specialist) will examine your condition and identify the fallen bladder.
- They may discuss the symptoms to confirm the exact reason and may order some additional tests to assess any more damage to the urinary system.
During the surgery,
- Under general anesthesia, an incision is made in the vaginal wall.
- The tissue between the bladder wall and the vaginal wall is tightened with stitches to allow the strengthening of the muscles and ligaments.
- Sometimes, extra tissue may be removed, or tissue grafts are used (if the tissue lining is very thin).
What to expect after the surgery?
- You may be required to stay in the hospital for one to two days.
- You will be discharged with a catheter in place for some time.
- You will be able to pee normally after two to six weeks.
- You can resume your normal activities in about six weeks.
- You may be able to resume sexual intercourse in less than six weeks.
- You will be informed to
- Avoid strenuous activities such as lifting heavy weights and standing for long periods for at least the first three months.
- Increase your activity level gradually.
- Avoid straining during defecation.
What are the possible complications?
- Bladder infection
- Bladder injury
- Leakage of urine
- Inability to pass urine
- Painful sex
- Formation of an opening between the vagina and bladder
- Surgery failure
Latest Health and Living News
Daily Health News
Health Solutions From Our Sponsors
Journal of Reproductive Medicine Vetere PF, Putterman S, Kesselman E. Major reconstructive surgery for pelvic organ prolapse in elderly women, including the medically compromised. J Reprod Med. 2003 Jun;48(6):417-21. PMID: 12856511. https://pubmed.ncbi.nlm.nih.gov/12856511/
University of Michigan https://www.uofmhealth.org/health-library/tv1498
Top Is Cystocele Repair a Major Surgery? Related Articles
Treatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
Bladder Cancer SlidesBladder cancer occurs when cancerous cells, often from the lining of the bladder, begin to multiply. Find more information about bladder cancer, the stages of bladder cancer, and available treatment options.
Bladder Infection (Cystitis)Bladder infection is an infection of the bladder, usually caused by bacteria or, rarely, by Candida. Certain people, including females, the elderly, men with enlarged prostates, and those with chronic medical conditions are at increased risk for bladder infection. Bladder infections are treated with antibiotics, but cranberry products and adequate hydration may help prevent bladder infections.
Bladder SpasmsPeople who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
CystoceleA cystocele is also known as a fallen or prolapsed bladder. Heavy lifting and straining may cause a cystocele, which causes urine leakage and incomplete emptying of the bladder. Mild cystoceles may require no treatment, while large cystoceles may require surgery.
Gallbladder CancerGallbladder cancer is a rare form of cancer with symptoms that include jaundice, abdominal pain, fever, nausea and vomiting, abdominal lumps, and bloating. Risk factors include being female and Native American. Treatment of gallbladder cancer depends upon the stage of the cancer, the type of gallbladder cancer, and whether the cancer can be removed by surgery.
Gallbladder Pain: Relief, Causes, and DietGallbladder pain (often misspelled "gall bladder") is generally produced by of five problems, biliary colic, cholecystitis, gallstones, and pancreatitis. Causes of gallbladder pain include intermittent blockage of ducts by gallstones or gallstone inflammation and/or sludge that also may involve irritation or infection of surrounding tissues, or when a bile duct is completely blocked. Treatment of gallbladder depends on the cause, which may include surgery.
Interstitial Cystitis (IC) and Painful Bladder Syndrome (PBS)Interstitial cystitis (IC)/painful bladder syndrome (PBS) is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
Is Gallbladder Cancer Aggressive?Gallbladder cancer (GBC) is one of the aggressive cancers of the biliary tract. The gallbladder generates and concentrates bile that aids in the digestion of fats. GBC is a rare, yet deadly cancer of the gastrointestinal tract.
Nerve Disease and Bladder ControlA nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
Overactive Bladder (OAB)Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Sex, Urinary, and Bladder Problems of DiabetesHaving diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
UTI SlideshowUrinary tract infections (UTI), including bladder infections, affect women and men, causing UTI symptoms like kidney infection. Read about UTI symptoms, treatment, causes, and home remedies.
What Is the Best Treatment for Cystocele?Cystocele, or bladder prolapse, is a condition in which the bladder sags down into the vagina due to the weakening of the supporting structure between the bladder and the vagina. The treatment of cystocele may vary depending on various factors such as the severity of the disease and the presence of symptoms or any underlying medical conditions. Treatments range from watchful waiting to surgery.