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Cystocele Repair and Sling for Women

This information describes a cystocele and how it is repaired.
 

What is a cystocele (SIS-tuh-seal)?

A cystocele, also called a prolapsed bladder, occurs when the tissue between the bladder and vaginal wall weakens and stretches, allowing the bladder to bulge into the vagina (see Figure 1). 
 
A cystocele can be caused by:

What is a cystocele repair?

A cystocele repair is a surgery in which the bladder is put back in its normal spot. Your surgeon will also reinforce the wall between your bladder and vagina. If you were told you also need a sling, it will be placed during your cystocele repair.  
 

What is a sling?

A sling is a piece of synthetic material that your surgeon loops around your urethra, which is the tube that carries urine out of your body (see Figure 2). The sling holds your urethra in its correct position and is permanent. 
 
Your doctor may decide that you need the sling without a cystocele repair.
 

Are there any risks or complications associated with this surgery?

Although not common, the following complications can occur:  
  • Pain 
  • Bleeding 
  • Infection
  • Ongoing leakage of urine 
  • Narrowing of the vagina 
  • Wearing away of the material on the sling, if you had one placed 
  • Injury to your bladder or ureters (tubes that take urine from your kidneys to your bladder) 
  • Long-term or permanent problems urinating
    • You may have to insert a catheter into your bladder to drain your urine.
    • You may also need another surgery to correct the problem. 
  • Not being able to hold your urine until you reach a toilet
  • Erosion of the sling into the vagina, urethra, or bladder. If this happens, the sling may need to be removed.

What can I expect during my surgery?

  • You will be asleep during your surgery.
  • A cystocele repair is done through a small incision (surgical cut) in the vaginal wall. 
  • If a sling is being placed, 2 smaller incisions will be made on your lower abdomen or inner thigh. 

What can I expect after my surgery? 

  • A thin, flexible tube called a catheter will drain urine from your bladder while the area heals.
    • Your doctor or nurse will remove the catheter 5 days after your surgery, whether or not a sling was placed. Please call the office to make the appointment. You will learn to care for the catheter before you go home.  
    • If you only had a sling placed, the catheter will be taken out the next day.
  • You will have a gauze dressing in your vagina to help stop bleeding. It will be removed before you go home. 
  • No stitches will need to be taken out; your body will absorb them.  
  • You will have mild vaginal bleeding. Make sure you have sanitary napkins at home.
  • You will go home 1 day after your surgery, whether or not a sling was placed. 
  • You can shower 48 hours after your surgery. Do not bathe or soak in a pool or hot tub until your doctor or nurse says it is safe.

Bladder spasms

While you are recovering, you may experience bladder spasms that can cause urine leakage. While they may feel uncomfortable or even painful, try not to take any medication for them. Doing so will slow the return of normal urination. Call your doctor or nurse if the spasms are severe.
 

Medications

You will be given 3 medications: 
  1. An antibiotic that you must take until all the pills are gone
  2. Medication to relieve pain after surgery
  3. A stool softener to keep your bowels loose; stop taking it if you have diarrhea

What instructions should I follow after my surgery?

  • Call your doctor if you have: 
    • A temperature of 101° F (38.3º C) or higher
    • Severe bladder spasms
    • An inability to urinate
    • Pain that is not relieved with your pain medication
    • More vaginal bleeding than when you were in the hospital
  • Make an appointment to see your doctor 2 weeks after your surgery.  
  • For 4 weeks after your surgery, do not put stress on your abdomen or strain when you have a bowel movement. 
  • Avoid strenuous exercise. Do not lift anything heavier than 10 pounds.
  • Do not have sexual intercourse until your doctor says it is okay.