About Your Cystocele Repair and Sling

This information explains what a cystocele is and how it’s treated.

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About Cystocele

A cystocele (sis-tuh-seal), also called a prolapsed bladder, is when your bladder shifts and pushes on the outside wall of your vagina (see Figure 1). This happens when the muscles between your bladder and vagina weaken and loosen.

Figure 1. Female anatomy without (left) and with (right) a cystocele

Figure 1. Female anatomy without (left) and with (right) a cystocele

A cystocele can be caused by:

  • Aging
  • Vaginal deliveries of heavy babies
  • Menopause (a permanent end of your monthly periods)
  • Obesity (having a high, unhealthy amount of body fat)
  • Frequent straining during bowel movements (pooping)
  • Heavy lifting
  • A hysterectomy (surgery to remove your uterus) or other gynecologic surgery
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Treatment for Cystocele

Treatment for a cystocele includes cystocele repair surgery, surgery to place a urethral sling, or both.

Cystocele repair surgery

A cystocele repair is a surgery to put your bladder back in its normal place. Your surgeon will fix the wall between your bladder and vagina to keep your bladder from moving again.

Urethral sling surgery

A urethral sling is a piece of mesh that holds your urethra (the tube that carries urine out of your body) in its correct position. Your surgeon will loop the sling around your urethra and attach the ends to your pubic bone (see Figure 2). The sling is permanent.

Figure 2. Female anatomy with urethral sling

Figure 2. Female anatomy with urethral sling

Some people get a sling without having cystocele repair surgery. If you’re having cystocele repair surgery and getting a sling, your sling will be placed during your surgery. Your healthcare provider will talk with you about what would work best for you.

Risks of having treatment for cystocele

Most people who have cystocele repair surgery don’t have problems after their surgery. Rarely, the following complications can happen:

  • Urine (pee) leakage
  • Narrowing of the vagina
  • Painful sex
  • 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. To help with this, you may:
    • Have to insert a catheter (a thin, flexible tube) into your bladder to drain your urine.
    • Need another surgery to correct the problem.
  • Not being able to hold your urine until you reach a toilet
  • Wearing away of the sling into the vagina, urethra, or bladder. If this happens, the sling may need to be removed.
  • Cystocele may come back with time
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What to Expect During Your Cystocele Repair Surgery

  • You’ll receive anesthesia (medication to make you sleepy) during your surgery.
  • Cystocele repair surgery is done through a small incision (surgical cut) in your vaginal wall.
  • If a sling is being placed, your surgeon will make 2 smaller incisions on your lower abdomen (belly) or inner thigh.
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After Your Surgery

  • A catheter will drain urine from your bladder while the area heals. It will be taken out the day after your surgery before you leave the hospital.
  • You’ll have a gauze dressing in your vagina to help stop bleeding. It will be removed before you leave the hospital.
  • Your body will absorb your sutures (stitches) in 7 to 14 days (1 to 2 weeks). You won’t need to have them taken out.
  • You’ll have mild vaginal bleeding. Make sure you have sanitary napkins (pads) at home.
  • You’ll go home 1 day after your surgery, whether or not a sling was placed.
  • You can shower when you go home. Don’t bathe or soak in a pool or hot tub until your healthcare provider says it’s okay.

Follow-up

  • Make an appointment to see your healthcare provider 2 weeks after your surgery.
  • Don’t lift anything heavier than 10 pounds (4.5 kilograms) for 6 weeks after your surgery.
  • Avoid strenuous exercise, such as running or jogging, for 6 weeks after your surgery.
  • Don’t have sex or put anything in your vagina (such as tampons) for 6 weeks after your surgery.

Bladder spasms

While you’re 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. It will take longer for you to be able to urinate (pee) normally if you take medication to prevent the spasms.

 

Take your medications

You’ll get 3 medications:

  1. An antibiotic. You must follow the instructions on the bottle until all the pills are gone.
  2. Medication to relieve pain after surgery.
  3. A stool softener to keep your bowel movements (poop) soft. Stop taking it if you have diarrhea (loose or watery bowel movements).
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When to Call Your Healthcare Provider

Call your healthcare provider if you:

  • Have a fever of 101 °F (38.3 °C) or higher
  • Have severe bladder spasms
  • Aren’t able to urinate
  • Have pain that doesn’t go away with your pain medication
  • Have more vaginal bleeding than when you were in the hospital
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