This information describes what a cystocele is and how it’s repaired.
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.
A cystocele can be caused by:
- Vaginal deliveries of heavy babies
- Frequent straining during bowel movements
- Heavy lifting
- A hysterectomy (surgery to remove your uterus)or other gynecologic surgery
Treatment for Cystoceles
You may have cystocele repair surgery, surgery to place a urethral sling, or both.
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.
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.
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 doctor will talk with you about what would work best for you.
Most people who have cystocele repair surgery don’t have problems after their surgery. Rarely, the following complications can happen:
- Urine 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.
- Cystoceles may come back with time
What to Expect During Your Cystocele Repair Surgery
- You will receive anesthesia (medication to make you sleepy) during your surgery.
- A cystocele repair is done through a small incision (surgical cut) in your vaginal wall.
- If a sling is being placed, 2 smaller incisions will be made on your lower abdomen (belly) or inner thigh.
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 will have a gauze dressing in your vagina to help stop bleeding. It will be removed before you go home.
- Your body will absorb your sutures (stitches) in 7 to 14 days. You won’t need to have them taken out.
- 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 when you go home. Don’t bathe or soak in a pool or hot tub until your doctor or nurse says it’s okay.
- Make an appointment to see your doctor 2 weeks after your surgery.
- Don’t lift anything heavier than 10 pounds for 6 weeks after your surgery.
- Avoid strenuous exercise, such as running or jogging, for 6 weeks after your surgery.
- Don’t have sexual intercourse or put anything in your vagina (such as tampons) for 6 weeks after your surgery.
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 normally if you take medication to prevent the spasms.
You get 3 medications:
- An antibiotic. You must follow the instructions on the bottle until all the pills are gone.
- Medication to relieve pain after surgery.
- A stool softener to keep your bowel movements soft. Stop taking it if you have diarrhea (loose or watery bowel movements).
Call Your Doctor or Nurse if You:
- Have a temperature of 101° F (38.3º 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