Prolapse (Pelvic Floor) Repair

What is Prolapse Repair?

The muscles and the ligaments that support your vagina and womb can become over stretched and weakened, causing them to drop down. Your bladder and bowel, which are nearby, can also drop down and bulge into your vagina. This is known as a prolapse and can be repaired using vaginal repair surgery.

What are the alternatives?

If your prolapse is mild, pelvic floor muscle exercises and vaginal pessaries may help control your symptoms. However, if your prolapse is more severe, you may need to have surgery. Your surgeon will discuss your options with you.

Preparing for vaginal repair surgery

You will usually need to stay in hospital for between two and four days, depending on the type of surgery you have and how well you recover. The operation may be performed under general anaesthesia, which means you will be asleep during the procedure, or under local anaesthesia which completely blocks pain from the area and you will stay awake during the operation.

What happens during vaginal repair surgery

The type of surgery you have will depend on where your prolapse is and how severe it is. Your surgeon will usually repair your vaginal wall through your vagina, so all your stitches will be inside your vagina and you shouldn't have a scar on your abdomen (tummy).

What to expect afterwards

You will be given pain relief to help with any discomfort as the anaesthetic wears off. You may be offered patient controlled analgesia (PCA). This is a pump connected to a drip in your arm that allows you to control how much pain medicine you receive.

The catheter and vaginal dressing will be removed as your recovery progresses and you are able to move around, usually 24 hours after the operation.

The stitches in your vagina usually dissolve after about six weeks and don't generally need to be removed. This can be associated with some bloody discharge.

You will need to stay in hospital for two to four days. Before you go home, your nurse will advise you about caring for your wounds and may arrange a date for a follow-up appointment. If you have any problems once you are home you can either contact the hospital ward or seek advice from your GP.

Recovering from a prolapse repair

You can lift light items, such as a kettle, but don't lift anything heavy. If you have young children, you will need someone to help you with childcare.

You can usually drive again 4-6 weeks after the operation but always follow your surgeon's advice.

It's normal to have some blood-stained vaginal discharge for about six weeks after surgery. Use sanitary towels rather than tampons to help reduce the risk of infection. You will need to wait at least six weeks before having sex to allow the wound to heal properly.

What risks or complications can occur?

Vaginal repair is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Complications are when problems occur during or after the operation. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Complications specific to vaginal repair can include:

• Infection - antibiotics can help treat any infection
• Damage to the womb, vagina or cervix, and/or part of the bladder or bowel - you may need more surgery to repair the damage
• Problems passing urine - this usually improves without further treatment
• Mesh-related complications - your surgeon will discuss these with you depending on the type of mesh that may be inserted
• Vaginal repair surgery doesn't always repair a prolapse completely and some women find that the prolapse comes back. If this happens, you may need more surgery. Vaginal repair surgery may not ease any bladder and bowel symptoms or resolve sexual problems that you had before surgery.