Anterior and/or Posterior Vaginal Repair Melbourne

An anterior repair is a surgical procedure to repair the fascial support layer between the bladder and vagina. A posterior repair is a surgical procedure to repair the fascial support between the rectum and the vagina. Refer to Pelvic Organ Prolapse for further information.

The aim of surgery is to relieve symptoms of vaginal bulge and associated urinary symptoms. The procedure is performed under general anaesthesia. Your anaesthetist will discuss your anaesthetic prior to surgery.

Before surgery:

• Ensure your hospital paperwork is completed and sent to the hospital at least 7 days before surgery.
• Ensure you have all your tests completed 4-7 days before surgery. These include bloods, and urine test.
• Once admitted, you will be issued with anti-embolic stockings (compression stockings). You are required to wear these throughout your admission.
• If you are a Diabetic, are on any blood thinning medications or have any allergies please alert the nurse at your earliest convenience.

What are the risks of this surgery?

General risks:

• Anaesthetic reaction or problems (rare)
• Bleeding
• Wound or urinary tract infection

Specific risks (Anterior / Posterior Repair)

• Constipation
• Difficulty with urination
• Urinary symptoms
• Pain or discomfort with sexual intercourse
• Recurrence of prolapse

Following surgery:

• You will have intravenous fluids for 1-2 days. If you are drinking and eating well the intravenous fluids will be stopped.
• You will have a vaginal pack which will be removed by nursing staff approximately 2 days following your surgery.
• Continue to wear your compression stockings.
• You will have a urethral catheter for 2 days to allow healing to take place. Once your catheter is removed, nursing staff will monitor how effective how are emptying your bladder.
• You will find emptying your bladder will feel differently as pain in muscles and swelling improves. Take your time to empty your bladder and do not push or strain. If you are emptying well you will discharged.
• Avoid constipation by ensuring a high fibre diet with adequate fluids. Please speak to the nursing staff if you are having difficulties before discharge or the Practice Nurse after discharge.
• You are advised to take regular pain relief as this will enable you to mobilise gently on the ward.

Following discharge:

• You will return to the rooms for an ultrasound residual one week following surgery. Please empty your bladder when you arrive to the rooms and the nurse will then perform an ultrasound residual using the bladder scanner.
• You will also see your surgeon who will check on your progress.
• It is normal to have a creamy discharge for up to 6 weeks following your surgery. This is due to the stitches in your vagina. As the stitches dissolve, the discharge will also reduce and finally resolve. Please report any offensive smelling discharge
• You will need to return to the rooms for your first post-operative appointment 6 weeks after surgery. At this appointment you will also require another ultrasound residual. Please empty your bladder when you arrive to the rooms and the nurse will then perform an ultrasound residual using the bladder scanner.
• It is important you avoid constipation. Please ensure high fibre diet with adequate fluids. If you are having difficulties, please contact the Practice Nurse.
• You are advised to avoid heavy lifting for 6 weeks. Anything greater than 2 kilos is too heavy. This includes taking the bins out, vacuuming, carrying pets and holding shopping bags. After this time, you still need to avoid very heavy lifting i.e. greater than 5 kilos.
• You are advised to avoid any strenuous physical activity for 6 – 8 weeks. This includes bike riding, golf and attendance at a gym. Sometimes up to 12 weeks is advised.
• You are encouraged to walk gently every day.
• You are advised to refrain from sexual activity for 6 weeks. After this time you may find using additional lubricant helpful.
• You are advised to take 2-6 weeks off from work. Your doctor will discuss with you how much time is required as this varies depending on the work you do.
• You are advised to call the rooms if you develop any of the following symptoms:
  • Difficulty or inability to pass urine
  • Fever/chills
  • Offensive or blood stained vaginal discharge
  • Offensive urine,
  • Frequency, urgency and burning when trying to pass urine
  • Blood in urine