Cystocele

A cystocele occurs when the wall between your bladder and your vagina weakens and allows the bladder to droop into the vagina. This may cause discomfort with intercourse and difficulty emptying the bladder completely.

Cystocele classifications

  • Grade I: Is a mild cystocele when the bladder droops only a short way into the vagina.
  • Grade II: Is more severe when the bladder sinks far enough to reach the opening of the vagina.
  • Grade III: Is the most advanced cystocele when the bladder bulges out through the opening of the vagina.

What to expect after surgery?

• You may have an overnight stay at the hospital. During this time, you will have vaginal packing and a foley catheter.

• If you are unable to urinate after your procedure, you may go home with a catheter. You will be instructed to follow-up with your provider in 1 to 2 weeks for catheter removal.

• You may be expected to do breathing exercises called incentive spirometry to prevent respiratory infections if you are staying overnight at the hospital.

• On the day after surgery it is very important to get out of bed and begin walking. This will help prevent Deep Vein Thrombosis (DVT). Please follow the DVT prevention handout.

• Your bowels may be sluggish after surgery and pain medication can increase constipation. Follow the postoperative bowel program handout. The post operative bowel program should be followed for the next 6 weeks.

• You may shower when you go home, but do not bathe or sit in a hot tub for 4 to 6 weeks.

• You will likely experience vaginal discomfort for 1 to 2 weeks following the surgery. If you find thatyou are having discomfort while sitting try rolling a towel and fold it into the shape of an upside down horse shoe and sit on it. This will help take pressure of the vaginal area.

Activity and postoperative restrictions

• Walking and light exercise is important in preventing DVT. • You should expect to return to work in 1 to 2 weeks. • You should reduce your activity levels for the first week while healing. • Use stairs gently for the first week. • No heavy lifting, pulling or pushing over 10 to 15 pounds for 6 weeks. • No strenuous exercising for 6 weeks, a slow paced walk is acceptable.• No sexual intercourse for 6 weeks. • Avoid inserting anything in your vagina such as tampons; vaginal estrogen applicators can be used. • Do not drive for the first week. Do not drive while taking narcotics.

Medication

• You should resume your pre-surgery medication unless told otherwise.

• Do not take any aspirin products for the first two weeks.

• If you are taking Warfrin or Plavix, follow-up with your primary care provider postoperatively. They will discuss with you when to resume medication and dosing recommendations.

• If you are taking pain medication or iron supplements you should also be taking a stool softener to keep the stool soft.

• If your pain is mild you can stop taking the pain medication and switch to acetaminophen.

• In addition, you should be following the postoperative bowel program for the next 6 weeks and using vaginal estrogen if indicated.

Medications and items to have at home before surgery

  •  Stool softener
  •  Fiber
  •  Milk of Magnesia
  •  Acetaminophen
  •  Vaginal estrogen if applicable
  •  Frozen peas or ice packs

Diet

You may return to your normal diet. You may want to avoid acidic foods and drinks that may cause burning with urination. Drinks with caffeine may cause frequency and irritation to your bladder. If you’re not on a sugar or salt restriction diet, drink 8 to 10 glasses of water and Gatorade daily to avoid constipation and to prevent possible urinary tract infections.

If you experience any of these symptoms please call Urology Northwest at 425-275-5555:

• Fever over 101 Fahrenheit by mouth • Pain not relieved by medication • Rash or itching after taking pain medication • Continued nausea and vomiting • Abnormal swelling around operative site • Increased redness, warmth, hardness around operative site • Excessive draining or bleeding from surgical site • Inability to urinate • Swelling of the calf, ankle or foot • Increased warmth of the leg • Pain in the leg • Bluish discoloration of the skin or leg

Postoperative follow-up

You will need a follow-up appointment to monitor your progress postoperatively. You will be called for a postoperative follow-up 1 to 2 days after surgery. You can make your postoperative appointment at that time or by calling and speaking to a receptionist. If you have a catheter your follow-up appointment will typically be within 1 to 2 weeks after surgery.