Urogynecology Expert Forum
questions about cystocele and possible rectocele
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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questions about cystocele and possible rectocele

I've gone to my gynecologist, and she diagnosed cystocele, and recommended a urogynecologist here in Denver. She suggested a pessary--I tried a pessary several years ago for a different problem, and found it very uncomfortable, and I didn't wear it hardly at all. How complicated is the surgery to repair the cystocele and possible rectocele--is that an AP repair? Also how long would I stay in the hospital--I was given a pamphlet about these urogynecologists in Denver, and in the pamphlet they do talk about minimally invasive surgery for the cystocele with prolapse repair (without hysterectomy-already had the hysterectomy) or graft ad mesh repair for cystocele. Saw somewhere in your questions and answer section, someone was having problems with the mesh repair--is that common and how good is it--how long will the repair last. I am 77 years old.
Thank you.
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Hi,

Cystocele/rectocele diagnosis applies only if you can see a bulging from your vagina when  you squat and use a mirror to look at the labia. If this is not the case for you, then you do not have significant prolapse, and do not need surgery. Other prolapse symptoms include difficulty with bowel movements, problems emptying your bladder, low back pain/pressure, difficulty with intercourse (i.e, cannot get the penis into your vagina). If you do not have these symptoms, then you may not need any intervention. Prolapse, when present, can be repaired via abdominal or vaginal approaches. Abdominal approaches can involve open incisions (about the size of cesarean incisions), or laparoscopic/approaches, and the prolapse can be fixed using grafts (meshes) or sutures. THe abdominal graft repair is the most effective, and has the lowest risk of erosion or problems if done by a qualified surgeon. The vaginal procedures can also use sutures or vaginally placed grafts to hold up the vagina, both work reasonably well, but vaginally placed grafts tend to have a higher risk of erosion, can sometimes only fix part of the prolapse, and you can end up with a bulging from the top of the vagina, as you can see from some of our other questions here.

Dr. Hoyte

3 Comments
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Google the site U.P.R.I.S.E prolapse. Women there have had many surgeries and all share there info openly about what worked and what didn't and why. you might find it helpful. Good luck!
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Thanks for the info on UPRISE prolapse. I'll look it up.
Beverly761
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