Vaginal Rectocele Repair is typically done to correct bulging of the bottom wall of the vagina. This bulging can cause symptoms such as the sensation of sitting on a ball, incomplete emptying of the rectum, and pelvic discomfort. The surgery is usually done through a vaginal approach, but in some circumstances a combined abdominal and vaginal approach to the repair is made. Your doctor may recommend surgery to treat a large or severe rectocele, especially if you have symptoms such as:. Rectocele repair is a major surgery.
Repalr health questions? Obesity is an additional risk factor, and along with diabetes can affect the healing of the incision. Related Doctors View All Doctors. Smoking can also affect healing. Then the surgeon closes the top of the vagina the vaginal vault. The weakened layers are then repaired using absorbable stitches. Pre-operative medical conditions such as diabetes, high blood pressure, lung disease, and heart disease increase the risk associated with surgery, as does advanced age. If you develop a strong smelling vaginal discharge or excessive bleeding, burning or stinging on passing urine, increasing abdominal pains, vomiting, fever, painful swollen rspair, shortness of breath or chest pain, you Sex after posterior repair seek medical advice. Your doctor may recommend surgery to treat a large or posteiror rectocele, especially if you have symptoms such as:. Search Now.
Kissing fariys. Surgery for pelvic-floor disorders and sexual function
The most common surgery for prolapse is a pelvic floor repair, which is a broad term used to describe simple surgical repairs of the pelvic floor.
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The most common surgery for prolapse is a pelvic floor repair, which is a broad term used to describe simple surgical repairs of the pelvic floor. More specifically, the term anterior repair refers to correction of the front wall of the vagina; and posterior repair refers to correction of the back wall of the vagina. If the uterus is prolapsing, it may be removed hysterectomy. If you have already had a hysterectomy, then the top of the vagina vault can be lifted up and supported.
Anterior repair is a surgical procedure to repair or reinforce the weakened layers between the bladder and the vagina. The surgery can be performed under general, regional or local anaesthetic. There are many ways to perform an anterior repair, but a common method is by an incision being made along the centre of the front wall of the vagina, starting near the entrance and finishing near the top of the vagina.
The weakened layers are then repaired using absorbable stitches. Sometimes superfluous vaginal skin is removed. If you have a severe prolapse or this is a repeat operation, reinforcement material such as mesh may be used to strengthen the anterior vaginal wall. When you wake up from the anaesthetic you will have a drip to give you fluids and you may have a catheter in your bladder. You may also have a pack inside the vagina to reduce bleeding into the tissue.
Usually both the pack and catheter are removed within 24 — 48 hours after the operation. Once the catheter has been removed it is normal to monitor how much your bladder holds and whether or not you completely empty your bladder when you go to the toilet. For two or possibly three visits to the toilet your urine output will be collected and measured.
Then a small machine which is placed on your tummy will be used to check that your bladder has completely emptied. Healing takes around 3 months, so during this time you should avoid any task that can put pressure on the repair i. You should be able to drive and be fit for light activities within weeks of surgery. For driving, you must have the concentration and confidence to do an emergency stop, and it is advisable to check your own insurance policy for any restrictions following surgery.
You should wait weeks before having sexual intercourse. A prolapse of the back wall of the vagina posterior is usually due to a weakness in the strong tissue layers that divides the vagina from the lower part of the bowel. Posterior repair is a surgical procedure to repair or reinforce the weakened layers between the rectum and the vagina. There are many ways to perform a posterior repair, but a common method is by an incision being made along the centre of the back wall of the vagina starting at the entrance and finishing near the top of the vagina.
If you have a severe prolapse or this is a repeat operation, reinforcement material such as mesh may be used to strengthen the posterior vaginal wall. Vaginal Hysterectomy is a procedure which may be performed if you have a uterine prolapse.
This is when the uterus womb drops down into the vagina and in more advanced cases can extend beyond the entrance to the vagina.
A vaginal hysterectomy is the surgical removal of the uterus through the vagina. To remove the uterus the surgeon will make a cut at the top of of the vagina around the cervix. The surgeon then pushes the bowel and bladder away from the uterus, cuts the connecting tissues and then removes the uterus. Then the surgeon closes the top of the vagina the vaginal vault. As with all operations there is an element of risk involved and complications can occur. Below we have listed some complications that are more specifically related to anterior and posterior vaginal wall surgery.
This usually settles after a week or two and simple analgesics like paracetamol may help. The risk of developing deep vein thrombosis is increased following surgery. Your doctor may give you compression stockings and a daily blood thinning injection to minimise this risk. You can also perform small exercises whilst in bed to reduce the risk, such as rotating your ankles in a circular motion and bending and straightening your legs.
Whilst at home you should try to avoid any activity that can put increased pressure on the repair as this can cause the prolapse to recur. Try not to pick up children or shopping bags and see if someone else can do the housework and gardening for you. Excessive straining to pass a bowel motion can put pressure on the healing tissues in the vagina, so eating healthy balanced meals containing plenty of fibre will help avoid this.
Aim for at least five portions of fruit and vegetables a day. Choose wholegrain varieties of bread, pasta and rice, rather than white versions. Try to avoid foods that are high in fat such as cakes, biscuits and fried foods. You should also drink between 1. If you develop a strong smelling vaginal discharge or excessive bleeding, burning or stinging on passing urine, increasing abdominal pains, vomiting, fever, painful swollen legs, shortness of breath or chest pain, you should seek medical advice.
L-Shaped Side Sex —The woman is on her back, with her pelvis lifted. It seems to take so long to get back to normal and I am worried that my vagina will be adversely affected by the surgery. I had anterior and posterior repair 4 weeks ago. Keep me logged in. Likewise, mesh repairs are associated with a risk of mesh erosion and pain with sex and, in general, should be avoided in most circumstances. I see patients at 6 weeks and after checking the repair site, they can resume sexual activity gradually.
Sex after posterior repair. Safe Sex Positions For All Joint Replacement Candidates
ACIP recommends two options for pertussis vaccination. The authors report no financial relationships relevant to this article. Sexual dysfunction is challenging for patients and clinicians. Just as sexual function is multidimensional—with physical and psychosocial elements—sexual dysfunction can likewise have multiple contributing factors, and is often divided into dysfunction of desire, arousal, orgasm, and sex-related pain.
Addressing each of these dimensions of sexual dysfunction in relationship to pelvic reconstructive surgery is beyond the scope of this article. Here, we focus on aspects of sexual dysfunction most likely to be reported by patients after surgery for pelvic organ prolapse POP or urinary incontinence, or for both. We discuss what is known about why sexual dysfunction develops after these procedures; how to assess symptoms when sexual dysfunction occurs; and how best to treat these difficult problems.
Your year-old patient presents 2 weeks after vaginal hysterectomy, uterosacral vault suspension, anterior and posterior colporrhaphy, and retropubic midurethral polypropylene sling placement. She reports feeling tired but otherwise doing well.
The patient returns 8 weeks postoperatively, having just resumed her customary exercise routine, and reports that she is feeling well. Upon questioning, she says that she has not yet attempted to have sexual intercourse with her year-old husband. The patient returns 6 months later and reports that, although she is doing well overall, she is unable to have sexual intercourse. How can you help this patient? What next steps in evaluation are indicated?
Then, with an understanding of her problem in hand, what treatment options can you offer to her? The impact of surgery on sexual function is important to discuss with patients preoperatively and postoperatively.
Because patients with POP and urinary incontinence have a higher rate of sexual dysfunction at baseline, it is important to know how surgery to correct these conditions can affect sexual function. Native-tissue repair. A systematic review looked at studies of women undergoing native-tissue repair for POP without mesh placement of any kind, including a midurethral sling.
Posterior colporrhaphy, commonly performed to correct posterior vaginal prolapse, can narrow vaginal caliber and the introitus, potentially causing dyspareunia. Early description of posterior colporrhaphy technique included plication of the levator ani muscles, which was associated with significant risk of dyspareunia postoperatively.
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