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Vaginal repair surgery (colporrhaphy)

Key points

  • The muscles and ligaments that support your vagina and womb can become overstretched and weakened if you’re obese, or after childbirth or the menopause.
  • This can cause your vagina and womb to drop down. Your bladder and bowel can also bulge into your vagina.
  • The bulge of the womb, bladder or bowel into your vagina is known as a prolapse.
  • A vaginal prolapse can be repaired with vaginal repair surgery, an operation that can help to lift and tighten the walls of your vagina and improve your symptoms.

Vaginal repair surgery (colporrhaphy) is an operation to lift up and tighten the walls of your vagina to restore its normal support.

You will meet the gynaecologist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About vaginal repair surgery

The muscles and ligaments that support your vagina and womb can become overstretched and weakened if you’re obese or after childbirth or the menopause. This can cause your vagina and womb to drop down. Your bladder and bowel can also bulge into your vagina. The bulge of the womb, bladder or bowel into your vagina is known as a prolapse.

A vaginal prolapse can be repaired with vaginal repair surgery. This operation will help to strengthen the walls of your vagina and ease your symptoms. A gynaecologist, a doctor who specialises in women’s reproductive health, will perform the surgery.

What are the alternatives?

If your prolapse is mild and isn’t causing you any distress or symptoms, there isn’t always a need to have surgery. It’s your choice. Simply because you doctor has noticed a prolapse, doesn’t always mean you need surgery. Alternative treatments for a mild prolapse can include the following.

  • Pelvic floor muscle exercises. These can help to strengthen your weakened pelvic floor muscles. These exercises may not get rid of the prolapse, but they can help make you feel more comfortable. The good thing about these exercises is that they are safe to perform and have no risks. Even if you need, or decide to have surgery at a later date, pelvic floor exercise will help with your comfort in the meantime.
  • A ring pessary. This is a soft plastic ring or device, which is inserted into your vagina to push the prolapse back up. A ring pessary can help reduce the ‘dragging sensation’ you may feel with a prolapse, and improve any urinary or bowel symptoms you may have. You can use this pessary even during sexual intercourse.
  • A shelf pessary or Gellhorn. This type of pessary may suit you if you’re not sexually active. It’s a slightly stronger pessary inserted into your vagina.

These alternative treatments may help control your symptoms. However, if your prolapse is more severe, you may need to have surgery. Your gynaecologist will discuss your options with you, so you can make an informed decision about the treatment that would suit you best.

See our frequently asked questions for more information.

Preparing for vaginal repair surgery

Your gynaecologist will explain how to prepare for your vaginal repair surgery.

You’ll probably need to stay in hospital for one or two days, depending on the type of surgery you have and how well you recover. The operation may be done under general or local anaesthesia. General anaesthesia means you’ll be asleep during the procedure. Local anaesthesia is when pain is completely blocked from the area but you’ll stay awake during the operation.

If you’re having a general anaesthetic, you’ll be asked to follow fasting instructions. An anaesthetic can make you feel sick so it's important that you don't eat or drink anything for six hours before surgery. Follow your gynaecologist’s advice. If you have any questions, just ask.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your gynaecologist will discuss with you what will happen before, during and after your procedure, and any pain you might have. If you’re unsure about anything, ask. No question is too small. Being fully informed will help you feel more at ease and will allow you to give your consent for the procedure to go ahead. You may be asked to do this by signing a consent form.

What happens during vaginal repair surgery?

The operation usually takes about an hour, but this will depend on the type of operation you have – ask your gynaecologist how long your operation will take. The exact type of surgery you have will depend on where your prolapse is and how severe it is.

Your gynaecologist will usually repair your vaginal wall through your vagina. During the operation, your gynaecologist will use dissolvable stitches to strengthen the tissue that supports your vagina. This may be at the front or back wall of your vagina, or both, depending on the type of prolapse you have. He or she may also remove some of your excess vaginal skin.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You may have a catheter to drain urine from your bladder into a bag. You may also have a gauze dressing in your vagina to reduce bleeding. Both of these will usually be removed after a day or two.

Your nurse will give you advice about getting out of bed, having a bath or shower, and eating and drinking. You may see a physiotherapist who will give you exercises to do that are designed to speed up your recovery. A physiotherapist is a health professional who specialises in maintaining and improving movement and mobility.

You may be constipated after the operation. However, it's important not to strain when you go to the toilet as this will put pressure on your healing wound. Let your nurse know if you think you may be constipated and they will arrange treatment (such as a laxative) for you.

The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure, they should usually disappear in about one to two weeks.

Your nurse will give you advice about looking after yourself when you get home. For example:

  • keep mobile – use your leg muscles to help prevent deep vein thrombosis (DVT)
  • avoid becoming constipated and lifting heavy objects to reduce the chance of stretching the repair
  • don’t use tampons for around six weeks
  • don’t have sexual intercourse until you feel comfortable enough after six weeks

You may be given a date for a follow-up appointment. If you need one, this is usually between six weeks and six months.

You will need to arrange for someone to drive you home. Try and have a friend or relative stay with you for the first 24 hours after your operation if you’re discharged on the day of your surgery.

Recovering from vaginal repair surgery

It usually takes about six weeks to make a full recovery from vaginal repair surgery. But this varies between individuals, so it's important to follow your gynaecologist's advice. It’s best not to have sex until at least six weeks after your operation. Your gynaecologist will give you advice about when you can resume your usual activities and return to work at your follow-up appointment.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You may have some blood-stained vaginal discharge after the procedure, but this is normal. However, if this discharge smells or changes in colour, or if you have pain and feel unwell, contact your doctor for advice. These symptoms may indicate an infection, which can be easily treated with antibiotics.

What are the risks?

As with every procedure, there are some risks associated with vaginal repair surgery. We haven’t included the chance of these happening as they are specific to you and differ for every person. Ask your gynaecologist to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of vaginal repair surgery include:

  • pain and discomfort in your abdomen (tummy) and vagina
  • vaginal bleeding
  • passing urine more slowly

Complications

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
  • developing a blood clot, usually in a vein in your leg (DVT)

Complications of vaginal repair include: 

  • an infection – you may need to take antibiotics to treat this
  • damage to your womb, vagina or cervix, and/or part of your 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 gynaecologist will discuss these with you before surgery if they plan to use mesh to support your vaginal wall

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 further surgery.
Vaginal repair surgery may not ease the problems a prolapse can cause, such as bladder and bowel symptoms or resolve sexual problems. It’s important that you discuss what you can realistically expect from the operation with your gynaecologist prior to going ahead with any treatment.


Reviewed by Alice Rossiter, Bupa Health Information Team, August 2014.

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For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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