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Posterior Defect Specific Vaginal Repair

- Information for patients (Pelvic Health Care)

Prepared by:
Prof. Ajay Rane, Consultant Urogynaecologist MBBS MD MRCOG FRCS FRANZCOG CU
Audrey Corstiaans ,Urogynaecology Nurse

Updated: July 2007


What is a Posterior Defect Specific Vaginal Repair?

Posterior Defect Specific Vaginal Repair is an operation performed to correct prolapse of the back wall of the vagina. It involves the identification and repair of the supporting tissue breakages between the vagina and the rectum (back passage) that had resulted in the prolapse. This is usually carried out by using 2 layers of self-absorbing stitches, and these stitches do not need to be removed after the operation.

What is involved?
  • The operation is done either under a general or spinal anaesthesia and takes about 30 minutes.
  • It may be done with other procedures like hysterectomy or incontinence operation.
Complications:
  • There is a 1% chance of heavy bleeding requiring blood transfusion. Occasionally, wound infection can develop after the operation but you will be given antibiotics during the operation to reduce the chances of this happening. Most infection cases can be treated with antibiotics alone. There is a small chance of making sexual intercourse painful after the operation but most patients improve with time. In very, very exceptional circumstances the rectum can be injured during the operation which may require additional bowel surgery.
  • Anaesthesia is not without risks
Results

The success of the repair is usually around 80 - 90% at 12 to 18 months. Weight loss if overweight, reducing or quitting smoking, improving pelvic muscle tone by doing pelvic muscle exercises and continuing to do them after surgery will ensure that the operation is a success.

Recovery

When you go home you must not lift heavy objects or do strenuous work for about 6 weeks. Avoid intercourse for the same period. You can return to work usually in ten to fourteen days. 5 days of antibiotics have to be taken to prevent infection.

Afterwards

You will be seen in either the clinic or at urodynamics depending on what procedures you have had, 10 to 12 weeks after the operation. If everything is well the success of your operation should be permanent.

Post Operative Instructions
  • You will have some vaginal discharge for 4 to 6 weeks. This should be light bleeding or spotting only and this may vary during that period of time as healing occurs and your stitches dissolve.
  • Pain should be relieved with Panadol or Panadeine (remember if you take Panadeine, this increases the risk of constipation so ensure you have an adequate intake of fibre and fluids in your diet).
Do not use tampons, pads are better
Do not drive an automatic car for 1 week*
Do not drive a manual car for 2 weeks*
Do not make a bed for 2 weeks
Do not hang out washing for 4 weeks
Do not use Vaginal Oestrogens for 4 weeks
Do not mop or vacuum for 6 weeks
Do not stretch upward for 6 weeks
Do not lift anything over 4kg for 6 weeks
Do not have sexual intercourse for 6 weeks

* It is important to check with your insurance company, re driving your car as each company has different policies on driving and surgery.


The guidelines are minimum time before recommencing these activities.

- Remember to rest, if you are tired and uncomfortable you have been doing too much and need to slow down.
- Remember when emptying your bladder, sit on the toilet, feet flat and lean forwards.
- Drink 6 - 8 glasses of fluid per day; limit your caffeinated drinks to 3 per day.
- Ensure your fibre intake is 30 grams per day.
- If constipation is a problem, Lactulose, which you can buy from the chemist or another stool softener should be used.

Contact your G.P or Accident and Emergency of your local hospital if you experience any of the following
Pain that is not relieved by Panadol or Panadeine
Burning or difficulty passing urine
Increased vaginal bleeding or passing clots
Smelly or offensive vaginal discharge
You develop a temperature or become unwell.


Your doctor will be happy to discuss any concerns that you may have regarding this operation.

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