FAQs about Anterior-Posterior Vaginal Repair
These details are basically put together to help and assist your personal understanding and perception of what exactly is associated with anterior and posterior vaginal repair. This is really meant to be a guide as well as not likely to include every single detail of the procedure.
What is meant by Anterior Vaginal Wall Repair or Posterior Vaginal Wall Repair?
- Both surgical procedures are done to correct prolapse of the vaginal walls. They are often performed independently, or possibly jointly together, in case the womb is positioned to prolapse, consequently needing to be removed (vaginal hysterectomy).
Anterior Vaginal Repair
- Anterior Vaginal Repair corrects prolapse or the sliding forward of the front wall of the vagina. The bladder is situated behind this and tends to be drawn sown along with it. This will likely bring about symptoms such as discomfort as well as feeling a bulge in the vagina.
- During the course of the surgery, the vaginal wall is cut and the bladder pushed and moved back up into its normal position. It is supported in its place and the excessive vaginal mucosa tissues are trimmed after which it is be stitched close. The suturing is done alternatively with 2 or 3 layers to avoid post-operative complications such as bleeding.
Posterior Vaginal Repair
- A posterior vaginal wall repair corrects prolapse or rather the sliding forward of the back wall of the vagina. The rectum can be found behind this and tends to be pulled down along with it. This will likely bring about a feeling of physical discomfort, bulge in the vagina, as well as troubles with opening up and perhaps controlling the bowels. This procedure will involve a very similar method to push the rectum back to its normal position.
Both of the surgical procedures are performed under Intravenous Sedation or under General Anesthesia. This will be discussed with you with Dr. Vitasna. All the stitches are absorbable and thus be noticed coming out from the sutured area after 4-6 weeks after the procedure. This is definitely not unusual.
Prior to the operation, you will be invited to a pre-operative consultation where you will be evaluated for surgery. You will be received by a member of the nursing staff in our Center who will make inquiries regarding your previous medical history as well as arrange for some medical tests, i.e. blood tests, ECG, and probably a chest X- Ray.
What should you do before visiting our Center?
- You should prepare and take with you any pills or treatment medications you are currently taking.
I have started my period. Can I have the surgery?
- It is best to undergo the surgery after your period. It is not advisable to do the surgery just before the period starts or during the period.
What are the things needed to take with me in the hospital?
- You can possibly have the surgery done on the day of your consultation depending on the availability of Dr. Vitasna’s schedule. Otherwise you may book for a possible surgery on the day of your consultation. This you may do through online pre-consultation and arrangement.
- You may need to bring along with you nightwear, loosely fitting daytime clothing, personal hygiene stuff, loose fitting underwear and sanitary pads.
What goes on before the surgery?
- It is advisable to have a bath or perhaps a shower before you come into the hospital.
- A staff nurse will usher you to a treatment room where Dr. Vitasna will give her preliminary examination as you express to her your areas of concern.
- After the examination and assessment, you will discuss with Dr. Vitasna about your expectations and concerns. She will then explain to you about the surgery and you may freely ask your questions.
- After you have chosen the best alternative for your case, prices and quotes will be written down with you.
This ends your consultation.
After the consultation, what happens next?
- You will be given consent forms to sign, which gives us permission to perform surgery on you. A staff nurse will guide you through the process of payment and will review the post-operative care you need to do after the surgery.
- Meeting the Anesthesiologist: You will be directed to the anesthesiologist who will administer the anesthesia during the surgery. Please tell him/her about your allergies to medications, your medical history, dental treatments, previous surgeries you have had, and any family history with anesthesia problems.
- Preparation for Surgery: As you arrive in the ward, a staff nurse is going to assess your vital signs or the basic tests such as your temperature, respiration, your blood pressure and your pulse. She will check your information (name, birth date), show you your bed, assist you to change into a gown, and provide you with an identity wristband.
- If you are wearing nail polish or makeup, you may be asked to remove it.
- Jewelries are also to be taken out. Should you be unable to remove some piece of jewelry, a protective tape will be placed over it.
- Contact lenses are to be removed as well as glasses and dentures.
After all these have been done, a staff member will accompany you to the operating theater and will hand you over the care of the anesthetic team.
What happens after the surgery?
- After the surgery, you will be wheeled to the recovery room. Expect to be conscious a minute or two after the surgery ends. However, it is very unlikely you will remember anything until you are cleared to go back to your room in the ward.
- You may expect a narrow tube on your hand inserted in your vein to replace lost fluids. You may find a catheter draining urine from your bladder. This will be taken off when you can go to the bathroom and void.
What happens after the surgery?
- Occasionally, a bandage is rolled up and placed inside the vagina to help prevent bleeding. It will soon be removed as soon as there is no visible bleeding.
- A day after the surgery you are expected to be able to walk. You are encouraged to take a shower on the second or third day after surgery.
What are the common discomforts that I may experience after surgery?
- You will probably feel tired and nauseous. Pain and light vaginal bleeding may be experienced. Headache, diarrhea or constipation, are not uncommon.
Will I be in a lot of pain after the surgery?
- Pain levels depend on an individual’s pain tolerance. Pain varies from person to person.
- In our hospital, clients can choose to pay for a “pain-free program”, where you will be given a machine that you can control and enables you to give yourself appropriate levels of pain relief.
- While you haven’t eaten after surgery, a nurse will give you strong injections of strong pain relievers. Whenever you start eating, you will be given pain relief tablets. You will feel sick and nauseous in the first 24 hours after surgery. It is advised that you stay in bed until after you feel better.
How long will I be in the hospital?
- You will be asked to stay in the hospital for 3-5 days. Dr. Vitasna will visit you every day as you recover and will give you a surgical wound examination before you leave for home.
When can I resume sexual intercourse?
- Please allow for internal healing and wait 6-8 weeks before resuming sexual intercourse.
When can I drive?
- It is best to assess yourself of pain and discomfort. If you are comfortable sitting in a car and will be able to step on the brake in an emergency stop, then it is safe to drive.
What activities should I avoid?
- Never douche your vagina. Allow 6-8 weeks of healing and avoid lifting of heavy weights.
- Constipation and straining of the bowels can be avoided by drinking lots of fluids and eating fresh fruits and vegetables.
- A cough should be addressed and treated immediately. See your physician as soon as possible.
- You may shower but you are not allowed to have baths or go swimming in the ocean or the swimming pool within 6-8 weeks after surgery or until after your vaginal discharge has stopped.
When is my follow-up check?
- You will be seen a week after discharge from the hospital and the preceding month after the first follow up check. You may be able to return to work after a week as long as it does not involve lifting heavy objects.
What are the risks associated with the surgery?
You need to understand that “no surgery is without risk” and the risks include:
- Urinary retention (not being able to pass urine).
- Venous thrombosis or embolism due to prolonged immobility.
- Damage to the bladder or the urinary tract (common to Anterior Vaginal Repair).
- Disturbance to the bladder function (more common with Anterior Vaginal Repair)
- Damage to the intestine, rectum or alimentary tract (common to posterior Vaginal Repair)
- Hematoma formation (collection of blood) on top or sides of the vagina and may become infected.
- Uncomfortable sex after surgery especially when Anterior and Posterior Vaginal Wall Repairs are done together.
- A 30% chance of further surgery especially with prolapse. This may be prevented and kept to a minimal by taking adequate period of rest after surgery. Avoid lifting heavy objects, coughing, straining the bowels, and constipation.
What is the major benefit of this surgery?
- Anterior-Posterior Vaginal Repair improves and resolves vaginal prolapse, vaginal looseness and removes the feeling of lump or bulge from or in the vagina.
What are the possible problems after discharge?
- Severe vaginal bleeding, being unable to pass urine, and severe pain, should be reported to our Center immediately.
- You may certainly observe foul smelling discharges from the vagina. This must not cause you to panic and this may be due to the healing process where dead cells/ tissues are being passed out from the vagina. However, if this bothers you, then you may come and see Dr. Vitasna for an internal-pelvic examination.
What are other problems that should be reported to our Center?
- High fever
- Difficulty opening the bowels
- Pain and swelling of the legs or thighs
- Pain when passing urine or blood in the urine
What are the things I am expected to do during the healing period?
- Try to eat a healthy balanced diet, drink plenty of water, avoid alcohol and take your medications faithfully as prescribed.