A cystocele occurs when the barrier between the vagina and the bladder, known as the vaginal wall, is torn or severely weakened during childbirth. This results in the bladder protruding into the vagina. Similarly, a rectocele occurs when the rectum protrudes into the vagina due to a tear or weakening of the barrier between the rectum and the vagina, which is also part of the vaginal wall. Cystocele and rectocele surgery is generally carried out in the same manner, with the main difference between them being that cycetocele surgery aims to prevent the bladder from protruding into the vagina while rectocele surgery aims to prevent the rectum from protruding into the vagina. This means that they are performed on different portions of the vaginal wall.
The main type of cystocele and rectocele surgery is known as colporrhaphy. There are two types of colporrhaphy surgeries, anterior and posterior. Antierior colporrhaphy surgery aims to strengthen the front portion of the vaginal wall that separates the vagina from the bladder and posterior colporrhaphy surgery aims to strengthen the back portion of the vaginal wall, which separates the vagina from the rectum. Strengthening the vaginal wall prevents cystocele and rectocele by preventing the protrusion into the vagina of the bladder and rectum respectively.
Two common methods are used to strengthen the vaginal wall during a colporrhaphy. In some cases, doctors find the tear or the weak spot of the vaginal wall. Then, they fold the vaginal skin over the defect and sew it back onto itself. Surgeons can also attach a strong piece of mesh to the vaginal wall rather than fold it back upon itself. Both methods serve to strengthen the vaginal wall and stabilize the bladder or the rectum, which prevents them from continuing to protrude.
Colporrhaphy has a few complications. First, there is a risk of damaging other organs in the pelvic region such as the uterus. Also, there is always a chance that the protrusion is not corrected and will recur. Finally, as will any type of surgery, there is always the risk of infection, anesthesia complications, and bleeding.
Generally, cystocele and rectocele surgery is quite successful. Patients are typically hospitalized for two to three days, with a catheter remaining in place for anywhere from two to six days. The catheter typically remains in place longer in patients that underwent cystocele surgery. Upon returning home, patients are required to rest for the first few days and are advised not to engage in lifting items over 10 pounds or sexual intercourse.