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Repair of bladder prolapse (cystocele) or urethra prolapse (urethrocele)
Two common forms of pelvic organ prolapse are bladder prolapse (cystocele) and urethral prolapse (urethrocele). A cystocele occurs when the wall of the bladder presses against and moves the wall of the vagina. A urethrocele occurs when the tissues surrounding the urethra sag downward into the vagina. Both conditions are easy for your doctor to see during a physical exam. They often occur at the same time and are usually caused by damage that happens when a baby is delivered through the mother's birth canal (vagina).
While many women have some degree of
bladder
and
urethral prolapse, few ever have any symptoms, or the
symptoms do not appear for years. When symptoms do appear, they may include
difficulty urinating, involuntary release of urine (urinary incontinence), and pain during sexual
intercourse. Surgery is not required unless your symptoms interfere with daily
activities.
Unless another health problem is present that would require an abdominal incision, the bladder and urethra are usually repaired through an incision in the wall of the vagina. This surgery pulls together the loose or torn tissue in the area of prolapse in the bladder or urethra and strengthens the wall of the vagina to prevent prolapse from recurring.
There are several types of surgery to correct stress urinary incontinence. These surgeries lift the urethra and/or bladder into their normal position. To learn more about these surgical procedures, see the topic Urinary Incontinence in Women.
What To Expect After Surgery
General anesthesia usually is used during repair of the bladder and urethra. You may stay in the hospital from 1 to 2 days. You may go home with a catheter in place. You can most likely return to your normal activities in about 6 weeks. Avoid strenuous activity, such as heavy lifting or long periods of standing, for the first 3 months, and increase your activity level gradually. 1 Straining or lifting after you have resumed normal activities may cause the problem to recur.
Most women are able to resume sexual intercourse in less than 6 weeks. Urinary function usually returns to normal in 2 to 6 weeks.
Why It Is Done
Repair of the bladder and urethra is done to manage symptoms such as pressure on the vaginal wall from the movement of those organs, difficulty urinating, urinary incontinence, and painful intercourse. If you are experiencing involuntary release of urine (urinary incontinence), further testing may be needed to determine what procedure is needed.
Bladder and urethral prolapse often occur with the prolapse of other pelvic organs, so tell your doctor about any other symptoms you have. If your doctor finds a uterine prolapse, rectocele, or small bowel prolapse (enterocele) during your routine pelvic examination, that problem can also be repaired during surgery.
How Well It Works
Not much is known about how well the surgery works over time. Some experts report that up to 20 out of 100 women have another prolapse (recurrence) of the bladder or urethra after surgery. 1
Risks
Risks of cystocele and urethrocele repair include:
- Urinary incontinence.
- Urinary retention.
- Painful intercourse.
- Infection.
- Bladder injury.
- Formation of an abnormal connection or opening between two organs (fistula).
What To Think About
Pelvic organ prolapse is often caused or made worse by labor and vaginal delivery, so you may want to delay surgical repair until you have finished having children.
Surgical repair may relieve some, but not all, of the problems caused by a cystocele or urethrocele. If pelvic pain, low back pain, or pain with intercourse is present before surgery, the pain may still occur after surgery. Symptoms of urinary incontinence or retention may return or get worse following surgery.
You can control many of the activities that may have contributed to your cystocele or urethrocele or made it worse. After surgery:
- Avoid smoking.
- Stay at a healthy weight for your height.
- Avoid constipation.
- Avoid activities that put strain on the lower pelvic muscles, such as heavy lifting or long periods of standing.
Complete the surgery information form (PDF)
(What is a PDF document?)
to help you prepare for this surgery.
Citations
WebMD Medical Reference from Healthwise
ENABLEX is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:
- · having a strong need to go to the bathroom right away (also called "urgency")
- · leaks or wetting accidents (also called "urinary incontinence")
- · having to go to the bathroom too often (also called "urinary frequency")
IMPORTANT SAFETY INFORMATION
You should not take once-daily ENABLEX if you have certain types of stomach problems, glaucoma, or have trouble emptying your bladder. Side effects of ENBLEX include blurred vision, and more commonly dry mouth, constipation, indigestion, and abdominal pain. Use caution when doing certain activities until you know how ENBALEX affects you.
Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
