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Cystocele and Rectocele without Hysterectomy Overview

written by: Victoria Trix • edited by: DaniellaNicole • updated: 12/28/2009

It is possible to repair cystocele and rectocele without hysterectomy, but one is usually required to completely repair the entire area and prevent recurrences.

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    Rectoceles commonly happen when the last part of the large intestine, or the rectum, pushes through the vaginal wall. Cystoceles are said to occur when part of the bladder bulges out into the vaginal walls. This happens when the tissue that separates the bladder and vagina loosens and is commonly called an anterior prolapse. Cystoceles involve the vagina and bladder, as well as the muscles between the two, and rectoceles involve the rectum and vagina as well as the muscles separating the two.

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    Cystocele and Rectocele without Hysterectomy Treatment

    There is normally a surgery required to repair the cystocele and rectocele without hysterectomy. This is not normally done unless all other treatments have been tried and failed, including strengthening exercises for the muscles (Kegel exercises). Flexible devices known as pessaries are inserted into the vagina by a female or doctor. This helps to support the vaginal walls so that the cystoceles and rectoceles do not bulge. If these treatments have not worked after a period of time, surgery may be required. The surgical repair of these protruding areas can help a person have better bowel and bladder control and stress incontinence can be almost cured in this way. Any pain that was encountered during sexual intercourse would more than likely be eliminated if the pain was caused by the rectoceles or cystoceles.

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    Surgery

    The surgery itself consists of making a small incision into the vaginal wall to be able to access the muscles and tissues beneath. The tissues can then be stretched and stitched to be strengthened, or a mesh can be used to reinforce the walls and then be stitched into place. Any tissue or muscle that has been weakened in these areas due to prior surgery, age or pregnancy can be removed at this time, as well as any excess lining in the vagina that is not required. If incontinence is a problem, the surgeon can help with suspension and elevation of the bladder at this time. During surgery a patient will be catheterized in order to relieve pressure on the bladder. The only time a hysterectomy is required is when the uterus is prolapsed into the vagina. The surgery can take from 45 minutes up to many hours, depending on how much tissue is damaged and other required procedures such as supporting the bladder.

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    Recovery

    After the surgery, vaginal discomfort is usually present for up to two weeks, but prescriptions are given to help with pain for this time frame. Complications associated with cystocele and rectocele without hysterectomy surgical procedures include infection, bleeding, damage to vagina and rectum or bladder as well as nearby organs, and adverse reactions to the anesthesia used. The normal stay in the hospital after this type of surgery can be up to six days depending on your needs. Patients must not lift more than ten pounds or engage in sexual intercourse for approximately one month after the surgery. Tampon use is also discouraged.

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    Resources

    Hysterectomy Association from the article Rectocele and Cystocele (Prolapse of Bowel)

    ThirdAge.com from the article Cystocele and Rectocele Repair published on June 22, 2008