Pelvic floor repair at Exeter Hospital

What is pelvic floor repair?

The muscles, ligaments and connective tissue that hold a women’s internal organs in place are called the pelvic floor. The bladder, bowel, uterus, vagina and rectum are held in place by the pelvic floor. Your brain controls your pelvic floor muscles to help these organs function correctly. Several medical conditions such as an injury or childbirth can cause weakness or tears in the pelvic floor muscles called pelvic floor disease.

What happens during pelvic floor repair?

There are several types of pelvic floor repair. Your surgeon may perform several procedures during your operation. You should have a detailed discussion with your consultant to determine which option is the best in your case.

Anterior repair - repairs the weak muscles in the front wall of the vagina that support the bladder (anterior prolapse). An anterior repair is usually performed under general anaesthetic. The operation usually takes about half an hour.

Your surgeon will make a cut in the anterior (front) wall of your vagina so they can push your bladder and urethra back into place. They will stitch the support tissues together to provide better support for your bladder and urethra. They may cut away a small part of the vaginal wall to remove tissue left over from the repair.

Posterior repair - repairs the muscles in the back wall of your vagina that support your bowel (posterior prolapse). A posterior repair is usually performed under a general anaesthetic. The operation usually takes about half an hour.

Your consultant will make a cut in the back (posterior) wall of your vagina so they can push your bowel back into place. They will use stitches to tighten the supporting tissues along the length of the back wall of your vagina. They may need to cut away a small part of the vaginal wall to remove excess tissue. If the muscles on either side of your entrance to your vagina are weak they may use stitches to tighten them as well.

You should expect a slight discharge or bleeding from your vagina but you should let a member of the healthcare team know if this becomes heavy.

Going home after pelvic floor repair

You will usually be able to go home after two to three days. For the first two weeks at home, you should rest, relax and continue to do the exercises that you were shown in hospital.

It is best not to have sex for about six weeks or at least until any bleeding or discharge has stopped. Avoid standing for too long and do not lift anything heavy. You can go back to work once your doctor has said you are well enough to do so (usually after six to eight weeks).

Consult your surgeon before returning to any exercise or strenuous activities.

You should continue your pelvic floor exercises as soon as possible after the operation and keep doing them for life. This will help to prevent a return of any prolapse and reduce the risk of you becoming incontinent.

With any surgical procedure there can be complications:

• Pain
• Nausea (feeling sick)
• Bleeding
• Blood clots (DVT - deep vein thrombosis)
• Infection

Specific complications of pelvic floor repair:

• Incontinence
• Urinary infection
• Difficulty passing urine
• Damage to the bladder or bowel