Anterior Vaginal Repair

WHAT YOU SHOULD KNOW:

An anterior vaginal repair is a procedure to lift or tighten the front vaginal wall. This can help prevent you from leaking urine. The procedure is also called an anterior colporrhaphy.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Without treatment, you may have difficult, painful, or frequent urination, especially at night. You may continue to leak urine when coughing, sneezing, or laughing. You may also have pain when having sexual intercourse. Leaking urine may be embarrassing, and affect your daily activities. If you have a prolapse, it may push the bladder out of the vaginal opening even further. This may lead to other serious medical problems. Problems may also happen after this procedure, such as infection or bleeding. You may have problems during your procedure that may lead to an abdominal (open) surgery. Your bladder or uterus may get injured while having the procedure.

  • After your procedure, your symptoms may only be relieved for a short time, or they may not be relieved at all. Your caregivers may need to do more procedures and watch you closely for these problems. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Enema: You may need to have an enema the morning before your procedure. This is liquid put into your rectum to help empty your bowel. Caregivers will teach you how to do this.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Anesthesia: Anesthesia is medicine to make you comfortable during surgery. Caregivers work with you to decide which anesthesia is best and whether you will be awake or completely asleep. Do not make important decisions for 24 hours after having anesthesia. Avoid driving or using heavy equipment. Ask someone to drive you home and stay with you after you have had anesthesia.

    • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

During your procedure:

  • Your abdomen and genital area will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean. Caregivers may give general anesthesia to keep you completely asleep, or spinal anesthesia may be used.

  • During this procedure, a speculum is used to widen and hold open the vagina. Your caregiver will make an incision through the skin of your vagina. This will show the damage in the anterior vaginal wall, particularly in the supporting fascia. The damaged fascia is then folded and sutured after it has been separated from the vaginal skin. This makes the bladder to be pulled up into a more fixed position. Caregivers may also remove any excess vaginal tissue that may be present. The incision is then closed with stitches and a catheter may be inserted to drain your urine. A vaginal pack or sanitary pad is placed to cover your incision and control the bleeding.

After your procedure:

You may be taken to a recovery room until you are fully awake. You may need to lie flat and still in bed for a few hours. Do not get out of bed until your caregiver says it is OK. Your caregiver will decide when you will be taken back to your regular room. The vaginal pack used to cover your stitches keeps the area clean and dry to prevent infection. A caregiver may remove the vaginal pack soon after your procedure to check the incision. Ask your caregiver for more information about ways to prevent bleeding and take care of your incision.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Medicines: You may need any of the following:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  • Monitoring: Caregivers may check for your pulses on your legs or feet. This helps caregivers learn if you have problems with blood flow after your procedure. You may also have any of the following:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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