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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.

Getting Ready

The week before your procedure:

  • Ask a family member or friend to drive you home after your procedure. Do not drive yourself home.

  • Ask your caregiver if you need to stop using any of your present medications. These may include aspirin, ibuprofen, or blood thinners.

  • Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.

  • Dye may be used during your procedure to let caregivers see your bladder better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may also be allergic to this dye. Tell your caregiver if you are allergic to any of these.

  • Keep a record of the number of times you pass urine each day. Describe the color and amount of your urine for each time you use the bathroom. Bring this record with you when you see your caregiver.

  • Practice Kegel exercises, and keep doing them even after your procedure. These exercises squeeze your pelvic floor muscles and help them become stronger. Ask your caregiver for more information about Kegel exercises.

  • You may need to have urine tests, cystoscopy, chest x-ray, and blood tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

  • Ask caregivers about directions for eating and drinking.

  • Your bowel may need to be emptied and cleaned out before the procedure. Caregivers may give you a liquid medicine called an enema. This will be put into your rectum to help empty your bowel. Your caregiver will teach you how to do this.

  • You may be given a pill to help you sleep.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.

  • Do not wear contact lenses on the day of your procedure. You may wear glasses. Wear socks to help you stay warm.

  • If you are staying in the hospital after your procedure, bring your personal belongings with you. These include your bathrobe, toothbrush, denture cup (if needed), hairbrush, and slippers.

  • Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist may talk to you before your procedure. This caregiver will give you medicine to make you sleepy or completely asleep during your procedure.

  • You or a close family member will be asked to sign a consent form. It gives your caregiver permission to do the procedure. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

  • You may be given medicine to help you relax or make you drowsy. You will be taken on a cart to the operating room and then moved into a special bed. 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 spinal anesthesia, or general anesthesia to keep you completely asleep.

  • 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 pulls the bladder into a more fixed position. Caregivers may also remove any excess vaginal tissue that may be present. The incision is then closed with stitches. 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. You may have a Foley catheter in your bladder for 1 to 2 days after the surgery. 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 on catheter care, ways to prevent bleeding, and how to take care of your incision.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your appointment on time.

  • You have questions or concerns about your procedure.

  • You have a fever.

Seek Care Immediately if

  • You feel something is bulging out into your vagina and not going back in.

  • Your urine is leaking out more often than usual.

© 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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