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Posterior Vaginal Repair

AMBULATORY CARE:

What you need to know about posterior vaginal repair:

A posterior vaginal repair is surgery to fix a rectocele or vaginal hernia.

How to prepare for surgery:

Your healthcare provider will talk to you about how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. Your provider may tell you to shower the night before your surgery. He or she may tell you to use a certain soap to help prevent a surgical site infection. Your healthcare provider will tell you what medicines to take or not take on the day of your surgery. Arrange to have someone drive you home and stay with you.

What will happen during surgery:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given spinal anesthesia to numb you from the waist down. With spinal anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain. You may be given an antibiotic to help prevent an infection.
  • Your surgeon will make an incision in the middle of the back wall of your vagina. The incision will start near the vaginal opening. It will continue over the bulging area and a bit above the bulge. Your surgeon will remove the vaginal skin covering this area. He or she will place stitches in the tissue between your vagina and rectum to stop the bulging. Mesh or a graft may also be placed to make the repair stronger. Your surgeon may need to put some absorbable stitches into nearby muscles. He or she will then close your vaginal skin over the septum with stitches. The stitches will be absorbed by your body, so you do not have to get them removed. You will need to wear a sanitary pad to help control and monitor bleeding. The pad will also protect your surgery area.

What will happen after surgery:

Healthcare providers will monitor you closely for any problems. You may be able to go home the same day of surgery. You may have a Foley catheter in your bladder to drain urine after surgery. Healthcare providers will remove it as soon as possible after surgery.

Risks of surgery:

You may bleed more than expected or get an infection. Damage to your rectum may occur. Problems may develop during surgery that require an abdominal incision. The bulging may come back, or you may need more surgery. You may have trouble having a bowel movement after the surgery. You may have discomfort when you have sex. A mesh put in during surgery may damage the vaginal tissues and cause bleeding or discharge.

Contact your healthcare provider if:

  • You feel something is bulging out into your vagina or rectum and not going back in.
  • You cannot urinate.
  • You soak a sanitary pad with blood every hour for 4 hours.
  • You have vaginal pain that does not go away even after you take pain medicine.
  • You have pus or a foul-smelling discharge from your genital area.
  • You see blood in your urine.
  • You have a fever, chills, a cough, or feel weak and achy.
  • You have nausea and are vomiting.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Bowel movement softeners make it easier for you to have a bowel movement.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Incision care:

Care for your incision as directed. You can take a shower after 2 days. Do not take a bath or get in a pool or hot tub. Your healthcare provider will tell you when it is okay. He or she may tell you it is okay to take a sitz bath. Your healthcare provider will give you more information if a sitz bath is okay to do. Change your sanitary pad regularly. Keep track of how often you change the pad.

Self-care:

  • Do not have sex until your healthcare provider says it is okay.
  • Do not put anything in your vagina for 6 weeks after the surgery. This allows time for the wound to heal.
  • Do not lift more than 10 pounds for at least 6 weeks. Heavy lifting puts pressure on the surgery area and slows healing.
  • Avoid heavy exercise the first few weeks after the surgery. You may try light activity, such as short walks, 3 to 4 weeks after the surgery.
  • Try not to cough or strain to have a bowel movement. This may cause damage to the surgery area. Ask your healthcare provider about ways to make bowel movements easier so you do not have to strain.
  • Eat healthy foods and drink liquids as directed. This will help prevent constipation. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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