Pelvic Organ Prolapse Surgery

You have been given this leaflet because you have been diagnosed with pelvic organ prolapse and are considering an operation to fix your symptoms of prolapse. This leaflet will describe what pelvic organ prolapse is, what your options are, your hospital experience and recovery.

What is a pelvic organ prolapse?

Vaginal prolapse can occur when the uterus (womb) or vault (previous hysterectomy) and/or the walls of the vagina are no longer supported. Prolapse is described according to the parts of the vagina or uterus that are involved.

If the front wall of the vagina, where the bladder sits, is prolapsing this is called an anterior wall prolapse or sometimes known as a cystocele.

If the back wall of the vagina is prolapsing, where the bowel sits, this is called a posterior wall prolapse or sometimes known as a rectocele.

If the uterus and cervix (womb and neck of the womb) are falling into the vagina this is called a uterine prolapse.

If the top of the vagina, where the cervix and womb used to sit, called the vault, drops into the vagina, this is called a vault prolapse.

Prolapse can cause the following symptoms:

• A bulge or fullness inside the vagina, sometimes this can extend past the entrance of the vagina.
• A dragging sensation in the vagina.
• Difficulty emptying your bladder or bowel.
• Urinary tract infections.

What happens at the hospital?

Once you have chosen your operation and your consent has been signed, you will be placed on a waiting list. When you have received your date for the operation, you will attend the access lounge.

Here, you will be seen by the doctors and nurses in order to prepare for your operation. This is where you will stay until you go to theatre.

Once you have recovered from theatre, you will be transferred to a ward for an overnight stay. In some cases, you may be able to go home the day of the operation but this is dependent on what operation you have.

Before you go home, your urinary catheter (that will be inserted during your operation) will be removed and the nurses will ensure you are passing urine successfully and may need to scan your abdomen to ensure enough urine is passing.

Occasionally, your bladder may require more rest and you may go home with a catheter. This will be removed around 5 days after you have been discharged.

You will have a follow up appointment with the Urogynaecology Specialist Nurse around 3 months after your operation. At this appointment you will have an examination to ensure you have healed well and your recovery, symptoms and any questions that you may have can be discussed.

What are the advantages of an operation?

When diagnosed with a pelvic organ prolapse, patients are presented with the options of doing nothing, trying supervised pelvic floor exercises, wearing a pessary or having an operation.

You may choose an operation because you have trialed the other options and they have not worked, or you have declined these alternatives and would like to proceed with an operation.

If successful, an operation can reduce your vaginal bulge and vaginal prolapse symptoms without the need for further treatment, but there is a risk in the future you may need further input or treatment.

What are the associated risks?

There are always risks associated with having an operation. Spinal and general anaesthesia come with specific risks but this will be discussed more in depth with the anaesthetist.

Other general surgery risks such as bleeding, infection, thrombosis and wound complications exist and this can be discussed further with your consultant.

When having a pelvic floor repair, 3 out of 10 are unsuccessful. Not all women who have recurrence will need further treatment. Further discussion surrounding the risks will be discussed during your appointment with your healthcare provider.

Are there any alternative treatments?

Alternative treatment including having no treatment, managing your symptoms of pelvic organ prolapse conservatively, undergoing supervised pelvic floor exercises or wearing a vaginal pessary to help reduce your pelvic floor prolapse and reduce symptoms.

Not all of these options are suitable for everyone and these should be discussed further with your healthcare provider.

Associated leaflets

There are information leaflets specific to each type of operation for pelvic organ prolapse by the British Society of Urogynaecology which can be found at www.bsug.org.

There is also recovery leaflets on pelvic organ repair and vaginal hysterectomy at www.rcog.org.

Contact numbers

Urogynaecology Secretary

01642 624 216

Tuesday to Thursday; 8:00am to 4:00pm

Friday; 8:00am to 1:00pm

Gynaecology Secretaries

01642 383 838

Monday to Friday; 8:00am to 4:00pm

Urogynaecology Specialist Nurse

07760 554 010

Monday to Friday; 8:00am to 4:00pm

Please be aware these are not emergency lines and any urgent medical attention or query should be addressed with 111 or 999.

Further information

www.BSUG.org

www.RCOG.org

www.yourpelvicfloor.org/conditions/

References

British Society of Urogynaecology (Operation to Treat Prolapse of
the Uterus) Patient leaflet; Operations-to-treat-uterine-prolapseJan2021.pdf (bsug.org.uk)

British Society of Urogynaecology (Operation to Treat Vaginal Vault
Prolapse) Patient leaflet; Operations-to-treat-vaginal-vault-prolapseSep-2021.pdf (bsug.org.uk)

British Society of Urogynaecology (Anterior Repair) Patient leaflet;
Anterior-repair-BSUG-Apr-2020.pdf

British Society of Urogynaecology (Posterior Repair) Patient leaflet;
Posterior-Repair-2020.pdf (bsug.org.uk)

NICE Patient Decision Aid about choice of procedure for Vaginal
Vault Prolapse; surgery-for-vaginal-vault-prolapse-patientdecisionaid-pdf-6725286114 (nice.org.uk)

NICE Patient decision aid about choice of procedure for prolapse
of uterus; surgery-for-uterine-prolapse-patient-decision-aidpdf6725286112 (nice.org.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

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Telephone: 01642 624719

Freephone: 0800 092 0084

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Email: [email protected]

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Telephone: 01642 383551

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Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]