Patient Information Leaflet. Prolapse Repair

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1 Patient Information Leaflet Prolapse Repair What is it? A prolapse is caused by weakness in the tissues around the vagina. This may be your womb or bulging of the front or back vaginal wall with the bladder or bowel behind it. The most common symptom is a sensation of something coming down the vagina. A prolapse doesn t always need treatment and there are non surgical ways of treating them with pessaries. Why is it done? It is usually discussed if you are having symptoms such as discomfort, difficulty passing urine or difficulty emptying your bowels. Different types of surgery are suitable for different types of prolapse and the doctor will discuss this with you in the clinic. Pre-assessment visit You will be seen in this clinic to take a medical history and to see an Anaesthetist. The Anaesthetist will advise on the best type of anaesthetic for you. This may be a spinal or general anaesthetic. Blood tests and an ECG (tracing of your heart) may be done. You will be given an explanation about your operation and about what to expect between coming in and going out of hospital. Your questions will be answered and we aim to reduce your anxieties as much as possible. Risks and complications We will do our best to make your surgery as safe as possible, but with all operations there are risks such as bleeding, infection, and anaesthetic problems. Serious complications such as damage to the bowel or bladder are fortunately rare. Another rare but serious complication is thrombosis (blood clots) in the veins. Page 1 of 5

2 You will be given antibiotics to help reduce the risk of an infection also injections and stockings to reduce the risk of thrombosis. Common but minor complications are raised temperature and temporary difficulty emptying the bladder. Are there any alternatives? Some women decide to have a ring pessary fitted to relieve discomfort from a prolapse. This will usually be discussed with you before making a decision on surgery. There are a variety of operations that can be used to treat prolapse depending on the nature of the problem. These include vaginal hysterectomy, anterior repair, posterior repair, or a combination. These operations are done from within the vagina and leave no scar. Pre-operative care You will usually be admitted to hospital on the day of the operation. You will be asked to sign a consent form before the operation. Please ask any questions that you wish. A nurse will carry out a safety checklist ensuring we have the correct details about you. After the operation When you wake up from the anaesthetic you will be in the recovery area. You will be given pain relief in the form of strong painkillers or injections. Antisickness injections will be given if needed. The following equipment may be attached to you. Oxygen mask You will usually be given oxygen for about four hours. Drip or intravenous line This is a fine tube coming from a vein in your hand or arm, to give you fluids so that you do not become dehydrated. Catheter You will have a tube in your bladder to drain urine. It will usually be removed after hours. If you are unable to pass urine, you may be discharged with a catheter for approximately one week. Page 2 of 5

3 Vaginal pack You may have a gauze dressing in the vagina. This is usually removed on the following day. Recovery exercises For the first few days after your operation it is important to perform deep breathing exercises. This is to try to help prevent a chest infection and involves taking deep breaths slowly in and out, to improve the flow of oxygen. Try to do these five times every hour. To help prevent circulatory problems try not to cross your legs in bed and move your feet up and down at the ankles, also circle them round and round. Try to do these exercises up to 10 times every hour until you are mobile. Fluids and diet You will be offered small drinks of water after your operation. Further fluids and diet will be offered as you recover. Hygiene On the day after your operation you should be able to have a wash in the bathroom. Following this a shower can be taken daily. Bowels You may not have a bowel action for the first few days, this is quite normal. You will be given some suppositories to help if needed. A diet rich in fibre may help. Information about discharge from hospital You will usually be discharged approximately two days following your operation. Housework and exercise At first rest when you feel tired, but it is important to walk around the house to try to prevent complications with blood clotting. Gradually increase the distance that you walk outside as you improve. For the first two weeks you should not lift anything heavier than a kettle half full of water. Avoid vacuuming and ironing for four to six weeks. The prolapse could return and you are at risk of developing further prolapse if you do any heavy lifting. Swimming is possible six to eight weeks after surgery. More strenuous exercise such as gym work should be avoided for three months. Page 3 of 5

4 Vaginal bleeding/discharge It is possible to have some bleeding or discharge for up to six weeks following surgery. The discharge may contain threads as the stitches dissolve. If the discharge becomes offensive or smelly, see your GP as you may have an infection. It is best to avoid tampons and to use pads to reduce the risk of infection. Intercourse We advise you to wait five to six weeks before having sex. This is to allow the wound inside the vagina to heal. If you feel any discomfort a lubricant gel may be helpful. Bowels Try to avoid constipation by eating plenty of fruit, vegetables and wholemeal bread. Smears If the operation involved removal of the womb it is unlikely that you will need any further smears. Driving You should not drive for approximately five weeks, to avoid any problems with your recovery. Also you may be unable to perform an emergency stop. Time off work Take a minimum of four to six weeks off work, if you have a heavy job you may need eight to twelve weeks off. We would encourage you to get back to normal activity as soon as you are able. Discuss this with your consultant/gp. Follow up You may or may not require a hospital follow up visit and this will be discussed with you prior to your discharge after your surgery. If you develop problems or require advice following discharge you should initially contact your GP. Page 4 of 5

5 Useful contacts Women s Health Concern An independent service to advise, reassure and educate women about their health concerns Bladder and Bowel foundation A national organisation providing support and information for people with bladder or bowel incontinence. Helpline info@bladderandbowelfoundation.org Gynaecology nurse practitioner Monday Friday Gynaecology Ward Data Protection Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible. In order to assist us improve the services available your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews. Further information is available in the leaflet Disclosure of Confidential Information IL137, via Gateshead Health NHS Foundation Trust website or the PALS Service. Information Leaflet: NoIL160 Version: 2 Title: Prolapse Repair First Published: October 2008 Last reviewed: July 2011 Review Date: July 2013 Author: Data Protection Dr Beeby - Obstetrics This leaflet can be made available in other languages and formats upon request Any personal information is kept confidential. There may be occasions where your Page 5 of 5