DR. MAYANK MOHAN AGARWAL
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Laparoscopic paravaginal cystocoele repair

The aim of Laparoscopic paravaginal cystocoele repair is the correction of lateral vaginal defects causing cystoceles. The vagina and supporting fascia are resupported to their natural anatomical position.

Indication

The Management of cystoceles (bladder prolapse) treatment of stress incontinence with cystocele

Surgical Technique

This surgery can only be done under general anaesthesia (fully asleep). The surgical procedure is similar to the laparoscopic colposuspension. Three small incisions are created in the skin and entry is gained to the space between the pubic bones and bladder. The anterior vaginal fascia is stitched to the lateral pelvic wall using 4-5 sutures on each side of the bladder. After the completion of the surgery a cystoscopy (look inside the bladder) is performed to ensure no damage has occurred to the lower urinary tract. The small trocar sites (incision sites) in the skin are closed with absorbable sutures.

In hospital and recovery

You can expect 2  to 3 days hospitalisation. After the operation is performed you will have an I.V. drip in your arm and a small catheter will drain your bladder for 24hrs.

In the early postoperative period the nurses will check that you are emptying your bladder appropriately. Absorbable sutures are used on the skin that are not to be removed.

During recovery

In the early postoperative period you have to avoid situations where excessive pressure is placed on the repair like lifting, straining, coughing and constipation. Maximal fibrosis around the repair occurs at 3 months and care has to be taken during this time. If you develop urinary burning, frequency or urgency you should see your local doctor. You will have to see your doctor at 6 weeks for a review and sexual activity can usually be safely resumed at this time. You can return to work at approximately 4-6 weeks which depends on the amount of strain that will be placed on the repair at your work and on how you feel.