Anterior Repair

What is an anterior repair?

An anterior repair is a surgical procedure used to treat a prolapse of the front wall of your vagina. This condition, also known as a cystocele, happens when your bladder pushes into the vaginal wall due to weakened or stretched pelvic floor muscles and tissues. An anterior repair restores the normal position of your vaginal wall and bladder, relieving symptoms such as discomfort, pressure, and urinary problems.

Why might you need an anterior repair?

A cystocele can develop because of various factors, including childbirth, menopause, ageing, or frequent heavy lifting, all of which can weaken the pelvic floor. If this condition is causing significant discomfort or affecting your quality of life, an anterior repair may be recommended.

You might need an anterior repair if you experience:

• A feeling of heaviness or pressure in your vagina
• A noticeable bulge in your vaginal area
• Difficulty emptying your bladder fully
• Frequent urinary tract infections
• Stress incontinence (leaking urine when you cough, sneeze, or exercise)

In many cases, initial treatments such as pelvic floor exercises or using a vaginal pessary may help manage the symptoms. However, if these methods are not effective, surgery might be the best option to address the issue.

What happens during the procedure?

Anterior repair is usually performed under general or regional anaesthesia. During the procedure, your surgeon will make a small incision in the front wall of your vagina. They will then tighten and repair the tissue supporting your bladder to restore its normal position. Any excess or weakened tissue may be removed, and the incision is closed with dissolvable stitches.

The surgery typically takes about an hour. Depending on your individual situation, you may be able to go home the same day or require an overnight stay in the hospital. Your surgeon will explain what to expect and ensure you are comfortable throughout the process.

Recovery after anterior repair

Recovery from an anterior repair varies from person to person, but most women can return to normal activities within 4–6 weeks. To ensure proper healing, it’s important to follow your doctor’s advice and take steps to care for yourself during this time.

• Avoid heavy lifting, strenuous activities, and high-impact exercises for at least 6 weeks.
• Take short walks to promote blood circulation and aid healing.
• Follow your doctor’s instructions on caring for your stitches and managing any discomfort.
• Avoid inserting anything into your vagina, including tampons, and refrain from sexual intercourse until your doctor advises it is safe.

You may experience some light vaginal bleeding or discharge in the first few weeks after surgery, which is normal. This should gradually improve as you heal. Your doctor will schedule follow-up appointments to monitor your progress and ensure your recovery is on track.

Benefits of anterior repair

An anterior repair can significantly improve your quality of life by addressing the symptoms of a vaginal prolapse. Many women report relief from discomfort, improved bladder function, and greater confidence in their daily activities. By restoring the normal position of your bladder and vaginal wall, the procedure can help you regain comfort and control.

Risks of anterior repair

As with any surgery, there are potential risks associated with an anterior repair. While complications are rare, they may include:

• Infection or bleeding
• Pain or discomfort during intercourse
• Difficulty urinating or a temporary need for a catheter
• A risk of prolapse recurrence in the future

Your consultant will discuss these risks with you in detail and answer any questions you may have. They will ensure you have all the information needed to make an informed decision about your care.

Supporting your pelvic floor after surgery

In addition to surgery, maintaining a healthy lifestyle can help support your pelvic floor and improve your long-term health. Here are some steps you can take:

• Perform regular pelvic floor exercises to strengthen the muscles supporting your bladder and vagina.
• Eat a fibre-rich diet and stay hydrated to prevent constipation and reduce straining.
• Avoid heavy lifting and high-impact activities that may weaken your pelvic floor further.
• Maintain a healthy weight to reduce pressure on your pelvic floor.

These measures can help complement the benefits of your anterior repair and reduce the likelihood of further issues.