Cystocele
A cystocele is when the bladder falls down and often becomes visible. Urinary leakage often accompanies a cystocele. Cystoceles may cause pelvic pressure or just be unsightly. Cystocele repair (also called Anterior Repair or Anterior Colporrhaphy is the surgical reduction of the bulge to place the bladder back into its normal anatomic location. The traditional repair of plicating or overlapping tissues with suture unfortunately has a very high failure rate ranging from 25 to 60 percent. It is certainly one of the most challenging surgeries gynecologists and urogynecologists perform. More modern surgery treats cystoceles as a hernia of the bladder into the vagina, hence, the use of mesh or donor tissues as a patch or graft has been gaining steady acceptance. We have some of the most extensive experience in this type of surgery in Greece with success rates of about 90% in our hands. Cystocele Repair is done in the operating room under general, regional. The procedure takes 60 minutes to perform. Most insurance companies cover this procedure. The recovery period it varies from patient to another, but in general you need few days to go back again to job and some weeks (max 6) to have your sexual activity again.
Rectocele/Enterocele
When the bulge into the vagina comes from the rectum it is called a Rectocele or rectal prolapse. As with other forms of pelvic organ prolapse (cystoceles, Enterocele, vaginal prolapse) childbirth, chronic cough, chronic constipation, and obesity are predisposing factors. Symptoms are similar to cystoceles such as pelvic pressure, an unsightly bulge in the vagina, and constipation. Furthermore, the need of reaching into the vagina to push stool out is not uncommon.
A bulge into the vagina can also be caused by small bowel pushing the vaginal tissues. This is called an Enterocele. It can occur at the same time as a cystocele and a Rectocele. In fact, we often cannot tell what is causing the bulge in the vagina whether it is bladder, rectum, or bowel, or all! Modern repair uses mesh or donor tissue with excellent success found. This repair is technically quite challenging and few are trained in the modern repair of this problem. Surgical repair consists of using sutures to bunch up the bulging tissues together. More modern repair consists of the use of mesh or donor tissues. This newer method gives success rates of over 95% in our hands. Rectocele Repair is done in the operating room under general, regional, or local anesthesia. The procedure takes 60 minutes to perform. Most insurance companies cover this procedure. The recovery period varies from patient to another; almost you need few days to go back to your job and few weeks (max 6) to restart sexual activities.
You can visit the next link to understand the michanism of pelvic organs relaxation and prolapses;
http://www.mybladdermd.com/images/animations_prolapse.swf