Patient Story: A Cystocoele with Abnormal Emptying

Mrs VA was 53 years old with 4 teenage children. She gave this story.

“Every time I stand, a “squashy thing” comes out of the vagina. It is so uncomfortable. I have to sit in a funny position when I drive. I can’t empty my bladder properly. I get 5-6 bladder infections a year. I am always in and out of the GP’s office. My husband didn’t like the “squashy thing” when we had sex, so he came with me to ask the GP what we could do about it. She suggested a pessary but we didn’t like that idea much as we were still sexually active. The GP sent me off for a bladder repair. This was two years ago. The “squashy thing” came down again a few months after the operation. The GP tried a pessary this time round but it kept falling out. She said my vagina was short from the operation and that was why the pessary fell out. I went to see another surgeon.He said he would need to remove more vagina as part of the surgery. He said there was about a 60% chance that the operation would fail because the tissues were so poor”.

We found that the vaginal tissue covering the cystocoele was very thin and her vagina was a little short, all a result of the previous surgery. Clearly, no further tissue could be removed. A TFS operation which requires only an overnight stay was performed to support the prolapsed bladder without excision of vaginal tissue. 

The TFS is a relatively new method which inserts thin horizontal segments of tape to support the front wall of vagina like ceiling joists. No vaginal tissue is ever cut away. When reviewed at 12 months, the cystocoele had disappeared and there were no further episodes of infection or abnormal emptying.