Is it possible to have cystocele repair to a 70 year old female?

Answer 1

Yes, it is possible to have a cystocele repair at any age, but much of that decision would include factors such as overall current health and how much the cystocele negatively affects life for the female.

A cystocele is the "pouching out" of the bladder against the upper vaginal wall. It occurs from many causes, primarily when the ligaments and supports have become too lax to hold the bladder correctly in the abdominal cavity. Hormones during pregnancy allow the ligaments to stretch too much; multiple pregnancies can pull the bladder from its normal position. Aging with changes in hormones can make the bladder drop more. A similar condition can occur with the rectum, creating a rectocele when the rectum and its contents push against the back vaginal wall.

When the rectocele or cystocele (or both) are moderate to severe, the pouching into the vaginal walls can be felt with a finger inserted into the vagina. The pouching can make penile entry into the vagina difficult but not necessarily impossible. It helps to have an empty bladder and empty rectum before attempting intercourse.

But, both conditions can cause incomplete emptying of the bowel and bladder. Rectocele can contribute to constipation and so, the hard stool can collect in the pouch area and be felt through the back (posterior) vaginal wall. If bladder retention occurs, intercourse can put extra pressure on the pouch felt through the front (anterior) vaginal wall and thus create urinary incontinence during sex. A woman may need to press on the lower abdomen to press out more urine from the bladder, and may need laxatives to keep the stool soft and the rectum empty.

Since rectocele or cystocele can occur in any woman who has been pregnant, surgical repair is usually recommended at ages younger than 70 years.

If the 70-yr old is is good health overall, and possibly the conditions are interferring with intercourse, she could be evaluated for surgery and make the choice with recommendations of the physicians involved.

But, if the 70-yr old has other existing conditions, I'd recommend caution. Any lung conditions can complicate recovery. Cough, movement, and ambulation are important after any major surgery, so any restrictions to lung capacity or mobility could make recovery harder.

Also, while the bladder sling surgeries have improved through the last 20 years, they are still imperfect solutions. Many women report failed surgeries; incontinence may continue.

However, pessaries may be a good choice. A pessary is inserted into the vagina to push the bladder pouch up. Some women feel uncomfortable using the pessary but it is an alternative to surgery.