Will anterior prolapse repair improve vaginal tightness?

Question

32 yr old no prev pregnancy with a grade 2 cystocele. Will having an anterior native tissue prolapse repair improve vaginal tightness. Since having the prolapse my vagina feels more open/lax . I am worried about sexual function / confidence after the procedure

Anna Chacon, MD, FAAD · Answer

An anterior prolapse repair, also known as anterior colporrhaphy, is primarily aimed at addressing the prolapse itself by supporting the bladder and restoring its normal position. While the main goal of the surgery is to correct the prolapse, many patients do report an improvement in vaginal tightness following the procedure. This is because the repair often involves reinforcing the vaginal wall, which can help reduce the feeling of laxity.

However, the degree to which vaginal tightness is improved can vary from person to person, and it is important to have realistic expectations. The surgery may not entirely restore the vaginal tightness to what it was prior to the prolapse, but it can help improve the overall support and function.

Regarding concerns about sexual function and confidence, many women find that addressing the prolapse improves their confidence and comfort during sexual activity. It is important to discuss your specific concerns and goals with your surgeon prior to the procedure, as they can provide more personalized information based on your condition and the surgical approach they will use.

Additionally, pelvic floor exercises, either before or after surgery, can further enhance pelvic support and improve outcomes. A consultation with a pelvic floor physical therapist can be beneficial in addressing these concerns.

Mark N. Scheinberg, MD · Answer

Thank you for your questionWhen patients complain of vaginal laxness, The majority of of the problem is in the posterior or rectovaginal side the vagina along with the posterior vaginal opening. Fixing the cystocele (anterior side) can result in some narrowing may help minimally, but doesn't typically address or affect the problem of laxness.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Cystocele repair will not tighten your vagina. It will simply reducing the bulging that occurs when your bladder is loose and sagging. There is no way to tell if your vagina will feel open or larger after a cystocele repair without examining you. However, a mild bladder prolapse is unlikely to have any effect on vaginal tightness in general.

Burcak Tok, MD · Answer

Hello, cystocele and anterior wall repairs may cause a small vaginal narrowing sensation at first, but it is temporary. If it is done together with posterior wall repair, it will help you with vaginal narrowing. I hope I helped.

Joe Daniels, MBBS · Answer

It should, done properly and on purpose to achieve reduction vaginoplasty effect. However it may not necessarily guarantee specific “vaginal tightening” result, as the outcome needs to be agreed with surgeon

Michael P. Goodman, MD, FACOG · Answer

An "Anterior Repair" (aka "Anterior Colporrhaphy") will in no way improve vaginal tightness and for you would be an unnecessary operation. Having had no children you are most likely not a candidate for a surgical vaginal tightening, but may be one of the small number of persons who might benefit from a minimally invasive technique (RF or laser) or fat transfer. These temporary procedures however generally take 2-3 treatments & need to be repeated more or less annually. What will probably work best for you however would be "pelvic floor physical therapy" to improve muscle strength.

Best, Michael P Goodman, MD, FACOG, IF, AAACS. Sacramento, CA, USA

Best,  Michael P Goodman, MD, FACOG, IF, AAACS.  Sacramento, CA, USA

Nazli Korkmaz, MD · Answer

Cystocele, or bladder prolapse, can occur due to various factors including genetic predisposition to low collagen levels and weakened pelvic floor muscles, even in the absence of childbirth history. A grade 2 cystocele means the bladder has dropped to a point where it reaches or slightly protrudes through the vaginal opening during straining.
Treatment Plan OverviewTo develop a precise treatment plan, a thorough examination by a healthcare professional is essential. However, based on the given information, the treatment options may include:
Pelvic Floor Rehabilitation:
Physical therapy to strengthen the pelvic floor muscles.Biofeedback or electrical stimulation for additional support.Surgical Repair (Cystocele Repair):
Recommended if conservative treatments do not resolve symptoms.Surgery involves reinforcing weakened vaginal tissue or using grafts to provide support.Lifestyle Adjustments:
Weight management, avoiding heavy lifting, and managing chronic constipation or cough.
If surgery is anticipated, cystocele repair may involve either anterior colporrhaphy (traditional approach) . A detailed consultation will refine the treatment path based on your specific symptoms and anatomy.

Will anterior prolapse repair improve vaginal tightness?

Answers (7)

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