Colporrhaphy

Colporrhaphy is a surgical procedure used to repair your vaginal walls’ weaknesses. It is used to treat pelvic organ prolapse. Because the supporting muscles and tissues in your vaginal wall have become too weak to hold the organs in place, the organs inside your pelvis droop with POP. Colporrhaphy strengthens these muscles and tissues, allowing them to support pelvic organs such as the bladder and rectum.

Colporrhaphy is classified into two categories. Your doctor may conduct one or both of these treatments in conjunction with other procedures to repair vaginal wall abnormalities.

1. Anterior colporrhaphy (also known as cystocele repair): Weakened muscles between your bladder and vagina can cause your bladder to descend onto the front wall of your vagina. This is a kind of POP known as anterior wall prolapse.
2. Posterior colporrhaphy (also known as rectocele repair): Weakened muscles between your rectum and vagina can cause your rectum to droop onto the rear wall of your vagina. This is a kind of POP known as posterior wall prolapse. The muscles in the rear wall that hold your rectum in place are tightened during posterior colporrhaphy.

Is colporrhaphy a serious surgical procedure?

Yes. POP is treated with two types of surgery – obliterative (less invasive) surgery and reconstructive surgery (more invasive). Colporrhaphy is a restorative surgery performed through your vagina. Although colporrhaphy is less intrusive than other reconstructive surgeries that include opening your abdomen to reach your pelvic organs, it is still substantial surgery.

Why is this treatment carried out?

Colporrhaphy can help relieve POP symptoms that are interfering with your health. POP symptoms like urine or faecal incontinence (difficulty managing when you urinate or defecate) and painful intercourse can have a negative impact on your quality of life. Colporrhaphy can correct structural problems in your pelvis, allowing you to avoid the symptoms that these problems produce.

Who is in need of this treatment?

If you meet the following criteria, you may be a candidate for Colporrhaphy:

1. Conservative therapies have had little effect on your POP symptoms. The first line of treatment for POP is non-invasive procedures to strengthen your pelvic floor muscles or keep your organs in position. Pelvic floor exercises (Kegels), devices such as pessaries, and hormone therapy are among the treatments available.
2. You’re having annoying symptoms- Many persons with POP do not have symptoms that interfere with their daily life. Because any surgery has dangers (including colporrhaphy), it may not be worth the risk of consequences if POP isn’t bothering you.
3. You have no intention of having children- Having a kid following a colporrhaphy may increase the likelihood of structural abnormalities and symptoms reappearing. It could be advisable to postpone surgery until you have children.

What is the difference between anterior and posterior colporrhaphy?

Both treatments entail your clinician repositioning sagging organs. They then use dissolvable sutures to reinforce the weaker muscles and tissues that maintain these organs in place. The reinforcements hold your vaginal wall and organs in place.

What occurs prior to colporrhaphy?

Your provider will go over the risks and benefits of colporrhaphy with you so that you have all of the information you need to decide whether or not this surgery is suitable for you.

Your healthcare professional will first administer anaesthetic to make you comfortable. You’ll then be seated at a table with built-in comfortable footrests to support your legs. You’ll lie on your back, legs raised, knees bent at around 90 degrees, and calves supported by footrests. The dorsal lithotomy position provides your physician easy access to your vagina and the tissue between your vagina and anus (perineum).

When you’re in a good place, your provider will:

• Insert a bladder catheter to hold your pee during the procedure and provide either general anaesthesia (you’re unconscious) or regional anaesthesia (you’re numb but aware).
• Widen your vagina using a speculum to make it easier to inspect your vaginal walls.
• Make a vertical incision (cut) in your vaginal wall to expose the muscles and tissues.
• To access the weakest sections of your vaginal wall, make small, precise cuts along the top wall of your vagina (for anterior colporrhaphy) or the back wall of your vagina (for posterior colporrhaphy).
• Sew the toughest sections of your vaginal wall together.
• Dissolvable stitches are used to close the incision.

How long does it take to recover from colporrhaphy surgery?

If the weakening muscles are confined to a small portion, surgery could take as little as 30 minutes. If bigger portions of your vaginal wall require healing, colporrhaphy may take longer.

What happens following a Colporrhaphy procedure?

Depending on the amount of your vaginal wall repairs, you may be able to leave the hospital the same day, or you may need to stay overnight.

Immediately following surgery:

• To stop the bleeding, your physician may implant a pack into your vagina. It is typically possible to remove it after 24 hours.
• Your provider will determine if you can pee on your own or if a catheter is required. The majority of catheters can be removed within 48 hours of colporrhaphy.
• You may be given a stool softener or gentle laxative to help you poop without straining mending muscle and tissue.

You may experience the following common adverse effects:

• For a few days after surgery, you may have difficulty entirely emptying your bladder (urinary retention).
• For a few days after surgery, you may experience bloody vaginal discharge.
• For a few weeks after surgery, you may observe a creamy vaginal discharge. The discharge indicates that your body is digesting the sutures.
• You may have vaginal discomfort. It should be gone in four to six weeks.
• Your doctor may advise you to have a check-up four to six weeks after surgery. Follow your provider’s recommendations for scheduling follow-up appointments.

What are the benefits of this method?

Colporrhaphy can alleviate your POP symptoms without requiring a big cut into your belly. The rearranged organs frequently remain in place following surgery, and the symptoms do not reappear. Anterior colporrhaphy has a more mixed success rate. Even after surgery, the front wall of your vagina is the most typical location for an organ to slip out of place. Even if the walls weaken slightly following surgery, colporrhaphy often improves symptoms.

Unlike some treatments for pelvic organ prolapse, such as colpocleisis, you can have intercourse after colporrhaphy once you’ve healed.

What are the risks or side effects of Colporrhaphy?

Although colporrhaphy problems are uncommon, all surgery carries risks. Before surgery, be sure to address risk factors with your clinician, such as your general health and preexisting health concerns.

Among the complications are:

• Constipation.
• Bleeding.
• Intercourse that is painful.
• Anaesthesia-related reaction.
• Infection at the site of the wound.
• Damage to your pelvic organs.
• Infections of the urinary tract (UTIs).
• Incontinence, either urinary or faecal.
• Your surgeon may advise you to use mesh to strengthen your repair.