Colporrhaphy is a minimally invasive surgical procedure that repairs and strengthens the vaginal wall after a pelvic organ prolapse (POP). A pelvic organ prolapse occurs when one of the organs in the pelvic floor region slips out of its normal location in the body.
This displacement may cause a number of unwanted symptoms as the prolapsed organ pushes against the walls of the vagina. When nonsurgical treatment methods such as Kegel exercises, pelvic floor therapy, pessary insertion or hormone therapy fail to alleviate symptoms, surgical repair may be a recommended course of action.
During the colporrhaphy operation, an incision is made near the entrance of the vagina, extending inward toward the top of the vaginal canal. This incision gives the surgeon access to repair and restructure the weakened underlying pelvic floor tissue that caused the prolapse. The incision is sutured with strong, absorbable stitches. General, regional or local anesthesia may be used depending on which option the physician believes is best for the patient.
Colporrhaphy is a very common procedure. Approximately 1 in 10 women who have birthed children will require surgery to repair pelvic organ prolapse at some point in their lives. Anterior colporrhaphy (also known as anterior vaginal repair) treats prolapses that affect the front wall of the vagina, such as cystocele (prolapsed bladder). Posterior colporrhaphy (also known as posterior vaginal repair) addresses issues affecting the back wall of the vagina, such as rectocele (prolapse of the rectum).
Recovery and results
During the postoperative recovery period, a catheter may be inserted into the bladder, and a pack may be placed in the vagina to reduce initial bleeding. The catheter and pack are generally removed within 48 hours. In the days immediately after surgery, some bloody discharge is expected. In the weeks following, creamy vaginal discharge is normal, resulting from the body absorbing the dissolvable stitches.
In 70 to 90 percent of cases, colporrhaphy successfully repairs pelvic organ prolapse. And because the operation is minimally invasive, patients are often able to fully return to their normal activities upon healing, including sexual intercourse. Heavy lifting, vigorous exercise and other strenuous activities that may place pressure on the repair while it is still healing are best avoided. After three to four weeks of recovery, patients may resume light activities such as driving and walking. Patients generally reach full strength and recovery approximately three months after surgery.
Risks and considerations of colporrhaphy
All surgeries have risks of complications. Those related to colporrhaphy, while uncommon, may include:
- Adverse reactions to anesthesia
- Excessive bleeding
- Post-operative infection, including bladder infection (more common in patients receiving catheters)
- Painful intercourse
- Urinary incontinence
Certain factors such as age and pre-existing health conditions are also important to consider when deciding whether or not surgery is the best course of action. Additionally, women planning on having children, or having additional children, should postpone surgical treatment until they are no longer planning on getting pregnant.
To learn more about colporrhaphy and the treatment of pelvic organ prolapse, contact us to request an appointment.