What is colporrhaphy?
Colporrhaphy is a surgical procedure carried out to correct defects in the wall of a vaginal or a pelvic organ prolapse, which includes cystoceles and rectoceles. A colporrhaphy procedure is carried out with the aim of effectively restoring prolapsed organs back to their natural and normal position and bring relief to symptoms such as urinary incontinence and pelvic pain. A colporrhaphy procedure does not just repair the wall tissue, it also strengthens the structure of the vagina to help prevent the prolapse from reoccurring.
A pelvic organ prolapse is as a result of organs in the pelvic floor region slipping out of its natural location in the body. Colporrhaphy is a minimally invasive surgical procedure and it can be carried out either at the front (anterior) or the rear (posterior) of vaginal walls or sometimes both.
How’s a colporrhaphy procedure carried out?
There are two ways of performing a colporrhaphy procedure – the anterior colporrhaphy and the posterior colporrhaphy. Both colporrhaphy procedures, however, follow the same technique.
The first step taken in a colporrhaphy procedure is the application of general, local or spinal anaesthesia. The choice of anaesthesia may depend on the severity or location of the problem.
A speculum is then inserted into the vagina to hold it open, while an incision is made to separate the skin of the fascia from the lesion. This allows for the protruding organ to be lifted back into its exact position.
While performing a colporrhaphy procedure, several approaches may be taken to correct the vaginal defect. These include
- Sutures Support: Sutures are made in the tissue between the vagina and the bladder to hold in the exact position and strengthen the walls of the vagina. This colporrhaphy procedure is the simplest means of repairing a pelvic organ prolapse, but may not be sufficient in most cases.
- Sutures Attachment: In this colporrhaphy procedure, sutures are used to attach the vaginal walls to the tissue on the pelvic side. This procedure takes longer than the support procedure but it’s usually necessary in many cases (where the prolapse of the pelvic organ is more obvious).
- Synthetic Material: This colporrhaphy procedure involves the insertion of synthetic material between the bladder and the vagina in order to strengthen the vaginal wall. This, however, is a short-term success and results in a higher rate of post-surgical complications.
What is anterior colporrhaphy?
Anterior colporrhaphy is carried out to repair an abnormality or tighten the front (anterior) wall of the vagina, such as the urethrocele or cystocele. It is the colporrhaphy procedure opted for when the bladder drops out of its natural position and protrudes into the front of the vagina, thereby causing the front vaginal wall to sag.
During the anterior colporrhaphy procedure, the bladder is pushed back into its natural position and the supporting tissue in-between the front of the vagina and the bladder is then tightened and reinforced.
What is posterior colporrhaphy?
Posterior colporrhaphy is carried out to tighten or repair problems in the back (posterior) vaginal wall or rectum, including rectoceles. It is the colporrhaphy procedure opted for when the rectum drops out of its natural position and protrudes into the back of the vagina, thereby causing the back of the vaginal wall to sag, which may possibly result in bowel dysfunction.
During the posterior colporrhaphy procedure, the rectum is driven back to its original position, and the supporting tissue that separates the back of the vagina and the rectum is tightened and reinforced.
Why are the reasons for a colporrhaphy?
A colporrhaphy procedure may be required to treat vaginal prolapse. Vaginal prolapse is a condition characterised by the bulging of one of the pelvic organs (such as the uterus, bowel or bladder) into the vagina. While this isn’t a life-threatening condition, it may affect the quality of life.
What’s the recovery rate and results of a colporrhaphy procedure?
A colporrhaphy procedure, in about 70 to 90% of cases, successfully repairs a pelvic organ prolapse. Because of its minimally invasive nature, patients are able to fully return to their normal activities upon healing. Patients may resume light activities, such as driving and walking, after about 3 to 4 weeks of recovery. In general, patients reach full recovery and strength approximately 3 months after a colporrhaphy procedure.
What should be expected after a colporrhaphy procedure?
- A colporrhaphy procedure requires a 2 to 3 days hospital stay after the surgery for the management of any pain or discomfort by experts.
- Possible vaginal discharge or bleeding for a couple of weeks or so after a colporrhaphy procedure.
- Possible placement on laxatives to avoid constipation and straining when a patient visits the toilet.
- The use of a catheter may be required for a few days.
- An only a liquid diet will be permitted until normal bowel function resumes.
- Symptoms such as incontinence and pelvic pain subside.
Are there any risks and complications in a colporrhaphy procedure?
Possible complications that may result from a colporrhaphy procedure are
- Adverse reactions to the anaesthesia used.
- Excessive bleeding.
- Post-operation infection, like bladder infection (which is common in patients receiving catheters).
- Painful intercourse.
- Urinary leakage
- Possible injury to other pelvic structures.
- A recurrent prolapse.