Colporrhaphy, also known as vaginal wall repair, is a surgical procedure performed to correct defects in the vaginal wall, or pelvic-organ prolapse, including cystoceles and rectoceles. The colporrhaphy procedure aims to effectively restore prolapsed organs back to their normal position and relieve symptoms such as urinary incontinence and pelvic pain.
Reasons for a Colporrhaphy
A cystocele, also known as a prolapsed bladder, occurs when the supportive tissue between the bladder and the vagina weakens, causing the bladder to fall or prolapse into the vagina. A rectocele occurs when the wall between the rectum and the vagina weakens, causing the rectum to push into the vagina. The colporrhaphy procedure repairs and strengthens the vaginal wall, which can then support the prolapsed organs. Prolapse symptoms, such as pain, particularly during sexual intercourse, pressure, stress incontinence, and frequent bladder infections, will normally subside after a colporrhaphy.
The Colporrhaphy Procedure
There are two ways of performing a colporrhaphy. The anterior colporrhaphy is performed to repair an abnormality the front of the vaginal wall, such as a cystocele or urethrocele. The posterior colporrhaphy repairs problems in the back of the vaginal wall or rectum, including rectoceles.
Either colporrhaphy procedures may be performed under general or local anesthesia, depending on the severity of the problem and its location. During a colporrhaphy, a speculum is inserted into the vagina to hold it open, while an incision is made to separate the skin of the fascia from the lesion, which is folded over and sutured in place. Several different approaches to correct the vaginal defect may be taken while performing a colporrhaphy.
Sutures are made in the tissue between the vagina and bladder to hold the walls of the vagina in the correct position. This strengthening procedure is the simplest means of repairing pelvic-organ prolapse, but may not be sufficient in all cases.
Sutures may be used to attach the walls of the vagina to the tissue on the side of the pelvis. This procedure, takes longer than the simpler support procedure but is necessary in many cases where the pelvic organ prolapse is more pronounced.
Synthetic material may be inserted between the bladder and vagina in order to strengthen the vaginal wall. While research shows that surgical mesh results in greater short-term success, this procedure has become controversial since research indicates that it results in a higher rate of post-surgical complications.
Risks of a Colporrhaphy
While the colporrhaphy is a safe procedure, there are risks inherent in any surgery. These risks may include:
- Injury to other pelvic structures
- Recurrent prolapse
- Complications with anesthesia
- Urine leakage
Recovery from a Colporrhaphy
After the colporrhaphy procedure, patients may need a catheter for a few days and will be required to consume a liquid diet until normal bowel function resumes. The doctor will provide the patient with specific instructions to ensure a healthy recovery and effective results from the procedure. In most cases, patients will be able to return to regular activities after about four weeks.
After the colporrhaphy procedure, most patients find that symptoms such as incontinence and pelvic pain will subside.