A colporrhaphy is a surgical procedure to realign pelvic organs that have shifted from their appropriate locations. Pelvic organs may fall out of position and push against the vaginal walls when the tissues that support the pelvic organs become weakened, strained, or injured due to pregnancy, aging, or birthing.
These sagging organs cause discomfort, strain, pain, urine and bowel disorders, and swelling in the vagina (pelvic organ prolapse). A colporrhaphy is performed to restore these organs’ normal position and function by tightening the connective tissues that hold them in place.
What are the types of colporrhaphy?
Anterior repair colporrhaphy (anterior wall repair)
An anterior repair strengthens the front (anterior) vaginal wall. This procedure is performed when the bladder shifts from its place and protrudes into the front of the vagina, causing the front vaginal wall to collapse. This condition is also known as anterior wall prolapse, cystocele, or bladder drop.
During surgery, the bladder is reverted to its usual spot, and the connective tissue between the bladder and vagina is repaired and tightened.
Posterior repair colporrhaphy (posterior vaginal wall repair)
Posterior repair is performed to tighten the vaginal back wall when the rectum moves away from its correct position and protrudes into the rear of the vagina, causing the back wall of the vagina to sag and potentially creating bowel difficulties. This condition can be referred to as posterior wall prolapse, rectocele, or rectum fall.
During surgery, the rectum returns to its usual posture, and sutures are used to reinforce the vaginal fibromuscular layer, which connects the rectum and vagina.
What are the symptoms of vaginal or pelvic prolapse?
Symptoms of vaginal or pelvic prolapse may include a sensation of swelling within the vagina and pain or discomfort during sex.
You may experience difficulty passing urine. These may include a slow stream, an inability to empty the bladder, the urge to urinate more frequently, or a small amount of urine spilling when you cough, laugh, sneeze, or exercise (stress incontinence).
Typically, multiple contributing factors weaken the tissues that support the organs within the pelvis. You’re probably at greater risk of suffering a prolapse if any of the following apply to you:
- Childbirth – Your risk of developing a prolapse increases with the number of children you’ve had and the length and difficulty of your labor.
- Menopause – may alter hormone levels and cause tissue to collapse.
- Obesity may place extra pressure on the pelvic area.
- Previous pelvic surgery, such as a hysterectomy.
- Heavy lifting or manual labor
- Prolonged coughing or sneezing brought on by smoking, a lung disease, or an allergy.
- Constipation or struggling while using the restroom.
- Disorders like Marfan syndrome, Ehlers-Danlos syndrome, or joint hypermobility syndrome.
What to expect during a colporrhaphy?
As we said earlier, anterior colporrhaphy helps correct abnormalities of the anterior vaginal wall, such as cystocele or urethrocele. The posterior colporrhaphy fixes issues with the posterior vaginal wall or rectum, such as rectoceles.
Depending on the prolapse’s degree and location, colporrhaphy treatments may be conducted under either general or local anesthesia.
During colporrhaphy, a speculum is placed into the vagina to hold it open. At the same time, an incision is made to separate the fascia skin from the lesion, which is then folded over and sutured in place. This incision allows the surgeon to repair and reconstruct the damaged pelvic floor tissue causing the prolapse. The wound is then closed with absorbable, strong stitches.
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