Colporrhaphy- Vaginal Wall Repair

Sometimes we cannot avoid what happens to our bodies. We make our bodies experience certain health conditions due to the activities we have to undertake in life. Pelvic organ prolapse, for instance, may occur due to heavy lifting that can destroy the tissues supporting the vagina and rectum, or vaginal childbirth, which we can barely avoid. However, the good news is that if you experience this condition, all is not lost. You can still undergo treatment and have your life return to normal.

Colporrhaphy is one of the most known procedures used to treat pelvic organ prolapse. At Gyn LA, we have successfully conducted this procedure for our patients and yielded excellent results. We will first assess your condition and determine whether you are an ideal candidate for the process. After that, we will walk you through what the procedure entails before we can commence our work. We take care of our patients with much care and make them feel as comfortable as possible. If you are in Los Angeles and have a pelvic organ prolapse condition, reach out to us as quickly as possible so that we can start the treatment process right away.

Understanding the Meaning of Colporrhaphy

Colporrhaphy is a surgical process that repairs & strengthens the walls of the vagina after the prolapse of a pelvic organ. A pelvic organ prolapse takes place when a single or more of the pelvic floor organs slip out of their usual location in one’s body. Colporrhaphy is minimally invasive.

The displacement of any pelvic floor organs may lead to several unwanted signs and symptoms since the organ that has prolapsed presses against the vaginal wall. Factors that may lead to the prolapsing of the pelvic organs include repeated childbirth, age, ongoing physical activities, prior hysterectomy, and hormone deficiency. Signs and symptoms of pelvic organ prolapse are stress incontinence, pain when having sex, a vaginal bulge, difficulty in bowel movements or urination, and back pain.

When nonsurgical methods of treatment like pessary insertion, hormone therapy, pelvic floor therapy, or Kegel exercises fail to relieve the symptoms, then the doctor may recommend surgical repair.

During Colporrhaphy, the surgeon inserts a speculum into your vagina to hold it open in the course of the procedure. Then, he/she makes an incision close to the vaginal entrance, extending inwards towards the top of the vaginal canal. The incision enables the surgeon to access and repair & restructure the underlying tissue of the pelvic floor that led to the prolapse. After the repair, the surgeon then sutures the incision with strong and absorbent stitches. Local, regional, or general anesthesia might be used based on what option your doctor trusts to be ideal for you.

Colporrhaphy is common in the United States. Approximately one in ten women who have given birth will require to undergo this procedure to repair a prolapsed pelvic organ at a given stage in their lifetime. There are two types of Colporrhaphy procedures:

Anterior Colporrhaphy (anterior vaginal repair)
Posterior Colporrhaphy (posterior vaginal repair)

Anterior Colporrhaphy

This procedure is carried out to treat a prolapse that affects the front part of the vaginal wall, like a prolapsed bladder or urethra (i.e., cystocele and urethrocele, respectively). A bladder/urethra prolapses when it falls out of its normal position and bulges into the front of the vagina, leading to the sagging of the front part of the vaginal wall. Colporrhaphy is done to tighten the anterior (front) vaginal wall.

During this surgery, your doctor will make an incision on the anterior vaginal wall. Then, he/she will push your bladder or urethra back to their usual positions, and the supporting tissues between the bladder and the front part of your vagina will be tightened & reinforced using stitches. Your physician will have to cut away a slight part of the vaginal wall to get rid of excess tissue.

Posterior Colporrhaphy

This surgical procedure is performed to address issues that affect the back part of the vaginal wall, like a prolapsed rectum (rectocele). Rectocele is when your rectum falls from its usual place and bulges towards the posterior part of your vagina, resulting in the sagging of the back part of the vaginal wall, which may lead to bowel dysfunction. Posterior Colporrhaphy is carried out to tighten the posterior (back) part of the vaginal wall.

The procedure is quite similar to anterior Colporrhaphy. Here, a slight incision is made on the posterior vaginal wall so your rectum can be pushed back to its original position. Then, the supporting tissues between the rectum and back part of your vagina will be tightened & reinforced using stitches. As it is with anterior vaginal wall repair, your physician will have to cut away a slight part of the vaginal wall to get rid of excess tissue.

Note that neither of these surgeries is done until the prolapse symptoms have started interfering with a patient’s daily life. For instance, your physician may recommend a surgical procedure to treat severe and significant rectocele, especially when you are experiencing symptoms like:

Difficulty in bowel movements
Feeling that your bowel is full all the time even after just having a bowel movement.
Inability to control bowel movements

Diagnosis/Preparing for Surgery

Most often, a physical exam is used in diagnosing pelvic organ prolapse. Your doctor will insert a speculum into your vagina, and you will be requested to sit or strain uprightly. Then, the physician inspects the posterior, anterior, side (lateral), and upper (apex) vaginal walls for bulging or prolapse. In particular scenarios, a physical exam can’t diagnose the prolapse of the pelvic organs sufficiently. In these cases, for instance, a cystogram can be utilized to establish the degree of a cystocele. Here, the doctor fills the bladder with a urinary catheter with varying medium, and then the bladder gets x-rayed.

On the very day of this procedure, you will be requested to abstain from drinking and eating after midnight or at the minimum, eight hours before the procedure can be conducted. Your doctor may administer an enema the night prior to performing the procedure, that is, if you will undergo a posterior Colporrhaphy procedure. Also, your physician will advise you to stop taking ibuprofen, naproxen, and aspirin several days prior to your surgery. Not taking these drugs will lower the risk of having excessive bleeding. Consult your physician about the proper usage of medication in case you use warfarin or any other blood-thinning medicines.

As we mentioned earlier, Colporrhaphy is done under spinal or general anesthetic. For general anesthetic, you will be asleep, and you will feel no pain. For spinal anesthetic, on the other hand, you will be numb below the waist and incapable of feeling pain, but you will be awake. Usually, this operation takes about thirty minutes to complete.

What You Should Expect After Surgery

After undergoing Colporrhaphy, you may experience a watery discharge that’s blood-stained for a few weeks. As you continue healing, you may see dark spotting as your internal stitches dissolve. Also, you might feel fatigued, and you may want to take simple analgesia like Panadol to relieve discomfort or pain, mainly if you are going to sleep during the night.

When You Should Notify Your Physician

After surgery, the following are signs and symptoms that you should inform your doctor about as soon as they start occurring:

If you start having a fever (a temperature of 38 degrees Celsius)
In case the vaginal discharge increases and turns offensive.
If you have an increase in or persistent pain
In case you show symptoms or signs of a UTI, for instance:
A temperature of over 38 degrees Celsius
Pain and burning while passing urine
Frequent passage of urine
Passing blood while passing urine

Aftercare

After surgery, you will most probably stay in the hospital for a few days. The surgery may affect your bladder; therefore, a Foley catheter might remain in you for a single or two days. A catheter refers to a slight tube that is placed in the bladder to help withdraw urine from the body. You’ll be on a liquid diet up to the time the usual bowel functioning returns.

Once you are capable of urinating and having your normal bowel movement, you can recommence your regular diet. You’ll be directed to refrain from activities for multiple weeks that may lead to the straining of the part that has undergone surgery. Such activities include coughing, lifting, standing for long periods, sneezing, sexual intercourse, and straining with defecation.

Risks Associated with Colporrhaphy

All surgical procedures have dangers of complications. The risks linked to Colporrhaphy can be severe and may even lead to death. They include possible complications affiliated with infection, anesthesia, injury to the other pelvic organs or structures, excessive bleeding, blood clots in your lungs or legs, painful intercourse (dyspareunia), the failure to cure the defect, and recurrent prolapse. Fistula is an uncommon complication resulting from Colporrhaphy, whereby an opening grows between the bladder and vagina or the rectum and vagina.

Other risks may include:

Urinary incontinence
Post-operative infections like bladder infections (this is most common in those patients that receive catheters)
Constipation
Being or feeling sick
Unsightly scarring of the skin
Infection to the surgical site
Difficulty in opening your bowels
Developing a blood collection (hematoma) between your bowel and your vagina.

Particular factors like pre-existing medical conditions and age are essential to put in mind when determining whether a surgical procedure is an ideal option to undergo or not. Additionally, those women planning to conceive later should avoid surgery until they aren’t planning to get pregnant anymore.

The Normal Outcome

Usually, a woman is capable of resuming her normal activities, which includes sexual intercourse, approximately one month after undergoing the surgical process. After a successful surgery, the symptoms linked to rectocele or cystocele will recede, even though a distinct procedure might be required for treating stress incontinence. Anterior vaginal wall repair is about 66% successful in treating urinary continence.

Mortality and Morbidity Rates

There’s about a 1% danger of severe complications connected with Colporrhaphy. Generally, this procedure is seen to be secure, with a lower rate of general complications.

Alternatives

Typically, surgery is reserved only for severe conditions of the prolapse of the pelvic organs. Mild cases can be treated through several other medical options. The doctor may suggest that you perform Kegel exercises. Kegel exercises refer to a sequence of muscle relaxations and contractions around the perineal region. These kinds of exercises are believed to strengthen one’s pelvic floor. They can also help in preventing urinary incontinence.

Apart from Kegel exercises, your doctor may also recommend a pessary. A pessary refers to a device that’s inserted into one’s vagina to assist in supporting the organs in the pelvic floor. Pessaries are made in different sizes and shapes and have to be fitted into your body by a doctor.

Also, hormone replacement therapy might be prescribed if you have undergone menopause. Hormones can enhance the quality of the supporting tissues in the pelvis. You may also be advised to treat any constipation you are experiencing first before resorting to surgery.

Who Performs Colporrhaphy and Where It’s Performed

Usually, Colporrhaphy is conducted in a hospital operating room. A urologist or gynecologist may carry out this procedure. A gynecologist refers to a doctor that specializes in areas of reproductive & general health, labor, childbirth, and pregnancy in women. A urologist, on the other hand, is a doctor that has a specialty in diagnosing and treating diseases that affect the genital organs and urinary tract.

Find a Gynecologist Experienced in Vaginal Wall Repair Near Me

Having a pelvic organ prolapse is not the end of it. It is curable. All you need to do is consult a Gynecologist as soon as you start experiencing any of the symptoms we have discussed above. The doctor will examine you and recommend the best treatment option for you. In adverse conditions, your doctor may recommend Colporrhaphy, which is the most effective surgical procedure to restore the prolapsed organ to its normal position. If you are in Los Angeles and are experiencing severe symptoms of pelvic organ prolapse, contact Gyn LA at 310-375-8446 for help. Even though it comes with its risks, our gynecologists will handle your case with utmost care. We will make you as comfortable as possible as you undergo this procedure and provide excellent aftercare services soon after the surgery. Call us immediately for quick and efficient services.