Pelvic organ prolapse occurs when connective tissue weakens or tears, causing organs to move from their original position. Colporrhaphy surgery can repair prolapse of the bladder, rectum, urethra, or small intestine. Recovery time is four weeks, and risks include infection and bleeding.
The organs and other structures in the pelvis are held in place by connective tissue such as ligaments and muscles. If these connective tissues are torn or weakened, one or more organs may prolapse, meaning it has moved from its original anatomical position. Sometimes, a prolapse causes the bladder, rectum, or other structure in the pelvis to protrude through the vaginal wall. This type of prolapse is treated with a colporrhaphy procedure in which the organ is returned to its correct position.
There are several types of prolapse that can be treated with colporrhaphy. A prolapse of the urethra into the vagina is called a urethrocele, and a prolapse of the bladder into the vagina is a cystocele. A prolapse of the small intestine into the vagina is an enterocele, and a prolapse of the rectum is a rectocele. In the case of a urethrocele or cystocele, the cause is a defect in the fibrous tissue located between the bladder and the vagina, called the pubocervical fascia. A defect in the rectovaginal fascia, the connective tissue that separates the rectum from the vagina, can cause a rectocele.
Women have an increased risk of prolapse of one or more pelvic organs as they age. Other risk factors include childbirth, physical activity and hysterectomy. Additionally, hormone deficiency can also increase the risk of prolapse. A woman suffering from pelvic organ prolapse might experience symptoms such as incontinence, back pain, and painful bowel movements or urination. Intercourse may be painful or difficult, and the walls of the vagina may swell due to pressure from the prolapsed organ.
Colporrhaphy surgery can be performed in one of two ways, depending on the type of prolapse involved. In an anterior colporrhaphy, surgery is done on the front of the vaginal wall to repair a urethrocele or cystocele. In a posterior colporrhaphy, the procedure is done on the posterior vaginal wall to repair a rectocele. Enterocele surgery can be posterior or anterior, depending on the nature of the intestinal prolapse.
In most cases, the patient will receive general anesthesia, but if a woman is unable to receive general anesthesia for medical reasons, she may have local anesthesia. At the beginning of the procedure, the surgeon inserts a speculum into the vagina. This device holds the vaginal walls open to allow the surgeon to more easily visualize and repair the vaginal walls. The skin of the vagina is then incised so the surgeon can locate the defect in the connective tissue causing the prolapse. Once the defect is located, the surgeon folds and sutures the connective tissue to tighten and strengthen it, thus preventing prolapse.
Recovery time for the procedure is approximately four weeks. Depending on the nature of the prolapse, a woman may need to maintain a liquid diet for several days. You should avoid activities such as heavy lifting, prolonged standing and sexual intercourse, which place great strain on the incision site and could cause the wound to reopen. Risks of the colporrhaphy procedure include infection and bleeding at the incision site and damage to other organs in the pelvis. It is rare for prolapse to recur after surgery, but it is possible if the surgery did not correct the defect in the connective tissue.
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