A simple explanation of Colpocleisis: a surgery to lower the pelvic organs

Sometimes, with age, especially for our mothers and grandmothers, one of the discomforts that comes with it is that organs like the uterus and bladder drop down a little. This can be very annoying when walking or doing work. In medical terms, we call this Pelvic Organ Prolapse (POP). Today, we are talking about a successful and uncomplicated surgery to treat this condition. That is the Colpocleisis surgery.

Simply put, what is Colpocleisis?

To understand this, let's first take a look at pelvic organ prolapse (POP). Think about it, the lower part of our abdomen (pelvis) is where our important organs like the uterus, vagina, bladder, and rectum are located. These organs are held in place by a web of muscles and tissues called the pelvic floor. As we age, and after having several children, these muscles can weaken. Then those organs can drop down, and sometimes even protrude out of the vagina.

Colpocleisis is a surgical procedure in which the prolapsed organ is brought back into the body and the walls of the vagina are stitched together to prevent it from coming out again. This is a very effective treatment for POP.

There are two types of surgery for POP, right?

Yes, there are two main types of surgery. Colpocleisis is one of these two. Let's see what the difference is between the two.

Are there any types of colpocleisis surgery?

Yes, there are two main types. Your doctor will decide which type is right for you.

• Total Colpocleisis: In this, the front and back walls of the vagina are completely sewn together. The vagina is shortened.
• Partial/Le Fort colpocleisis: This also involves cutting the vagina. However, two small openings are left for fluids to exit the uterus. This method is best for those who have not had their uterus removed.

Who is this surgery best suited for?

Colpocleisis surgery is not for everyone. It is especially suitable for those with certain reasons.

• For those who no longer have any hope of having sex: This is a very important point. After the surgery, the vagina becomes too short for sexual intercourse. Therefore, this surgery is considered for women who no longer have any hope of having a sexual life. This should be understood well before the surgery.
• For those who cannot tolerate other major surgeries: This is a great option for older people who have other health problems like heart disease, diabetes, or who cannot tolerate hours of anesthesia. This is a quick and less stressful surgery.
• For those whose organs are too low to be controlled by other treatments: Sometimes, pelvic floor exercises (Kegel exercises) or vaginal pessaries can help control the condition. However, if the organs have completely protruded from the vagina, surgery is the best solution.

What happens before the surgery?

Before you undergo this surgery, the doctor will carefully examine your health.

Health check-up

• Several blood tests are done.
• An EKG test will be performed to see if there is a heart condition.
• Your complete medical history will tell you about the medications you are taking.
• Ask if there is any difficulty passing urine or stool.
• They will ask you about your symptoms (do you feel like something is coming out of your vagina, are you in pain, are you bleeding, etc.).

Basic tests that may be required

Since vaginal examinations cannot be performed after colpocleisis surgery, screening is done to check for any risk factors such as cervical cancer or uterine cancer. For this,

• Pap smear
• Examination of a small piece of tissue from the uterus (Endometrial biopsy)
• Transvaginal ultrasound

Tests such as: Sometimes, if there is a risk of uterine cancer, the doctor may recommend a hysterectomy along with this surgery.

What happens during the surgery?

There's nothing to worry about. This surgery only takes about an hour .

1. You will either be given a general anaesthetic (analgesia) or a local anaesthetic (regional anaesthesia) so that you will not feel any pain.

2. A catheter is inserted to drain urine during the surgery.

3. Special socks (compression stockings) are worn to prevent blood clots in the legs.

4. The doctor removes the thin membrane inside the vagina, stitches the vaginal walls together with dissolvable threads.

After surgery, the vaginal opening becomes smaller and the vagina becomes shorter, but there is no change in the external appearance.

What happens after the surgery?

You may be able to go home the same evening as your surgery, or you may have to stay in the hospital overnight. Bring someone to drive you home. The doctor will ask you to come back in about two to four weeks.

These are the things you can typically expect during recovery:

• Vaginal bleeding and pain: This will subside within a week. You can take painkillers prescribed by your doctor for the pain.
• Yellow discharge: Don't worry about this. This is something that comes out when the dissolvable thread inserted inside dissolves. It will completely heal in 6-8 weeks.
• Urinary retention: It may be a little difficult at first, but the condition will gradually improve.
• Constipation: Your doctor will advise you to use medication that will help you pass stool more easily for a while.

What are the benefits and risks of this surgery?

How long does it take to heal?

It can take about 6 weeks to fully heal.

• First two weeks: You will feel tired and sore. Get plenty of rest.
• After a few weeks: You will be able to resume normal activities such as walking and driving.
• After 6 weeks: You can start going to work.

Avoid lifting weights or doing strenuous exercise during this time. It will be helpful to bring and store the necessary items at home before the surgery.

In what situations do you need to see a doctor immediately?

If you experience any of the following symptoms during your recovery, it could be a sign of an infection or other problem. So talk to your doctor right away .

• Fever
• Severe stomach pain
• Difficulty urinating
• A foul-smelling vaginal discharge
• If the pain from the wound is getting worse
• Excessive bleeding from the wound or bleeding that does not stop

Colpocleisis is a very good surgery that brings great relief and makes life easier for many people suffering from POP. If you have any further questions about this, do not hesitate to talk to your doctor and make the decision that suits you best.

Colpocleisis, Pelvic Organ Prolapse, POP, Uterine Prolapse, Pelvic Organ Prolapse, Gynecological Surgery, Gynecology, Le Fort colpocleisis, Women's Health, Surgery