Have you ever heard your mother or grandmother say something like "prolapsed uterus" or "low uterus"? Sometimes when this is a little severe, it feels like an organ is protruding from the vagina. This is a very uncomfortable and embarrassing condition for many women. So, a special surgery called Colpocleisis is done to treat this. Today, we will talk about this, its advantages and disadvantages, and everything in a simple way.
First, let's see what is Pelvic Organ Prolapse?
Simply put, the organs inside our pelvic cavity, such as the uterus, bladder, and rectum, are held in place by a mesh of muscles and tissues. We call these the pelvic floor muscles. Over time, especially as we get older and have had several children, these muscles gradually weaken.
Think of it like the straps of a heavy bag that gets old and stretched over time. When these muscles weaken, the organs start to sag or fall down. This is what we call pelvic organ prolapse (POP) . Sometimes, when it gets severe, the organs can actually fall out of the vagina.
So what is this surgery called Colpocleisis?
There are two main types of surgery to treat this condition of the uterus. Colpocleisis is one of them. Let's take a look at the differences between the two.
| Procedure Type | What is simply happening? |
|---|---|
| Reconstructive Procedures | This involves making incisions in the abdomen or vagina and reattaching the prolapsed organ. This is a major surgery and can take several hours. |
| Obliterative Procedures - e.g. Colpocleisis | In this, the abdomen is not cut. It goes through the vagina, and the walls of the vagina are sewn together . That is, the vagina is closed. Then the lowered organ goes back up and stays inside, so that it cannot come down again. This is simpler than the other one, and it takes less than an hour. |
Colpocleisis is a relatively simple and highly successful surgery that essentially closes the vagina.
Two types of colpocleisis surgery
There are two main types of colposcopy surgery.
1. Total Colpocleisis: In this, the front and back walls of the vagina are completely sewn together. The vagina is almost completely closed.
2. Partial/Le Fort Colpocleisis: This also shortens and closes the vagina. However, it leaves two small openings for the secretions from the uterus (for example, menstrual blood) to exit. So this method is most often suitable for someone who has not had their uterus removed .
Who is this surgery recommended for?
This is not a surgery for everyone. Your doctor will consider several factors before recommending it. This surgery is often suitable for:
- For those who have no hope of having vaginal sex in the future , because the vagina will be so short after the surgery that it will be impossible to do so.
- For people with other health conditions (e.g. heart disease) who cannot tolerate major reconstructive surgery. This surgery is simpler and carries fewer risks.
- For those whose uterine prolapse is so severe that it cannot be controlled with simple treatments like Kegel exercises.
- This is a very good solution for older women, who are often in their 80s and 90s .
What happens before the surgery?
If you decide to have this surgery, the doctor will examine you carefully before doing so.
Most importantly: Your doctor will talk openly with you about this surgery, especially about the impact on your sex life after surgery, and about any tests that you may not be able to do in the future. It is very important that you agree to all of this.
You can do these things before surgery:
- Health assessment: Blood tests, EKG to check heart function, questions about medications you are taking, etc.
- Initial tests: Since vaginal examinations cannot be performed after surgery, tests such as a Pap smear, endometrial biopsy, and transvaginal ultrasound may be performed prior to the procedure.
- If you smoke: You will be asked to quit smoking at least 4-6 weeks before surgery, as smoking can delay wound healing.
What happens after the surgery?
After surgery, you may be able to go home the same day, or you may need to stay in the hospital overnight. You can expect the following in the first few days:
- 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. This is something that happens when the dissolvable stitches inside you dissolve. This will completely heal in 6-8 weeks.
- Difficulty urinating: It can be a little difficult at first. You may need to wear a catheter for a few days. But this will get better with time.
- Constipation: You may need to use laxatives for a while.
Recovery time: It may take about 6 weeks to fully recover and return to normal activities. During this time, you should avoid lifting weights or doing strenuous exercise.
What are the benefits and risks of this surgery?
Like any other, this one has both advantages and disadvantages.
| Advantages | Risks/Complications |
|---|---|
| There is a very high success rate (between 90% - 100%). Symptoms disappear completely. | The usual risks of any surgery (blood clots, infections, bleeding). |
| The surgery takes less time (about an hour). | There is a small chance of developing stress urinary incontinence (SUI) after surgery. |
| The recovery time is short. There is no need to stay in the hospital for a long time. | This is an irreversible surgery. |
| The risk of recurrence is very low. |
Important: Even though vaginal intercourse is no longer possible, the ability to orgasm through external stimulation (clitoral stimulation) is still possible . Therefore, there is still a chance to have a healthy sex life.
When to see a doctor
If you experience any of these symptoms after going home from surgery, you should call your doctor immediately .
- Fever.
- Severe stomach pain.
- Increased difficulty urinating.
- A foul-smelling vaginal discharge.
- If the pain from the incision is getting worse.
- If the cut is bleeding heavily or if the bleeding does not stop.
Take-Home Message
- Colpocleisis is a very successful and safe surgery for prolapsed uterus (POP) in older women.
- You will not be able to have vaginal sex after this surgery, so you should talk to your doctor and think carefully before making this decision.
- This surgery is simpler, quicker, and has a relatively shorter recovery time than other major surgeries.
- If you or someone in your family has this condition, don't be afraid or embarrassed. Talk openly with your gynecologist about whether this surgery is right for you and what the pros and cons are.


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