Weakening of the vaginal walls and related problems? Let's learn about Colporrhaphy surgery in simple terms

Do you sometimes feel a heaviness in your vagina, a feeling of something coming down, or a small ball-like sensation? Some women may experience this, especially after having children or as they age. This condition can make it difficult to perform daily activities. So today, let's talk about a surgery that can be a good solution to this.

What is Colporrhaphy? Let's understand it simply.

Colporrhaphy is a surgical procedure to correct a weakness in the walls of your vagina. It is a treatment for a condition called Pelvic Organ Prolapse (POP) . Think of it this way: the organs inside our pelvis, such as the bladder and rectum, are held in place by the muscles and tissues in the walls of the vagina. It's like a wall separating a room.

Now, when these walls weaken with age, due to childbirth, or due to heavy lifting, the organs start to descend or sag into the vagina. That's what we call `Pelvic Organ Prolapse (POP)`.

So, what the colporrhaphy surgery does is strengthen those weakened muscles and tissues and bring the organs that have descended back to their original position.

There are two main types of colporrhaphy surgery:

This surgery is mainly divided into two parts. Sometimes your doctor may decide to perform one or both of these parts together, depending on the need.

Is this a major surgery?

Yes, colporrhaphy is considered a major surgery . But it has an advantage. Most of the time, this surgery is done through the vagina. That means there is no need to cut open the abdomen. Therefore, it has fewer complications and can heal faster than abdominal surgeries.

Why might you need this treatment?

If the symptoms caused by POP are a major disruption to your daily life, you should consider this surgery.

• Urinary incontinence is the involuntary loss of urine when coughing, laughing, or lifting heavy objects.
• Difficulty defecating.
• Pain during sexual intercourse.

These things can make it difficult to live a happy life. Colporrhaphy surgery can help you overcome these weaknesses, eliminate the symptoms, and live a comfortable life again.

Who is this surgery suitable for?

This surgery is not recommended for everyone. Whether you are a good candidate for this surgery depends on several factors.

• If other treatments don't work: There are non-surgical treatments for this condition. Pelvic muscle strengthening exercises (Kegels), vaginal devices (pessaries), and hormone therapy are tried first. If these don't relieve your symptoms, surgery may be considered next.
• If your symptoms are severe: Some people with POP don't experience much discomfort. For those people, the risk of surgery isn't worth it. But if it's a major disruption to your daily life, surgery may be the best solution.
• If you don't plan on having more children: If you have another child after this surgery, the pressure during pregnancy and childbirth can weaken the repaired areas again. Therefore, doctors usually advise that it is better to have this surgery if you think the family is complete.

What happens before and during the surgery?

Before surgery

Your doctor will do these things before surgery:

• Discuss your symptoms and medical history: When you know exactly what problems you are having, it is easier for the doctor to decide exactly where to repair during surgery.
• A physical examination is performed: A bimanual pelvic exam is performed to check for any weakness or prolapse.
• Tests will be ordered if necessary: ​​Most of the time, no additional tests are needed. However, sometimes you may be asked to do something like an MRI scan to better assess the condition of the muscles.
• Medication to prevent infection: You may be given an antibiotic to take on the day of surgery.
• If you are postmenopausal: You may be given a cream containing the hormone estrogen to apply to your vagina. This will thicken the tissue in the vaginal walls, making the surgery easier.

During surgery

You will not feel any pain during the surgery.

1. Anesthesia: Either ``general anesthesia``, which puts you completely asleep, or ``regional anesthesia``, which numbs only the lower abdomen, is used.

2. Preparation: You will be made to lie on a special bed to make the surgery comfortable. A tube (catheter) will be inserted to drain your urine.

3. Surgery: The doctor will use a speculum to examine the vagina. He will then make a very small incision in the vaginal wall to identify any weakened muscles and tissues.

4. Repair: Next, the strong tissues are brought together and the areas are reinforced using dissolvable sutures.

5. Suturing: Finally, the incision made in the vaginal wall is closed with dissolvable stitches.

This surgery can usually take anywhere from as little as 30 minutes to an hour or more , depending on the extent of the repair.

After surgery and recovery period

After the surgery

Depending on the nature of the surgery, you may be able to go home the same day or stay in the hospital overnight.

• After surgery, a pack may be placed inside the vagina to absorb any bleeding. It will be removed in about 24 hours.
• The catheter is usually removed in one to two days.
• To prevent straining during bowel movements, you may be advised to take a stool softener for a while.
• You may experience a bloody vaginal discharge for a few days after surgery and a creamy discharge for a few weeks. This is normal as the stitches inside dissolve.
• There may be some vaginal pain for 4-6 weeks.

Take care of these things during recovery

It can take up to 3 months to fully heal. During this time, your doctor will give you these instructions:

• Do not lift weights heavier than 2-3 kilos.
• Avoid strenuous exercise (squatting, weight lifting).
• Do not strain hard when defecating.
• Avoid sexual intercourse for 6-8 weeks.
• Avoid getting out of the bathtub and taking a shower.
• Avoid using tampons or douching.

Usually within 3-4 weeks you will be able to walk, drive, and return to work if your job is not too strenuous.

What are the benefits and risks of this surgery?

Advantages:

• Relieves POP symptoms.
• Since the stomach is not cut, you can recover quickly.
• After recovery, you can resume your normal sex life.

Risks:

Like any surgery, there are some risks, but they are very rare.

• Constipation
• Excessive bleeding
• Pain during sex
• Wound infection
• Urinary tract infections (UTIs)

Talk openly with your doctor about this and ask any questions you have.