Colpocleisis
Incontinence

Colpocleisis: Closing Off Prolapse

Pelvic prolapse is one of those conditions that is common but rarely discussed. Approximately 1/3 of American women have a pelvic floor disorder, such as incontinence, and 11% of those with pelvic prolapse will require surgery. However, similar to pelvic prolapse being on the hush-hush, so are its surgery options. Colpocleisis, pronounced kal-po-kli-sis, is a surgery option for pelvic prolapse with a 90-95% success rate. Keep reading to see if this is a good option for you.

What is Colpocleisis?

Colpocleisis, also known as vaginal closure surgery, is a procedure done to correct bladder, uterine, and vaginal prolapse. This surgical treatment option shortens the length of the vaginal canal and doesn’t require abdominal incisions. The surgery is best for a woman with advanced prolapse where the top of the vagina droops outside of the vaginal opening. Your doctor may also propose colpocleisis if you’re not a good candidate for extensive surgeries, but more on that later.

You’ll Want To Keep This In Mind, Too

Because this procedure significantly shortens the vaginal canal, it’s not a good option for those who still plan on being sexually active. Therefore, if you don’t plan to have penetrative vaginal sex, this is a very successful, low-risk surgery.

And if you want to take some time to decide about that, Lily Bird absorbent pads and underwear are always a great option in the interim to help with bladder leaks.

Preparing For The Surgery

Before your surgery, you’ll meet with a doctor who will explain what all you should expect. Be sure to tell your physician if you take any medications, as some, like blood thinners, could affect your surgery. If you smoke, you’ll want to stop 6 to 8 weeks before your surgery. Smoking makes it more challenging for your body to heal post-surgery and could increase your risk of complications.

You may need to complete some tests such as blood tests, ECGs, and X-rays to ensure you’re healthy enough to go through with it. Lastly, confirm with your doctor about if you’ll need to stop eating a certain number of hours before your scheduled surgery.

What to Expect During Colpocleisis Surgery

During the surgery, your surgeon will remove the vaginal lining. After that, they’ll sew together your internal vaginal walls. This stops the vagina from bulging out. Your surgeon will then use dissolving stitches to sew the front wall of the vagina to the back wall, which prevents other prolapsed organs from drooping. In some cases, sutures are used to narrow the vaginal opening to prevent the prolapse from happening again.

Towards the end of the surgery, your surgeon will push the uterus above the stitches they placed in the vagina. They’ll likely use drainage funnels to unload any excess blood and mucus.

How Long Does The Surgery Take?

Remember when we said that your doctor might suggest this procedure if you’re not a good candidate for extensive surgeries? Well, the reason behind that is because this surgery doesn’t take long to do. In fact, it’s all done in about an hour.

After Your Colpocleisis Procedure

Once you’re all done with surgery, you’ll spend a couple of hours in the recovery room for monitoring. You’ll also have an IV for fluids and a catheter in your bladder. Most women have their catheter removed after 24 to 48 hours and you should be able to pee as you normally would. If not, your doctor might send you home with a catheter to use temporarily. This is the case for about 50% of people who have the surgery.

Vaginal closure surgery can be an outpatient procedure, but it depends on your health. Some women can go home the same day whereas others stay one night in the hospital. You will need someone to drive you home.

Recovery and Results of Colpocleisis

Before you go home, try to arrange for someone to stay with you a few days or at least check-in daily. Do expect a little pain and to feel more tired than usual. You’ll need at least 4 to 6 weeks to heal, so you likely won’t go back to work until after that amount of time has passed.

If you see creamy white or yellow discharge, that’s normal. The discharge will decrease over time and as the stitches absorb. However, if you notice a foul odor, contact your doctor right away. It’s also common to see blood-stained discharge, but it shouldn’t be a lot. Typically the blood is brown and is a result of the body breaking down blood trapped under the skin.

Will It Look Different “Down There?”

Many women worry that the external appearance of their vaginal area will look different, but it looks the same. It’s only the inside that’ll look different, but nobody will be in there. If you’re concerned about getting frisky, please note that the clitoris is still fully functioning so you can still have fun.

Complications and Risks of Colpocleisis

Although the surgery is relatively safe, all surgeries do pose some risks. The following are some of the complications people could experience:

  • Anesthetic issues
  • Serious bleeding that requires a blood transfusion
  • Post-operative infection
  • Bladder infections
  • Clots in the blood vessels of the legs and lungs
  • Hematoma*
  • Constipation*
  • Bladder and/or bowel injury*

The complications with asterisks (*) are specific complications related to colpocleisis.

A Successful Procedure for Pelvic Prolapse

If you’ve been dealing with severe pelvic prolapse for a while now and want some relief, ask your doctor about colpocleisis. When pessaries, pelvic floor exercises, and other options haven’t worked, this procedure is a good choice. Approximately 9 out of 10 women are satisfied with their results and 4 out of 5 don’t regret giving up sexual intercourse. For many, this surgery helps them reclaim the quality of life they once had, so it’s worth looking into.

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By Jessica Thomas, MPH