What to Expect from Colpocleisis

What is colpocleisis?

Colpocleisis is a type of surgery that’s used to treat pelvic organ prolapse in women. In prolapse, muscles of the pelvic floor that once supported the uterus and other pelvic organs weaken. This weakening allows the pelvic organs to hang down into the vagina and create a bulge.

Prolapse can cause a feeling of heaviness in your pelvis. It can make sex painful and urination difficult.

Up to 11 percent of women will eventually need surgery to treat prolapse. Two types of surgery treat this condition:

• Obliterative surgery. This procedure narrows or closes the vagina to support the pelvic organs.
• Reconstructive surgery. This procedure moves the uterus and other organs back into their original position, and then supports them.

Colpocleisis is a type of obliterative surgery. The surgeon sews together the front and back walls of the vagina to shorten the vaginal canal. This prevents the vagina walls from bulging inward, and provides support to hold up the uterus.

Reconstructive surgery is often performed through incisions in the abdomen. Colpocleisis is done through the vagina. This leads to a faster surgery and recovery.

Who is a good candidate for this procedure?

Surgery is recommended in general for women whose prolapse symptoms haven’t improved with noninvasive treatments like a pessary. Colpocleisis is less invasive than reconstructive surgery.

You might choose colpocleisis if you’re older, and you have medical conditions that prevent you from having a more extensive surgery.

This procedure is not recommended for women who are sexually active. You will no longer be able to have vaginal sex after colpocleisis.

The surgery also limits the ability to do a pap test and access the cervix and uterus for yearly screenings. A medical history of problems might rule out the procedure.

How to prepare for surgery

Before your surgery, you will meet with your doctor or another member of your medical team. You’ll go over how to prepare for your surgery and what to expect during the procedure.

Let your surgeon know about all the medications you take, even ones you bought without a prescription. You may need to stop taking certain medicines, including blood thinners or NSAID pain relievers, like aspirin, before your surgery.

You may need to have blood tests, X-rays, and other tests to make sure you are healthy enough for surgery.

If you smoke, try to stop six to eight weeks before your procedure. Smoking can make it harder for your body to heal after surgery and increase your risk of numerous problems.

Ask your surgeon if you’ll need to stop eating a few hours before your procedure.

What happens during the procedure?

You will be asleep and pain free (using general anesthesia), or awake and pain free (using a regional anesthesia) during this procedure. You may need to wear compression stockings on your legs to prevent blood clots.

During the surgery, the doctor will make an opening in your vagina and sew the front and back walls of your vagina together. This will narrow the opening and shorten the vaginal canal. The stitches will dissolve on their own within a few months.

The surgery takes about one hour. You’ll have a catheter in your bladder for about a day afterward. A catheter is a tube that’s inserted into your urethra to remove urine from your bladder.

What’s the recovery like?

You’ll either go home on the same day of your surgery or stay in the hospital overnight. You will need someone to drive you home.

You can go back to driving, walking, and other light activities within a few days to weeks after your surgery. Ask your doctor when you can return to specific activities.

Start with short walks and gradually increase your activity level. You should be able to return to work after about four to six weeks. Avoid heavy lifting, intense workouts, and sports for at least six weeks.

Risks from this surgery include:

• blood clots
• infections
• bleeding
• damage to a nerve or muscle

Can you have sex after the procedure?

After surgery, you will not be able to have vaginal intercourse. The opening to your vagina will be too short. Make sure you are ok with not having sex before you have this surgery, because it’s not reversible. This is worth discussing with your partner, your doctor, and those friends whose opinion you value.

You can be intimate with your partner in other ways. The clitoris is fully functional and able to provide orgasm. You can still have oral sex, and engage in other types of touching and sexual activity that don’t involve penetration.

You will be able to urinate normally after the surgery.

How well does this procedure work?

Colpocleisis has very high success rates. It relieves symptoms in about 90 to 95 percent of women who have the procedure. About 95 percent of women who are surveyed afterward say they are either “very satisfied” or “satisfied” with the outcome.

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