Treatment may be required to treat a vaginal prolapse - when one of the pelvic organs (uterus, bowel or bladder) bulges into the vagina. Such a prolapse isn't life-threatening, but may affect your quality of life.
Colporrhaphy (also known as ‘vaginal repair’, ‘vaginal wall repair’ or ‘prolapse repair’) is the surgical repair of a defect in the wall of the vagina. A colporrhaphy returns the prolapsed organ back to its natural position, repairs the wall tissue and can strengthen the structure of the vagina to help prevent a prolapse reoccurring.
Anterior colporrhaphy is a repair to the front vaginal wall to treat cystocele (the prolapse of the bladder into the vagina) and can help women who suffer from urinary incontinence. A colporrhaphy may be recommended when other treatments, such as pelvic floor exercises, have not proved successful.
Posterior colporrhaphy is a repair to the rear vaginal wall to treat rectocele (prolapse of the rectum into the vagina). Sometimes both procedures are required at the same time.
Perineorrhaphy is the surgical reconstruction of muscles and tissues at the opening of the vagina in order to repair a perineal tear which may have arisen as a result of childbirth. A perineorrhaphy can also successfully help correct looseness of the vaginal opening by decreasing its size without reducing sensation.
The operation may be carried out under a general anaesthetic (so you’ll be asleep) or a spinal anaesthetic (so you’ll stay awake but won’t feel anything).
The surgery is carried out through the vagina. The vaginal wall will be cut so the protruding organ can be lifted back into its correct position. Normally sutures will be used to strengthen the wall repair and the cut will be stitched using dissolvable sutures. Occasionally it may be suggested that a synthetic or biological mesh will be used.
You’ll need to stay in hospital for two or three days. Immediately after surgery we’ll help you manage any pain or discomfort with painkillers. We’ll discuss your aftercare and arrange any follow-up appointments with you before you leave hospital.
You may experience vaginal bleeding or discharge for a couple of weeks or so after your operation.
You’ll need to eat a healthy diet and you may need to take laxatives to avoid constipation and straining when you go to the toilet. You won’t be able to drive for about four weeks or lift anything heavy for around eight to twelve weeks. Depending on the type of work you do you may not be able to return to work for four to six weeks.
You’ll need to wait three months before taking part in strenuous exercises or sport. However, during this time you may be recommended to start pelvic floor exercises to ensure the best long-term success.
As with any surgical procedure there can be some risks, including:
- blood clots (including deep vein thrombosis (DVT))
Specific risks of vaginal/pelvic prolapse surgery include:
- urinary retention
- injury to the rectum/ bowel/bladder/uterus
- scarring and shortening of the vagina
- pulmonary embolism (blood clot in the lungs)
- recurrence of the condition
Sacrospinous fixation (SSF). A suture is passed through the sacrospinous ligament which is deep inside the pelvis. This is used to elevate the uterus/cervix/vaginal vault. The suture will dissolve as the tissues heal and it is important to avoid heavy lifting and strenuous exercise as this healing takes place.