2. 2
• To function normally, the vagina must have adequate length,
elasticity, a well-estrogenated lining, and rest upon a responsive
levator muscle plate.
• Symptoms of vaginal relaxation may include a sense of pelvic
heaviness, recognition by the patient of a bulge or protrusion from
the vagina, urinary incontinence, and dyspareunia.
• Colporrhaphy is carried out to repair the anterior or posterior
vaginal walls.
INTRODUCTION
3. 3
• Colporrhaphy is a surgical procedure that repairs a defect in the
wall of the vagina.
• It is the surgical intervention for both cystocele and rectocele.
• The repair may be to either or both of the anterior or posterior
vaginal walls.
• The colporrhaphy procedure aims to effectively restore prolapsed
organs back to their normal position and relieve symptoms such as
urinary incontinence and pelvic pain.
INTRODUCTION
4. 4
• The colporrhaphy procedure repairs and strengthens the vaginal
wall, which can then support the prolapsed organs.
• Prolapse symptoms, such as pain, particularly during sexual
intercourse, pressure, stress incontinence, and frequent bladder
infections, will normally subside after a colporrhaphy.
INTRODUCTION
5. 5
• Colporrhaphy is a surgical procedure to repair pelvic organ
prolapse such as cystocele (prolapsed bladder) or rectocele
(prolapsed rectum).
• Colporrhaphy, also known as vaginal wall repair, is a surgical
procedure performed to correct defects in the vaginal wall, or
pelvic-organ prolapse, including cystoceles and rectoceles.
DEFINITION
6. 6
• Colporrhaphy is a minimally invasive surgical procedure that
repairs and strengthens the vaginal wall after a pelvic organ
prolapse (POP).
DEFINITION
8. 8
• Approximately one in 10 women will require surgery to repair
pelvic organ prolapse at some point in their lives.
INCIDENCE
9. 9
• A cystocele, also known as a prolapsed bladder, occurs when the
supportive tissue between the bladder and the vagina weakens,
causing the bladder to fall or prolapse into the vagina.
• A rectocele occurs when the wall between the rectum and the
vagina weakens, causing the rectum to push into the vagina.
INDICATION
10. 10
• Anterior colporrhaphy (also known as anterior vaginal repair)
treats prolapses that affect the front wall of the vagina, such as
cystocele (prolapsed bladder).
• Posterior colporrhaphy (also known as posterior vaginal repair)
addresses issues affecting the back wall of the vagina, such as
rectocele (prolapse of the rectum).
TYPES OF COLPORRHAPHY
11. 11
• There are two ways of performing a colporrhaphy.
• The anterior colporrhaphy is performed to repair an abnormality
the front of the vaginal wall, such as a cystocele or urethrocele.
• The posterior colporrhaphy repairs problems in the back of the
vaginal wall or rectum, including rectoceles.
THE COLPORRHAPHY PROCEDURE
12. 12
• The procedure can be performed under regional or general anaesthesia.
Anterior vaginal repair:
• A speculum is inserted into the vagina to hold it open.
• Midline incision to the vagina overlying the bladder and urethra.
• Dissection in a plane directly below the vagina and lateral of the bladder allows
the damaged fascia supporting the bladder to be exposed.
• The fascia is plicated in the midline using sutures.
• Permanent mesh reinforces the repair and is anchored through the obturator
foramen and exits through small incisions at both sides of the upper inner
thigh.
• The vaginal skin is closed.
PROCEDURE
13. 13
Posterior and vault repair:
• A speculum is inserted into the vagina to hold it open.
• An incision is made to the posterior wall of the vagina.
• Dissection below the vagina identifies the rectovaginal fascia and opens the space
between the rectum and the pelvic floor muscle to the sacrospinous ligaments.
• Defects in the fascia are corrected by centrally plicating the fascia using sutures.
• Permanent mesh reinforces the repair and is anchored bilaterally to the pelvic side
wall and exits through a small incision approximately 3cm lateral and down from
the anus.
• The vaginal skin is then closed.
PROCEDURE
17. 17
• The patient can expect to stay in hospital between 3-6 days.
• The vaginal pack is removed on the first day and the bladder catheter after
the first few days.
• In the early postoperative period, the patient should avoid situations where
excessive pressure is placed on the repair i.e lifting, straining, coughing and
constipation.
• Patients are able to fully return to their normal activities upon healing,
including sexual intercourse after 6 weeks.
NURSING MANAGEMENT
18. 18
• Success rate of the surgery is about 85 – 90%. Serious complications are rare
with this type of surgery.
PROGNOSIS
19. 19
• Recurrent prolapse.
• Mesh erosion
• Infection.
• Urinary tract infection.
• Urinary Incontinence
• Difficulties passing urine
• Inadvertent damage to bladder, urethra, bowel or
• Fistula
• Hemorrhage
• Clots can form in the legs or lungs after surgery
• Ongoing vaginal pain and/or persistent pain during intercourse
COMPLICATIONS
