Colporrhaphy

Colporrhaphy is a surgical procedure aimed at restoring the anatomical structure and functional integrity of the vaginal walls. It is performed to treat pelvic organ prolapse, including prolapse of the vagina, uterus, bladder, or rectum, which may develop as a result of age-related changes, childbirth, trauma, or previous surgical interventions.

The operation focuses on reinforcing weakened pelvic floor muscles and connective tissues, helping to relieve symptoms, improve quality of life, and prevent further descent of pelvic organs.

Indications for colporrhaphy

Colporrhaphy is commonly indicated for the following conditions:

1. Cystocele (bladder prolapse). A condition in which the bladder descends and bulges into the anterior vaginal wall, causing pelvic pressure, urinary dysfunction, and a sensation of vaginal heaviness.
2. Rectocele (rectal prolapse). Prolapse of the posterior vaginal wall, where a portion of the rectum protrudes into the vaginal canal, leading to difficulty with bowel movements.
3. Uterine prolapse. Descent of the uterus into the vaginal canal due to weakening of the supporting ligaments and pelvic floor muscles.
4. Combined pelvic organ prolapse. Simultaneous prolapse of multiple pelvic organs, such as the bladder, uterus, and rectum.

Common symptoms that may indicate the need for colporrhaphy include:

• Pelvic pressure or heaviness;
• Urinary disorders, including frequent urination or urinary incontinence;
• Difficulty with defecation;
• Discomfort or pain during sexual intercourse;
• A sensation of bulging or protrusion from the vagina.

Types of colporrhaphy

The procedure may involve the anterior or posterior vaginal wall, depending on the location of the prolapse:

1. Anterior colporrhaphy (anterior vaginal repair). Performed to correct cystocele, this procedure reinforces the tissues supporting the bladder and the anterior vaginal wall, restoring normal anatomical position.
2. Posterior colporrhaphy. Conducted to treat rectocele, this operation strengthens the posterior vaginal wall, helping to eliminate rectal bulging and improve bowel function.
3. Colporrhaphy for uterine prolapse. In cases of uterine prolapse, the procedure may include repositioning and suspension of the uterus or, in severe cases, hysterectomy.

How colporrhaphy is performed in Belarus

The surgery is performed under local or general anesthesia. Depending on whether anterior, posterior, or combined repair is required, the procedure may last from 30 minutes to several hours.

1. The surgeon makes a small incision in the anterior or posterior vaginal wall.
2. Weakened pelvic floor tissues and muscles are tightened and reinforced. In some cases, surgical mesh may be used to provide additional support.
3. The incisions are closed with absorbable sutures.
4. After surgery, the patient remains under medical supervision for several hours or days, depending on the extent of the procedure.

Recovery after colporrhaphy

Full recovery typically takes 4–6 weeks. During this period, patients are advised to avoid heavy lifting, strenuous physical activity, and sexual intercourse. Careful hygiene of the surgical area is essential, and antiseptic solutions may be prescribed for wound care. Analgesic medications can be used in the early postoperative period to manage pain and discomfort.

Colporrhaphy provides favorable outcomes in most cases. Many women report significant improvement in quality of life, reduction or complete resolution of prolapse symptoms, and restoration of normal pelvic organ function. Recurrence of prolapse is uncommon when postoperative recommendations are followed and pelvic floor muscle strengthening is maintained.

This operation can substantially improve daily comfort by relieving symptoms such as pelvic discomfort, urinary incontinence, and bowel dysfunction. Adherence to medical advice during recovery is crucial to achieving optimal results and minimizing complications.