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Colporrhaphy is a medical surgery to repair and/or strengthen the vaginal wall from physical damage. In certain conditions, the tissues of the vaginal walls may be torn or damaged that can cause pain to patients. The main goal of the surgery is to fix the vaginal walls in its normal anatomical condition and removing the pain it causes the females. Since this ailment is not as detrimental compared to other vaginal diseases, the operation is usually done when the pain is limiting the patient to perform daily activities.
Surgery begins with the proper diagnosis of the vaginal walls to determine which part of the vagina is damaged. The rectocele is the damage in the rectovaginal septum or the wall near the rectal area and cystocele is the damage in the walls to the bladder. A speculum is used to open the vagina thus allowing the surgery to proceed. The surgeon will use stitches to hold the tissues together in order to give support to the entire vaginal area.
After the operation, the patient should rest until the stiches are completely healed. During the healing period, there will be certain discomforts that can be felt by the patient.
Colporrhaphy or Vaginal repair surgery is done in order to lift and strenghten the vaginal wall and restore its normal support. The purpose of this surgery is to repair a rupture or a pelvic organ prolaspe that could be caused by age, obesity, repeat childbirth, hormone deficiency, and more. Some symptoms of Pelvic organ prolaspse are:
- Vaginal bulge
- Back pain
- Difficulty urinating or releasing your bowel movement.
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By definition, a colporrhaphy is the surgical repair needed when there is a defect in the vaginal wall. There are four primary causes for this kind of defect: 1) when the bladder protrudes into the vagina (“cystocele”), 2) when the rectum protrudes into the vagina (“rectocele”), 3) when the urethra encroaches into the vagina (“urethrocele”), and 4) when the small intestines protrudes into the vagina (“entreocele”).
When this happens, a prolapse has occurred. A prolapse happens when an organ becomes displaced and ends up somewhere else other than where it is supposed to be. In the pelvis, organs are usually kept in place either by tissue or ligaments. Cystocele and urethrocele are caused by a defect in the fibrous tissue which separates the bladder and the vagina (“pubrocervical fascia”). When the rectum prolapses, this is caused by defects in the fibrous tissue that separates the rectum from the vagina (“rectovaginal fascia”). When the urethra prolapses, this is caused by a defect in the uterus, making in protrude downward into the vagina.
There are numerous reason for pelvic organ prolapse, including age, having more than one child, a decrease in hormones, rigorous physical activities, and having had a hysterectomy.
There are some warning signs that pelvic prolapse has occurred, including the leakage of urine not linked to physical activity, a vaginal bulge, pain during intercourse, difficulty in bowel movement and/or urination, and back pain. Among those suffering from pelvic organ prolapse, some fifty percent of women reported that they had urinary incontinence, and ten percent say that the incontinence occurs on a regular basis. The percentage increases with age, with twenty percent of women over age seventy-five experiencing this symptom. A recent study reports that nearly sixteen percent of women from ages forty-five to fifty-five have experienced mild pelvic prolapses but only three percent require surgery.
Factors that are linked to pelvic organ prolapse include age, repeated childbirth, hormone deficiency, ongoing physical activity, and prior hysterectomy. Symptoms of pelvic organ prolapse include stress incontinence (inadvertent leakage of urine with physical activity), a vaginal bulge, painful sexual intercourse, back pain, and difficult urination or bowel movements.
The physician will diagnose the prolapse by using a speculum. The patient will sit in an upright position or be asked to strain. While doing so, the physician will inspect the anterior, posterior, upper (apex) and side (lateral) vaginal walls. While some prolapse may be diagnosed in this manner, others like determining cystocele, may require that the bladder be filled with a urinary catheter using a dye called a “contrast medium.” The bladder is then x-rayed.
For those who must undergo surgery, the colporrhaphy may be performed on either the front wall (anterior) or the back wall (posterior) of the vagina, or sometimes both. When the surgery is anterior, the surgeon is treating either a cystocele or an urethrocele prolapse. A posterior surgery is performed to treat a rectocele. Surgery is not typically scheduled until the symptoms begin to interfere with a patient’s daily life.
If surgery is required, the patient will be instructed to refrain from food or drink after midnight on the night prior to the procedure. Once in the operating room, the patient will be given either a general, regional, or local anesthesia. A speculum is used during surgery to hold the vagina open. Then an incision is made into the skin of the vagina to determine where the fascia has occurred. The skin is then separated from the fascia; the defect then is folded and stitched (sutured) to put it back in place. Any excess skin is removed and the incision is closed.
Following the surgery, a Foley catheter will likely remain in place for up to two days. The patient will be prescribed a liquid diet until a normal bowel movement occurs. Physical activity that might strain the repairs must be avoided for a about four weeks, including sexual intercourse, lifting, and long periods of standing.
Source: Encyclopedia of Surgery, ©2004 Gale Cengage. All Rights Reserved.
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