A colpocleisis (vaginal closure) is a surgical treatment option for pelvic organ prolapse in which the length of the vaginal canal is shortened. It is performed through the vagina and does not require any abdominal incisions. The surgery and recovery are very quick. After this surgery, the vagina will be very short, so it is not a good treatment option for women who want to be sexually active with vaginal intercourse.
How is the surgery performed?
At Northwestern Medicine, your Urogynecologist will perform a colpocleisis through the vagina. It is considered “natural orifice surgery,” so you will not have any incisions on your abdomen. This procedure is the least invasive surgical procedure for prolapse repair and can be done quickly under regional (spinal) or general anesthesia, making it an attractive option for women who have medical problems and are not good candidates for more extensive surgeries. In this procedure, the length of the vaginal canal is shortened by sewing the front and back walls of the vagina together and the size of the opening of the vagina (introitus) is reduced. This effectively reduces the vaginal prolapse and prevents further development of prolapse. However, because the vagina is permanently shortened after surgery, women can no longer have vaginal sexual intercourse. Colpocleisis can be performed on women who have undergone a previous hysterectomy or those who still have a uterus.
How successful is the surgery?
Colpocleisis is very effective and has success rates as high as 95 percent. There are many clinical research studies demonstrating that colpocleisis is safe and effective even in women who are older or have medical problems. Most women are highly satisfied after the procedure.
Are there any complications?
As mentioned previously, this surgery has been extensively studied, and thus the complications are very well known. Your urogynecologist will evaluate you and will modify certain things that might predispose you to a complication. Colpocleisis is the safest surgical procedure to treat prolapsw with the least amount of complications. Although rare, if you experience a complication, your urogynecologist will address this immediately utilizing surgical or non-surgical techniques.
Complications general to any type of surgery, including blood clot, infection, bleeding, or nerve or muscle injury, can be encountered with this surgery as well. Again, your doctor will work with you, your primary care team, and our anesthesiology team to minimize your risk of these things happening.
What is the recovery?
Since your urogynecologist is able to perform this surgery utilizing a minimally invasive approach, you will most likely be able to go home the day of surgery. To help you accomplish this goal, we have worked with our anesthesiology team to develop an Enhanced Recovery After Surgery (ERAS) program. Your urogynecologist will determine if you are a candidate for this program at your pre-surgical visit.
We also appreciate that you are undergoing surgery to restore your quality of life, and thus we would like to get you doing the things you want to do as quickly as possible postoperatively. You can return to your normal activities as soon as you feel ready including exercise and work. It is normal to feel tired and sore during the first 2 weeks after surgery, but we encourage you to be more and more physically active as your energy improves.
After surgery, it is not unusual to have a yellowish discharge. This is from the dissolving of the stitches your urogynecologist uses to perform the surgery. These stitches are mostly gone by 6-8 weeks.
How should I prepare for surgery?
You will meet with your surgeon as well as our nurse pre-operatively to discuss specific instructions to follow before and after surgery.