General Information

Definition. Colporraphy is a plastic surgical procedure to correct relaxation of the pelvic supporting structures. The anterior relaxation is called cystocele; the posterior relaxation, rectocele. Frequently, another weakening is present, called an enterocele; this is a condition in which a hernia sac develops between the rectum and the vagina, often causing discomfort from pressure.

Signs and Symptoms

Of relaxation of the anterior vaginal supporting tissues adjacent to the urinary bladder:

• Stress incontinence - leakage of urine from the bladder with sneezing, coughing, straining, laughing, or crying.
• A large, soft mass (the bladder) bulging downward into the vagina when standing or straining (this mass prevents complete emptying of the bladder)

Of relaxation of the posterior vaginal supporting tissues:

• Relaxation of the opening into the vagina, which some couples find unacceptable for satisfying sexual intercourse
• Possible difficulty in having normal bowel movements if the muscles surrounding the rectum have been overstretched or injured

Cause. Relaxation of the pelvic musculature and ligaments is caused by damage to these areas during repeated childbirth as well as lifelong pressure on pelvic supports from everyday standing.

Purpose of Surgery. Cystoceles, rectoceles, and enteroceles are hernias that cause organs to protrude into areas where they are not meant to be. When these hernias exist, women cannot feel completely fit or intact. The surgical procedure is designed to repair these hernias. Surgical repair of the hernia may be combined with a hysterectomy, or with a hysterectomy plus removal of the fallopian tubes and ovaries.

Despite skillful surgery, sometimes the plastic repairs are not permanent and may need to be repeated several months or years later.

Important Points in Treatment

What to Expect After Surgery. If you have undergone surgery that required sutures anywhere within the vagina, you can expect to notice them falling out when they no longer hold tissue together. These loose sutures have no clinical significance. Do not worry about them.

After an A and P repair, the vagina will be shortened somewhat, but this shortening should cause no lasting problem.

Your next menstrual period may be heavier than usual, but it should resume about the expected time.

If you needed birth control measures before surgery, you will still need them, for no reproductive organs have been removed (unless you've also had a hysterectomy).

Activity. Stay as active as your condition and state of well-being allow. Try different positions when you sit or lie down to find the one most comfortable for you.

General Measures

• Use either tampons or sanitary pads, as you did before surgery. There is no need to change from your usual custom.
• Seek help for the psychological or emotional factors that may complicate your postoperative recovery.
• Heat helps. If you have pain, place a heating pad or hot-water bottle on the abdomen or back. Hot baths frequently aid muscle relaxation and relieve discomfort, as well as reducing any disagreeable odor from vaginal discharge.

Medications. You may need no medicines. Do not use any medicines - even those bought without prescription - until you discuss them with your physician. Carefully follow the instructions. Do not share any medications prescribed for you with anyone else - not even with a close friend or relative who has undergone the same treatment. The treatment for every patient must be individualized and administered with the help and supervision of a physician. If you have a vaginal discharge with an unpleasant odor, your physician may prescribe a vaginal cream. If you are accustomed to douching, you may resume douching after you have been able to resume sexual intercourse.

Call Our Office If:

• There is excessive bleeding (soaking a pad or tampon as often as one each hour)
• You develop signs of infection: fever over 100 degrees, muscular aching, headache, a general feeling of ill health
• A feeling of the need for increased frequency of urination persists for longer than 1 month
• Vaginal discharge persists beyond 4 weeks after surgery
• You develop swelling or pain at the surgical site
• You experience any other symptoms you believe are related to your surgery

Disclaimer: The articles and information, while with the best effort to be accurate and up-to-date, may not be. Also, every physician and medical professional holds their own views on certain diagnosis and advice. There truly are no textbook cases. It is always best to consult with your personal physician regarding medical/health related problems. The information is to be used as a general resource and not as a substitute for trained medical advice and/or treatment.