Colpectomy is a surgical procedure that closes the vaginal opening completely. The surgery is usually used to treat uterus prolapse (cystocele, rectocele, or enterocele) in women. In prolapse, the muscles of the pelvic floor, which support the uterus and other pelvic organs, weaken. This weakening allows the pelvic organs to bulge into the vagina. Symptoms of prolapse include painful sexual intercourse, bleeding, and difficulty in urination. This procedure is not recommended for women who are sexually active because patients may no longer be able to have vaginal sex after the procedure.
The surgery is usually done under general anesthesia or spinal anesthesia. The patient’s vitals and urine output are monitored throughout the procedure.
- During the surgery, the internal vaginal walls are sewn together so that the vagina cannot bulge out.
- Dissolvable stitches are placed to sew the vagina to the back wall, which pushes the prolapsed organs inside the body and prevents them from bulging.
- The surgeon may place some sutures to narrow the vaginal opening to help prevent the re-prolapse.
- Other operations to correct the pelvic floor may be done at the same time. Surgeries like hysterectomy or surgery to correct urinary incontinence may be done.
- If the uterus is not removed, it may be pushed up above the stitches placed in the vagina.
- Small tunnels may be created to drain the blood or mucus out.
- After this surgery, the vagina is only about 1 inch long and the opening is very narrow, which prevents vaginal sex. The outside of the vaginal area, including the labia and vulva, still looks the same.
- Because the outside is the same, external sexual stimulation, such as stimulation of the clitoris and the arousal in women is still possible.
- The procedure is usually an outpatient procedure, and the patient may go home on the same day or they may need to stay in the hospital maximum for a day.
- The surgery is completely done through the vagina without disturbing the belly cavity. The average recovery time may range from 15 to 30 days or more.
- Urinary or bowel incontinence
- Bladder infections
- Wound infections
- Blood clot formation
- Pelvic pain
- Injury to nearby organs
- Excessive bleeding
- All surgeries have a risk of death. Some surgeries have a higher risk than others. The chance of dying from this kind of surgery is less than one in 10,000.
What is the outlook of patients with colpectomy?
The success rate of the colpectomy is between 90-95%. After the procedure, the patient may have tiredness, spotting, and pain, which is usually managed through a good diet and pain medications. Most women recover well and find relief from prolapse symptoms. The patient may usually feel fit within 60 days with proper care. Colpectomy is only advised to patients who are not sexually active and when the patient is completely sure that she will never want to have intercourse again. Patients will continue to pass urine and have bowel movements in the same fashion. This technique has a high rate of success and safety.
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