Colpectomy/Colpocleisis
Pelvic organ prolapse (POP) is a common condition, especially in post-menopausal women, and almost 50% of women who have carried at least one pregnancy to full term can be identified as having at least mild POP by physical exam. POP is the most common indication for hysterectomy in women aged 55 years and older in the United States. This process can cause a variety of symptoms, including vaginal bulging/fullness, pelvic pressure, urinary incontinence, difficulty emptying the bladder, chronic constipation, and difficulty evacuating the bowels. These symptoms can significantly compromise daily activities. Fortunately, most women with POP do not have bothersome symptoms and treatment is only recommended if a patient is having symptoms that significantly affect her quality of life. It cannot be assumed that nonspecific symptoms, such as pelvic pressure or back pain, will be alleviated with prolapse treatment.
In symptomatic patients with POP, the options for treatment are as follows: observation, pelvic floor muscle rehabilitation (Kegel exercises), vaginal insertion of a pessary, or surgical restoration. There are many factors that go into deciding which treatment is best for each patient. These deciding factors include the patient’s symptoms, her desire for treatment, the type and degree of the prolapse, her desire for vaginal intercourse, and whether or not she is healthy enough to undergo surgery.
An option for patients who are no longer having vaginal intercourse and do not desire to use a pessary, or a pessary has been unsuccessful, is a surgical procedure called Colpectomy/Colpocliesis. This is a vaginal surgery (with or without vaginal hysterectomy) which effectively eliminates the prolapse and results in a shortened and narrowed vagina. It may be done under general anesthesia or regional (spinal or epidural) anesthesia. Usually patients stay overnight in the hospital and it requires between four and six week recovery.
Learn more about Pelvic Organ Prolapse and treatment options.