Colpoperinorrafia
Introduction
- One out four women will have a pelvic floor disorder during her lifetime.
- Pelvic organs prolapse is a pelvic floor disorder where one or more organs descend from their normal position.
- Most women with prolapse have mild or no symptoms.
- In about 2-6% the symptoms tend to be mild to severe.
- Non-surgical treatment options are usually tried first. If these options do not work and your symptoms are severe, you may consider surgery.
Definition
- Anterior and/or posterior vaginal wall repair surgery (anterior and/or posterior colporrhaphy) is a surgery that tightens the anterior and/or posterior wall of the vagina.
- Pelvic floor disorders include urinary and fecal incontinence, and pelvic organ prolapse. Which are prevalent in the female population and may occur at the same time.
Causes
Pelvic organ prolapse occurs when the normal support provided by the muscles and tissues of the pelvic floor is weakened by the following main causes:
- Pregnancy and childbirth
- Previous pelvic surgery
- Menopause and aging process
- Increased pressure in the abdomen: Obesity, constipation, persistent coughing
- Heritage
Organs affected
- The cavity between the rectum and the back wall of the uterus (usually with a part of the small intestine, which is called an enterocele.
- Uterus.
- The upper part of the vagina in women who have had a hysterectomy (the vaginal vault).
- The anterior wall of the vagina (usually with the bladder, which is called the cystocele)
- The posterior wall of the vagina (usually with the rectum, which is called a rectocele).
Symptom
- Feeling of fullness or heaviness in the pelvic region.
- Tightness or painful tenderness in the lower abdomen or pelvis.
- Dyspareunia (painful or uncomfortable intercourse).
- Difficulty urinating or having bowel movements.
- Sensation of a mass of tissue at the entrance or outside the vagina.
Surgical treatment options
- In anterior colporrhaphy, sutures are used to strengthen the anterior wall of the vagina so that it supports the bladder once again.
- In posterior colporrhaphy, sutures are used to strengthen the posterior wall of the vagina so that it supports the rectum once again.
Risks include pain during intercourse and injury to the bladder, ureters or rectum.
- Sacrocolpopexy is the treatment of vaginal vault prolapse and enterocele.
- It can be performed with an abdominal incision or laparoscopically.
- Surgical mesh is placed in the anterior and posterior walls of the vagina. A special Y-shaped mesh may be used.
- The ends of the mesh are then attached to the sacrum and the vagina is lifted back in place.