Colpocleisis

Colpocleisis is a surgical procedure which results in close the vaginal canal. It is used to treat advanced vaginal prolapse, especially in older women who are no longer sexually active. The Colpocleisis is a safer alternative to more invasive operation such as the sacrocolpopexy or those procedures which utilize mesh. The colpocleisis results in excellent support, high cure rates but renders a patient with a closed vaginal canal and unable to engage in intercourse in the future.

Safest Surgery for Complete Vaginal Vault Prolapse

Patient is an 84-year-old woman who has complete vaginal prolapse x 12 months. She reports her vaginal bulge has been as large as a softball. She used a pessary for approximately 1 year. She had a previous hysterectomy as well as an anterior repair and posterior repair for a cystocele and rectocele.

She saw a urogynecologist in Chattanooga TN who diagnosed her with: complete vaginal vault prolapse, enterocele, rectocele, and cystocele. He recommended a robotic sacrocolpopexy and an anterior and posterior repair. She came to see Drs Miklos and Moore for a second opinion.

After reviewing her history with the patient and her daughter. The patient was found to suffer from pressure, lower back pain, difficulty emptying her bladder as well as her rectum. She also has a history of hypertension (high blood pressure), macular degeneration, acid reflux, arthritis, and a hiatal hernia. She denies sexual activity for more than 5 years and claims she has no desire to engage in sexual activity in the future. I explained to the patient that the operation recommended to her by her urogynecologist in TN is a very good operation with a very high cure rate, however, it is an abdominal surgery which on average takes approximately 4 hours by the average urogynecologist. (Figure 1) Compare the incision sites inside the vagina for the colpocleisis, which is a much safer, efficient and less painful surgery. (Figure 2) Please note the 6 sutures in the center of the photo have yet to be cut and the rubber drains are the urethral catheter and a temporary drain for the surgery.

Robotic Sacrocolpopexy 4-5 abdominal incision surgery

Figure 1: Robotic Sacrocolpopexy 4-5 abdominal incision surgery
Colpocleisis – single vaginal incision surgery

Figure 2: Colpocleisis – single vaginal incision surgery

I recommended another excellent operation, known as the Colpocleisis which has the following benefits:

  • 45 minutes’ surgical time
  • No abdominal incision
  • Less pain
  • Faster recovery
  • Less blood loss
  • Can be performed without general anesthesia

Colpocleisis vaginal surgery for advanced uterine prolapse or vaginal vault prolapse is an excellent choice or option for the patient for the not sexually active patient of advanced age or advanced medical fragility and who understands that intercourse will no longer be an option after the surgery.