Colpocleisis

Why is it done?

• The aim of surgery is to relieve the symptoms of vaginal bulge and / or laxity.
• Improve bladder function.
• Used where women are elderly and have no desire to be sexually active again.
• Vaginal prolapse is a common condition causing symptoms such as a sensation of dragging or fullness in the vagina, and difficulty emptying the bowel or bladder and back ache.
• About 1 in 10 women need surgery for prolapse of the uterus or vagina.

Image Caption: Complete closure of the vagina

Pre-requirements

• An informed consent is required from the patient and a pre-admission clinic will be arranged.
• Patients may not eat or drink from midnight the previous evening.
• Patients are to refrain from smoking before the procedure.
• Patients allergic to IODINE / CHLORHEXIDINE should clearly state this at the pre-admission clinic as well as to theatre staff and Dr Schoeman.
• Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery. This may be replaced by once daily Clexane injections.
• Pre-operative blood tests are required 4 days prior to surgery.
• Patients with cardiac illnesses require a cardiologist/ physician report.
• A chest X-ray is required for patients with lung disease.
• Be prepared for an 2-3 day stay.

How is it done?

• This procedure is done under a spinal / general anaesthetic, as decided by the anaesthetist.
• A large portion of the vaginal mucosa is removed on the bladder and rectal side, from the vault to the introits.
• The edges of the front wall are sewn to the back wall, therefore occluding the whole urethra.
• The sides of the vagina is not occluded to allow drainage of fluids.
• A catheter is placed into the bladder at the end of surgery.
• The catheter is removed the next day

What to expect after the procedure?

• When you wake up from the anesthetics you will have a drip to give you fluids and may have a catheter in your bladder.
• The catheter is usually removed the next morning.

Complications?

There are also general risks associated with surgery:

• Wound infection.
• Urinary tract infection.
• NO MORE VAGINAL INTERCOURSE.
• Rarely – Bleeding requiring a blood transfusion and Deep vein thrombosis (clots) in the legs, Chest infection.

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Colpocleisis