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Operations: Posterior colporrhaphy

Insurance code: P2230

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: Posterior repair or colporrhaphy is a vaginal repair procedure to correct posterior vaginal prolapse or to change the shape or size of the vagina to improve comfort or satisfaction during intercourse. It is sometimes carried out to help bowel function and to help rectal emptying.

Description of procedure: The posterior vaginal skin is opened and the underlying rectum is reflected away. Stitches are inserted into the surrounding muscles or tissues to provide support to the vagina. Biological or artificial materials are sometimes left in place to help improve the vaginal tissues. Some excess skin may then be removed before the vaginal skin is closed with stitch material.

Anaesthetic: This operation can be carried out under either a general anaesthetic or with a spinal anaesthetic that uses local anaesthetic and a slight sedative.

Length of stay: The length of stay depends on post-operative recovery but three nights stay would be typical.

Post-operative management: A vaginal pack is left in the vagina overnight to reduce bruising. A catheter is left in the bladder overnight and removed the following morning. The catheter is then left out provided bladder function is normal.

Potential complications
Complications at the time of surgery include peri-operative bleeding, and damage to structures such as the rectum. These complications are rare but require corrective surgery immediately or as soon as a problem is recognised. Venous thrombosis (DVT) can follow any pelvic surgery. Stockings are therefore worn and heparin injections given each day to reduce the risk. Early mobilisation and early discharge from hospital reduce the risk of thrombosis. Infection in the vaginal skin is common because of proximity to the bowel and anti-biotics are given at the time of surgery to reduce risk of infection. If offensive discharge, increasing pain or unusual bleeding are noted during the post-operative phase a course of anti-biotics may be necessary.

Post-operative consultation
A routine appointment is normally booked for six weeks to ensure the vagina is well healed although other appointments may be necessary to ensure the post-operative course goes smoothly.

Other considerations
Sex is best avoided until the skin has healed and sutures have dissolved. This may take up to nine weeks. Heavy lifting is best avoided for three months to prevent stitches giving way but light lifting is not a problem. Driving short distances is practical once comfortable and strong sedative pain killers are no longer being taken.

Relevant websites

Information on the surgical repair of prolapse

Information on some issues related to vaginal prolapse repair surgery