colporrhaphy

Colporrhaphy is a surgical procedure to repair defects of the vaginal wall, usually to correct pelvic organ prolapse. Prolapse may involve the anterior vaginal wall (cystocele) or the posterior vaginal wall (rectocele), and colporrhaphy may be performed as anterior colporrhaphy, posterior colporrhaphy, or a combined repair when both compartments are involved.

Indications include symptomatic prolapse with a sensation of bulge, pelvic pressure, vaginal discomfort, urinary or bowel symptoms, or failure of nonoperative treatments such as pessaries. The procedure is commonly carried out via the vaginal route, though abdominal approaches exist for certain patients.

Technique generally involves making incisions in the affected vaginal wall, identifying the fascial layers supporting the prolapsed segment, and placing sutures to plicate and reinforce the pelvic fascia to restore normal support. Native tissue repair is common; use of grafts or mesh may be employed in selected cases, but transvaginal mesh use has declined due to safety concerns.

Outcomes vary with patient factors; success rates for correcting prolapse are reported in the literature, with risks of recurrence or persistent symptoms. Complications may include bleeding, infection, injury to surrounding structures, urinary retention, dyspareunia, and mesh-related complications if mesh is used. Recovery entails anesthesia recovery, a period of pelvic rest, and gradual resumption of activities over several weeks.

Colporrhaphy can be performed alone or as part of a broader pelvic floor reconstruction. In some patients, alternative procedures such as sacrocolpopexy or colpocleisis may be considered depending on anatomy, comorbidities, and reproductive plans.