Colpocleisis is a surgical procedure in which the opening of the vagina, known as the lumen, is closed. This procedure is used to treat pelvic organ prolapse and is primarily considered to be a treatment option among women who are older and no longer interested in being sexually active. This surgery is performed by a gynecological surgeon and it may require a brief hospital stay, typically a single night, for the purpose of monitoring the patient and confirming that the procedure was successful.
In pelvic organ prolapse, the support structure which keeps the pelvic organs in place fails, causing them to sag. This can lead to problems such as incontinence, fistula, pain, discomfort during sex, and infection. The conventional treatment for prolapse is reconstruction, in which a surgeon rebuilds the connections used to keep the pelvic organs stable so that they will stay in place. However, reconstruction is an invasive surgery which is long and can be dangerous and for some patients colpocleisis may be a better choice.
In a colpocleisis procedure, the patient is given local anesthesia along with medications which are designed to reduce stress and keep the patient comfortable. The procedure usually takes under two hours, and involves sewing the opening of the vagina shut to provide more structural support to the pelvic organs so that they cannot prolapse. The surgeon may also perform a sling procedure to reduce the risk of urinary incontinence, providing more support to the bladder so that the vagina will not drag on it and cause incontinence.
There are some risks to this procedure, as with any surgical procedure, including infection. The patient may also be at risk for urinary incontinence if a sling is not placed to support the bladder. In addition, it can be difficult to treat uterine bleeding because of the closure of the vaginal opening. A small opening is left in place so that blood and mucus draining from the uterus can be identified, but the option of a quick physical examination to determine the cause is not possible when the vagina has been closed.
This procedure also comes with some psychological risks which must be assessed before moving forward with the procedure. Patients who have undergone a colpocleisis cannot have penetrative intercourse. For some patients this may be perfectly acceptable and not a cause for concern, but others may worry about sexual intimacy and their relationships with their partners. Patients should weigh this risk carefully before consenting to the colpocleisis procedure.
