What is Vaginal Repair (Colporrhaphy) ?

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Why do you need Vaginal Repair (Colporrhaphy) ?

Colporrhaphy is indicated for:

  • Pelvic organ prolapse (POP):
    • Anterior colporrhaphy: Repairs a cystocele (bladder prolapse into the vaginal wall).
    • Posterior colporrhaphy: Repairs a rectocele (rectum prolapse into the vaginal wall).
    • Often combined with uterine prolapse surgery (e.g., vaginal hysterectomy) or apical support procedures (e.g., sacrospinous fixation).
  • Symptomatic prolapse:
    • Pelvic pressure or bulge: Feeling of something “falling out” of the vagina.
    • Urinary issues: Stress incontinence, difficulty urinating, or frequent urinary tract infections (UTIs) with cystocele.
    • Bowel issues: Difficulty with bowel movements, constipation, or fecal incontinence with rectocele.
    • Sexual dysfunction: Discomfort or pain during intercourse (dyspareunia).
  • Risk factors:
    • Childbirth (esp. vaginal deliveries), aging, menopause (low estrogen), obesity, chronic constipation, or heavy lifting.

The procedure aims to restore vaginal anatomy, alleviate symptoms, and improve quality of life. It is typically recommended for stage II–III prolapse (per Pelvic Organ Prolapse Quantification, POP-Q system) when conservative treatments fail.

Why Do Vaginal Repair (Colporrhaphy) Costs Vary in Philippines?

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Vaginal Repair (Colporrhaphy) Procedure

  • Before Surgery Evaluation:
    • Diagnosis:
      • Pelvic exam: Assesses prolapse stage (POP-Q system); identifies cystocele, rectocele, or uterine prolapse.
      • Urodynamic testing: Evaluates bladder function (e.g., incontinence, urinary retention).
      • Defecography (if rectocele): Assesses rectal prolapse severity.
      • Blood tests: Hemoglobin, clotting profile, and kidney/liver function.
    • Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior; antibiotics (e.g., cefazolin) pre-surgery.
    • Consent: Risks, including recurrence, are explained.
  • Surgical Techniques:
    • Anterior Colporrhaphy (for cystocele):
      • Performed under spinal or general anesthesia, lasting 1–1.5 hours.
      • Vaginal approach (no abdominal incisions); the patient is in the lithotomy position (legs in stirrups).
      • An incision is made in the anterior vaginal wall; the bladder is repositioned.
      • Pelvic fascia (supportive tissue) is plicated (stitched) to strengthen the vaginal wall; excess vaginal tissue may be excised.
      • The vaginal mucosa is closed with absorbable sutures (e.g., Vicryl).
    • Posterior Colporrhaphy (for rectocele):
      • Similar approach, lasting 1–1.5 hours.
      • An incision is made in the posterior vaginal wall; the rectum is repositioned.
      • The rectovaginal fascia is plicated, and the perineal body (tissue between vagina and anus) may be reinforced.
      • The vaginal mucosa is closed with absorbable sutures.
    • Combined Procedures:
      • Often done with vaginal hysterectomy (for uterine prolapse) or midurethral sling (for stress incontinence).
      • Mesh (rarely used now): Previously used for added support, but largely abandoned due to complications (e.g., erosion).
    • Intraoperative Tools:
      • Cystoscopy: Confirms bladder/ureter integrity post-anterior repair.
      • Rectal exam: Ensures no rectal injury post-posterior repair.
  • After Surgery:
    • Hospital stay: 1–2 days.
    • Pain management: Oral analgesics (e.g., ibuprofen) for 1–2 weeks.
    • Antibiotics: For 1–2 days to prevent infection.
    • Catheter: Removed after 1–2 days (to manage urinary retention, esp. anterior repair).
    • Instructions: Avoid heavy lifting, straining, or intercourse for 6–8 weeks.

Recovery After Vaginal Repair (Colporrhaphy)

  1. Hospital Stay: 1–2 days.
  2. Post-Surgery Care:
    • Pain: Vaginal discomfort or perineal pain for 1–2 weeks, managed with analgesics.
    • Activity: Walking within 24 hours to prevent clots; avoid heavy lifting (>5 kg), straining, or strenuous activity for 6–8 weeks.
    • Bleeding: Light vaginal spotting for 1–4 weeks; heavy bleeding is abnormal.
    • Bladder/Bowel: Catheter removal in 1–2 days; normal bladder function resumes in 1–2 weeks; laxatives for constipation (esp. posterior repair).
    • Intercourse: Avoid for 6–8 weeks until healed.
    • Pelvic floor exercises: Start after 6 weeks to strengthen muscles (under physiotherapy guidance).
  3. Diet: High-fiber foods (e.g., fruits, vegetables) and 2–3 liters water daily to prevent constipation.
  4. Follow-Up:
    • Visit at 1–2 weeks for wound check; 6–8 weeks for recovery assessment.
    • Urodynamic testing (if incontinence persists): At 3 months.

Most resume normal activities in 4–6 weeks; full recovery takes 6–8 weeks. Symptom relief: 80–90% experience reduced pelvic pressure and improved bladder/bowel function; 70–85% report better quality of life.

Risks and Complications

  • Surgical Risks:
    • Bleeding (2–5%): 1–2% may need intervention; rare reoperation.
    • Infection (2–5%): Urinary tract, vaginal, or pelvic; treated with antibiotics.
    • Blood clots (1–2%): Deep vein thrombosis (DVT); early ambulation reduces risk.
  • Organ Injury:
    • Bladder/ureter injury (1–2%, anterior): May need repair or stenting.
    • Rectal injury (<1%, posterior): Rare, requires surgical correction.
  • Long-Term:
    • Recurrence (10–20% within 5 years): Higher with ongoing risk factors (e.g., obesity, constipation).
    • Urinary issues (5–10%): New or persistent incontinence; may need additional surgery (e.g., sling).
    • Dyspareunia (5–10%): Painful intercourse due to vaginal narrowing or scarring; often improves with time or dilators.
    • Vaginal shortening (2–5%): May affect sexual function; rare with modern techniques.
    • Chronic pain (1–3%): Due to nerve irritation or scarring; may need physiotherapy.

Report fever, severe pain, heavy bleeding, difficulty urinating, or fecal leakage promptly.

Frequently Asked Questions (FAQs)

What causes vaginal prolapse?

Weakened pelvic floor muscles from childbirth, aging, menopause (low estrogen), obesity, chronic constipation, or heavy lifting.

Can I avoid surgery for vaginal prolapse?

Yes, for mild cases (stage I–II): 50–70% improve with pelvic floor exercises (Kegels), pessary (vaginal support device), or lifestyle changes (e.g., weight loss).

Will colporrhaphy affect sexual function?

Most women (80–90%) report improved sexual function (due to symptom relief); 5–10% may experience dyspareunia, often temporary.

How soon can I resume activities?

Light activities in 1–2 weeks; normal routines in 4–6 weeks; full recovery in 6–8 weeks.

Is colporrhaphy covered by insurance in India?

Yes, for symptomatic prolapse; confirm with your provider.

Signs of complications?

Fever, severe pain, heavy bleeding, difficulty urinating, or fecal leakage.

Will I need a hysterectomy with colporrhaphy?

Not always; depends on uterine prolapse severity. Colporrhaphy can be done alone or with hysterectomy if the uterus is also prolapsed.

Lifestyle changes post-surgery?

Avoid heavy lifting/strain long-term, maintain healthy weight, do pelvic floor exercises, manage constipation, and attend follow-ups.

Conclusion

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Looking for Best Hospitals for Vaginal Repair (Colporrhaphy)

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₱) Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

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