June 24, 2022 Author : Isabel Grilo Colpocleisis is an obliterative surgery in which pelvic organ prolapse is resolved by removing or closing all or part of the vaginal canal . It is reserved for women who are not sexually active, nor intend to maintain this possibility . As it is a well-tolerated and faster-performing procedure, it may be indicated in women with several other diseases (comorbidities) for whom the risk associated with reconstructive surgery to correct the prolapse is high. The success rate of colpocleisis in resolving pelvic organ prolapse is high – on the order of 90%-95% – which makes it an option also for women with recurrent prolapse. Colpocleisis can be performed on women who still have their uterus or who have previously had a hysterectomy (removal of the uterus). When stress urinary incontinence is present in addition to pelvic organ prolapse, surgery is usually performed at the same operative time to correct this problem. Having a colpocleisis eliminates the possibility of having vaginal intercourse and having a medical evaluation of the uterus (when present) vaginally. If you want to maintain the possibility of having vaginal intercourse, surgical resolution of the prolapse is not possible by colpocleisis, and it is necessary to choose another technique. Complications of colpocleisis Any surgery has potential complications , both related to the procedure and anesthesia. Urinary infections may occur, which are more frequent in patients on catheters. Depending on the specific risk of each patient, it is common to advise the use of compression stockings and therapeutic measures to avoid the formation of blood clots and complications that may be associated with them. There are also specific complications related to colpocleisis : Hematoma: accumulation of blood in the vaginal wall, which may be associated with symptoms of more intense and prolonged pain. In most cases, the hematoma resolves spontaneously. However, it may need to be drained. It can also progress to infection. In this type of surgery, bladder and bowel injuries are rare. Postoperative period and return to normal activity Colpocleisis is performed with the patient in a catheter and the catheter is kept in the bladder until 24-48 hours after the intervention, then removed. Soon after the surgery, vaginal discharge is common, which can last 4 to 6 weeks and is due to the presence of the suture stitches from the surgery in the vagina. In the postoperative period, it is important to maintain good intestinal functioning, avoiding constipation and the associated effort . Therefore, laxatives are often prescribed to be used during this period. Physical exertion should also be avoided for 4 to 6 weeks after surgery. After 3-4 weeks of surgery, as a rule, some light physical activity can be started, with short walks. The level of physical activity must be increased gradually but avoiding physical exertion and carrying weights (greater than 5 kg) for at least 6 weeks and always complying with specific medical indications. Sources International Urogynecologial Association. Colpocleisis . Meet the obstetrics-gynecology clinical team from Hospital da Luz network and book your consultation. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
