With age, the length and thickness of muscle fibers change. The vagina, which is a muscular-elastic tube and part of the birth canal, loses its elasticity over the years. This negatively affects sexual relationships and affects personal life. You can change the state of affairs for the better by doing an anterior colporrhaphy. It belongs to invasive procedures and has indications and contraindications.
What is colporrhaphy?
Surgical intervention aimed at removing excess tissue from the walls of the vagina and sewing together the connective membrane located under them is called colporrhaphy. It is a type of vaginoplasty.
There are several types of vaginoplasty. Each differs in its technique of execution and is used under certain conditions. Anterior and posterior colporrhaphy is an operation on the vagina, which is performed when its walls prolapse and prolapse. Also, indications for these types of surgical intervention are various mechanical violations of the integrity and functionality of the internalfemale genital organ and perineum.
Mediated colporrhaphy is a gynecological surgical operation to form an obstruction for a prolapsed uterus by suturing the walls of the vagina. A woman will be denied this procedure if she has pathologies of the cervix and internal reproductive organs.
Types of colporrhaphy
Vaginal reduction operations are divided into three types: posterior, median and anterior. The last most commonly used.
- Posterior colporrhaphy - plastic surgery to suture the posterior wall of the vagina and perineal muscles. With age or due to disease and injury, the pelvic floor muscles lose their elasticity. This threatens with prolapse or even prolapse of the rectum, uterus, ovaries, bladder. Even small anatomical deviations can seriously disrupt the entire urinary and reproductive systems. The operation is aimed at strengthening the muscles that hold the pelvic organs. The procedure is performed as an independent procedure or in combination with the anterior or median.
- The Lefort-Neigebauer operation (median colporrhaphy) is a gynecological surgery aimed at creating an obstruction by stitching the walls of the vagina to prevent prolapse. Surgical manipulation is performed in older women who do not live sexually. This is due to the technique of the procedure - after it, close side passages appear in the vagina, preventing prolapse of the uterus, but at the same time excluding reproductive function. The Lefort-Neugebauer operation is often combined with plastic surgery of the muscles of the pelvicbottom.
- Anterior colporrhaphy - suturing the anterior wall of the vagina and connective tissue membranes above the bladder (cystocele plasty). The operation is performed for medical reasons and to improve the quality of sexual life.
When is colporrhaphy performed?
During difficult childbirth, in order to avoid arbitrary ruptures of the vagina and traumatic brain injuries of the child, they resort to dissection of the posterior wall of the vagina and perineum. After an episiotomy, the orgasmic cuff is restored using levatoroplasty, anterior and posterior colporrhaphy allows correction of the female genital organ after a difficult natural childbirth.
Intimate plastic surgery is also performed for other reasons.
- Renewal or improvement of the ability to experience sexual pleasure.
- Descent or prolapse of the vaginal walls.
- Repeated vaginal prolapse after hysterectomy.
- Mechanical damage to the internal penis.
- Foreign body sensation.
- Persistent pain in the lower abdomen and lower back.
Transgender women undergo feminizing vaginoplasty to transform male genitalia into female.
Causes of vaginal prolapse
The main indication for anterior and posterior colporrhaphy is vaginal prolapse. The displacement of the walls of the vagina with its exit from the genital gap is a serious violation due to various reasons.
Pathology in most cases does not manifest itself andis diagnosed only at the second or third stage at a gynecologist's appointment. The prolapse can be partial - displacement of the anterior or posterior wall beyond the female genitalia - or complete - the exit of the entire muscular-elastic tubular organ from the vulva.
The main factor influencing vaginal prolapse is multiple births. There are other reasons as well.
- Failure to follow the recommendations of the doctor regarding the recovery of the body after childbirth.
- Increased intra-abdominal pressure.
- Presence of neoplasms in the pelvis.
- Sudden weight gain and loss.
- Dysplasia.
- Hemorrhoids.
In older women, vaginal prolapse is associated with age-related changes in elastic muscle tissue.
Contraindications for surgery
Features that prevent the use of posterior, median and anterior colporrhaphy can be relative and unconditional.
Conditional.
- Under 18 years of age. The ban applies only to intimate plastic surgery of an aesthetic nature.
- Patient's refusal to use this surgical procedure.
The list of absolute contraindications is much wider.
- Thinning and stretching of the pubocervical connective tissue sheath.
- Vesico-vaginal fascia atrophy.
- Damage to the epithelium of the cervix.
- Insufficiency of the urinary sphincter.
- STDs.
- Benign growths, tumors.
- Pregnancy (alltrimesters).
- Presence or predisposition to the formation of keloid scars.
- Blood clotting disorders.
- Diseases of all organs caused by pathogenic microorganisms.
- Decompensated diabetes.
- Acute thrombosis.
- Pelvic bone deformities.
Features of preparation for colporrhaphy
If there are no contraindications, the gynecologist prescribes preoperative laboratory tests using various devices and instruments. In parallel, a woman must carry out certain simple preparatory activities.
- A few days before the operation of the anterior colporrhaphy, it is recommended to sanitize the vagina with antimicrobial suppositories and antiseptic solutions.
- The hair around the vagina must be shaved on the day of the intimate plastic surgery.
- Cleansing enema the night before.
- If a woman suffers from varicose veins, it is recommended to wear compression stockings for a while.
Upon admission to a medical institution, the operating gynecologist performs a vaginal and rectal examination.
How anterior colporrhaphy works
Intimate plastic surgery is performed under general anesthesia. On the front wall of the vagina, stepping back 1 cm from the opening of the urethra and to the anterior lip of the cervix, a median longitudinal incision is made. It is easy to perform, the tissues are slightly injured, the bleeding is small. The vaginal mucosa is separated with a scalpel, removing the urethra and fundusurethral bladder. Then, a wide incision of the fascia tissues and its separation from the wall of the bladder is performed. Vertical sutures narrow the muscles of the urethra and the area of the bottom between the mouth of the ureters and the inner lumen of the urethral canal. The free edges of the flaps are sutured by duplication, overlapping each other. At the end, the mucosa of the external genital organ is sutured, selecting tissues of the cervix to strengthen the bladder in the upper position.
If retroversion of the uterus is detected during surgical procedures, then the technique of anterior colporrhaphy can be corrected.
Complications
As practice shows, patients rarely have complications. They are mostly associated with non-compliance with medical prescriptions. The most common phenomenon is the divergence of the seams. Because of what, after colporrhaphy, the anterior wall of the vagina sags.
Hematoma is not a complication and does not require special therapy. But if it increases or causes physical suffering, you should see a doctor.
Infection of wounds is practically excluded due to antibiotic course postoperative therapy. However, if the pain syndrome does not go away, the vagina has acquired an uncharacteristic red tint, you should immediately inform the gynecologist.
Rehab
The length of stay in the hospital depends on the complexity of the anterior colporrhaphy and the specifics of the postoperative process. Patients usually go home a few hours after the operation. Before leaving, the doctor gives a few recommendations.
- For 3 days, a woman should observe bed rest, getting out of bed should be rolling to one side.
- To prevent seams from coming apart, sitting is not recommended for a week.
- No sex or sports for a month.
On the third day after the operation, antibacterial drugs are prescribed, you must complete the entire course.
Rehabilitation after anterior colporrhaphy, according to patients, is easy and fast. Unpleasant is only a slight discomfort in the early days and the rejection of sex for a month.
Pregnancy after colporrhaphy
Correction of the vagina does not have a negative effect on reproductive function. Moreover, after an anterior colporrhaphy, many women enjoy intimacy more and have sex more often. This naturally increases the chance of conceiving a child. In order to avoid unwanted pregnancy, you must take care of contraception.
After vaginoplasty, a woman can give birth naturally, provided that the fetus is not large. But when she becomes registered for pregnancy, it is necessary to inform the gynecologist about the transferred intimate plastic surgery.
Alternative Methods
The technique of anterior colporrhaphy surgery allows you to eliminate second and third degree vaginal prolapse. If a woman regularly visits a gynecologist and the prolapse is insignificant, a laser vaginal tightening is used. The method is non-surgicalvaginoplasty and is focused on improving the elastic-viscous properties of the muscles of the vaginal walls by exposing them to a non-ablative laser beam.
Thread lifting of the vagina - tightening the vagina by implanting biodegradable threads into the walls of its canal. The long-term result is due to the creation of a natural connective tissue framework in the area of the threads.
Colporrhaphy refers to vaginoplasty, but is often used for medical reasons. The method allows not only to eliminate damage to the female genital organ, but also to improve the quality of sexual pleasure.
