Overview
Colpocleisis is a surgical procedure that closes or narrows the vaginal canal to support prolapsed organs. It is a highly effective option for women with advanced prolapse who no longer desire vaginal intercourse, as well as for patients with significant medical comorbidities who may not be ideal candidates for more complex reconstructive surgery.
When Is Colpocleisis Appropriate?
- Severe or recurrent pelvic organ prolapse
- Women who no longer desire vaginal intercourse
- Patients with significant comorbidities that increase surgical risk
- Women who wish for the shortest, safest operative procedure
Advantages
- Shortest operative time of all prolapse procedures
- Lowest recurrence rates — success rates of 90-95%
- Can often be performed under spinal or regional anesthesia
- Minimal blood loss and shorter recovery
The Procedure
The vaginal walls are stitched together, obliterating the vaginal canal and keeping the prolapsed organs in their correct position. An anti-incontinence procedure may be performed simultaneously if stress incontinence is present or anticipated.
Limitations
- Permanent loss of vaginal intercourse — this is not a reversible procedure
- Not suitable for women who wish to maintain sexual function
- Cervical cancer screening may no longer be possible in the usual manner
Recovery
- Hospital stay: typically 1 night
- Return to light activities: 1-2 weeks
- Full recovery: approximately 4-6 weeks
Risks and Success Rates
Colpocleisis has the highest success rate of all prolapse procedures at 90-95%. It also has the shortest operative time and lowest surgical risk. However, it permanently eliminates the ability to have vaginal intercourse. Approximately 1 in 5 women may later regret this decision. Potential risks include:
- Urinary tract infection — approximately 6% of patients
- Constipation — common in the short term
- Hematoma — collection of blood at the surgical site
- Bleeding requiring transfusion — uncommon for this procedure
- Bladder or bowel injury — rare
- Venous thromboembolism — rare
Illustrations courtesy of the International Urogynecological Association (IUGA) Patient Information Leaflets.