With age, the length and thickness of muscle fibers change. The vagina, which represents the muscle-elastic tube and part of the birth canal, loses its elasticity over the years. This adversely affects sexual relationships and affects personal life. You can change the situation for the better by making front colporaphy. It refers to invasive procedures and has indications and contraindications for conducting.
What is colporaphia?
Surgery aimed at eliminating excess tissue from the walls of the vagina and stitching the connective membrane located beneath them is called colporaphia. It is a type of vaginoplasty.
There are several types of vaginoplasty. Each is different in its execution technique and is used under certain conditions. Anterior and posterior colporaphia is an operation on the vagina that is performed with the lowering and loss of its walls. Also, indications for these types of surgical interventions are various mechanical violations of the integrity and functionality of the woman's internal genital organ and perineum.
Median colporaphia is a gynecological surgery to form a barrier for the 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 colporaphia
Operations to reduce the size of the vagina are divided into three types: posterior, median and anterior. The latter is the most commonly used.
- Posterior colporaphia - plastic surgery to suture the posterior wall of the vagina and perineal muscles. With age or due to illnesses and injuries, the muscles of the pelvic floor lose their elasticity. This threatens with prolapse or even prolapse of the rectum, uterus, ovaries, bladder. Even small anatomical abnormalities 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 or in combination with the anterior or median.
- The Lefora-Neugebauer operation (median colporaphia) is a gynecological surgical procedure aimed at creating an obstruction by stitching the walls of the vagina to prevent loss. Surgical manipulation is performed in elderly women who do not live sexually. This is due to the technique of the procedure - after it, close lateral passages appear in the vagina, preventing the prolapse of the uterus, but at the same time excluding the reproductive function. The operation of Lefora-Neugebauer is often combined with plasty of the pelvic floor muscles.
- Anterior colporaphia - suturing of the anterior vaginal wall and connective tissue membranes above the bladder (cystocele plastic). The operation is used for medical reasons and in order to improve the quality of sexual life.
In what cases do colporaphia take place?
During complex births, in order to avoid arbitrary ruptures of the vagina and traumatic brain injuries, the child resort to dissection of the posterior wall of the vagina and perineum. After an episiotomy, the orgasmic cuff is restored using levatoroplasty, the anterior and posterior colporaphia allows the correction of the woman's genital organ after a difficult natural birth.
Also, intimate plastic surgery is performed if there are other reasons.
- Renewal or improvement of the ability to experience sexual pleasure.
- The prolapse or prolapse of the walls of the vagina.
- Repeated vaginal prolapse after hysterectomy.
- Mechanical damage to the internal genital organ.
- Foreign body sensation.
- Constant pain in the lower abdomen and lower back.
Transsexuals undergo feminizing vaginoplasty in order to transform male genitalia into female.
Causes of vaginal prolapse
The main indication for anterior and posterior colporaphia 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 and is diagnosed only at the second or third stage at a reception by a gynecologist. Prolapse can be partial - displacement of the anterior or posterior wall beyond the female genitalia - or complete - exit of the entire muscular-elastic tubular organ from the vulva.
The main factor influencing the prolapse of the vagina is multiple births. There are other reasons.
- Failure to comply with the doctor's recommendations regarding the restoration of the body after childbirth.
- Increased abdominal pressure.
- The presence of neoplasms in the pelvis.
- Dramatic weight gain and weight loss.
- Dysplasia.
- Hemorrhoids.
In older women, vaginal prolapse is associated with age-related changes in elastic muscle tissue.
Contraindications for surgery
Features that impede the use of posterior, median and anterior colporaphia can be relative and unconditional.
Conditional.
- Age to 18 years. The ban applies only to intimate plastic aesthetic nature.
- The patient's refusal to use this surgical procedure.
The list of absolute contraindications is much wider.
- Thinning and extension of the pubocervical connective tissue membrane.
- Atrophy of the vesicovaginal fascia.
- Damage to the cervical epithelium.
- Urinary sphincter insufficiency.
- Venereal diseases.
- Benign tumors, tumors.
- Pregnancy (all trimesters).
- The presence or predisposition to the formation of keloid scars.
- Blood coagulation disorders.
- Diseases of all organs caused by pathogenic microorganisms.
- Uncompensated diabetes.
- Acute thrombosis.
- Pelvic bone deformities.
Features of preparation for colporaphia
If there are no contraindications, the gynecologist prescribes preoperative laboratory tests using various apparatuses and devices. In parallel, a woman must carry out certain simple preparatory measures.
- A few days before the operation of anterior colporaphia, 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 intimate plastic.
- On the eve of doing a cleansing enema.
- 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 is the front colporaphia
Intimate plastic surgery is performed under general anesthesia. On the front wall of the vagina, backing 1 cm from the opening of the urethra and to the front lip of the cervix, make a median longitudinal section. It is simple to perform, tissues are slightly injured, and bleeding is small. The vaginal mucosa is separated with a scalpel, removing the urethra and the bottom of the urethral bladder. Then perform a wide cutting of the fascia tissue and its separation from the wall of the bladder. Vertical sutures narrow the muscles of the urethra and the bottom section between the mouth of the ureters and the internal lumen of the urethral canal. The free edges of the flaps are sutured in a duplicate manner, overlapping each other. At the end, suturing of the mucosa of the external genitalia is performed, selecting tissue of the cervix to strengthen the bladder in the upper position.
If retroversion of the uterus is detected during surgical procedures, the technique of anterior colporaphia can be adjusted.
Complications
As practice shows, patients rarely have complications. They are associated mostly with failure to comply with medical prescriptions. The most common occurrence is seam divergence. Because of which, after colporaphia, the front 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 need to see a doctor.
Wound infection is virtually excluded due to antibiotic course postoperative therapy. However, if the pain does not go away, the vagina has acquired an uncharacteristic red tint, you should immediately inform the gynecologist about this.
Rehabilitation
The length of hospital stay depends on the complexity of the anterior colporaphia and the specifics of the postoperative process. Patients usually go home a few hours after surgery. Before leaving, the doctor gives several recommendations.
- Within 3 days, a woman should observe bed rest, getting out of bed should be rolling to one side.
- To avoid divergence of seams, it is not recommended to be in a sitting position for a week.
- Refusal of sex and sports for a month.
On the third day after the operation, antibacterial drugs are prescribed, it is necessary to complete the entire course.
Rehabilitation after anterior colporaphia, according to patients, is easy and fast. Unpleasant is only a little discomfort in the early days and the rejection of sex for a month.
Pregnancy after colporaphia
Vaginal correction does not have a negative effect on reproductive function. Moreover, many women after anterior colporaphia get more pleasure from intimacy and have sex more often. This, of course, increases the likelihood of conceiving a baby. In order to avoid an unwanted pregnancy, contraception must be taken into account.
After vaginoplasty, a woman can give birth naturally, provided that the fetus is not large. But when she will be registered for pregnancy, it is necessary to inform the gynecologist about the transferred intimate plastic.
Alternative methods
The technique of surgery for anterior colporaphia eliminates vaginal prolapse of the second and third degree. If a woman regularly visits a gynecologist and the omission is negligible, a laser vaginal tightening is used. The method relates to non-surgical vaginoplasty and is aimed at improving the viscoelastic properties of the muscles of the walls of the vagina by exposing them to a non-ablative laser beam.
Vaginal thread lifting - vaginal tightening by implantation of biodegradable threads into the walls of its channel. The long-term result is due to the creation of a natural connective tissue framework in the filament area.
Colporaphia 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.