Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach
CPT4 code
Name of the Procedure:
Trachelorrhaphy
Common name(s): Cervical Repair, Cervicorrhaphy
Summary
Trachelorrhaphy is a surgical procedure performed vaginally to repair damage or defects in the uterine cervix. This procedure is often indicated after childbirth injuries, cervical tears, or other traumas to the cervix.
Purpose
The primary purpose of trachelorrhaphy is to repair and reconstruct the cervical tissue to ensure proper functioning and prevent future complications:
- Addresses cervical lacerations, tears, or deformations.
- Aims to restore the normal anatomical structure and function of the cervix.
- Expected to prevent complications like infection, excessive bleeding, or infertility.
Indications
- Cervical tears or lacerations resulting from childbirth or trauma.
- Structural abnormalities of the cervix.
- Repeated infections or inflammation of the cervix.
- Excessive bleeding or discharge related to cervical defects.
- Patients who have not had success with less invasive treatments.
Preparation
- Patients may be instructed to fast for 8-12 hours before the procedure.
- Adjustments to certain medications, particularly blood thinners, may be required.
- Pre-procedure diagnostic tests may include pelvic exams, Pap smears, or cervical imaging studies.
- Anesthesia assessment and routine blood tests will be conducted.
Procedure Description
- The patient is placed in a lithotomy position (lying on the back with legs supported).
- Anesthesia (usually regional or general) is administered.
- The surgeon uses specialized instruments to visualize the cervix via the vaginal route.
- Damaged or torn areas of the cervix are carefully trimmed and cleaned.
- Surgical sutures (stitches) are then used to close and repair the cervical tissue.
- The procedure ends with a final assessment to ensure proper repair and hemostasis (control of bleeding).
Duration
Typically, trachelorrhaphy takes around 1 to 2 hours.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Obstetrician-gynecologist (OB-GYN) surgeon
- Nurses or surgical assistants
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Infection
- Bleeding
- Reaction to anesthesia
- Scar tissue formation
- Cervical stenosis (narrowing)
- In rare cases, fertility issues
Benefits
- Restores the integrity and functionality of the cervix.
- Reduces the risk of infection, bleeding, and other complications.
- Can improve reproductive health and outcomes.
- Most patients experience symptomatic relief shortly after recovery.
Recovery
- Post-procedure instructions may include avoiding strenuous activity and sexual intercourse for a recommended period.
- Pain management typically involves prescribed pain relievers.
- Patients are usually advised to follow up with their OB-GYN for assessment of healing.
- Recovery time can vary, generally ranging from a few days to a few weeks.
Alternatives
- Nonsurgical treatments such as medications for minor cervical issues.
- Less invasive surgical options may be considered based on the extent of the damage.
- Each alternative has different success rates and risks, making consultation with a healthcare provider critical for informed decision-making.
Patient Experience
- During the procedure, patients will be under anesthesia and should not feel pain.
- After the procedure, mild to moderate discomfort is common, which can be managed through pain relief medications.
- Patients may experience some spotting or discharge, which should subside in a few days.
- Recovery instructions focus on minimizing discomfort and ensuring proper healing, with restrictions on activities to prevent complications.