Name of the Procedure:

Colpocleisis (Le Fort type)

Summary

Colpocleisis (Le Fort type) is a surgical procedure performed to treat pelvic organ prolapse. It involves closing off the vaginal canal to provide support to the prolapsed organs. This procedure is typically considered for elderly women who are no longer sexually active.

Purpose

Colpocleisis aims to relieve symptoms of pelvic organ prolapse, such as pressure, discomfort, and urinary incontinence. The goal is to improve quality of life by stabilizing the position of pelvic organs like the bladder, uterus, and rectum.

Indications

• Severe pelvic organ prolapse
• Symptoms impacting daily activities and quality of life
• Older age and no desire for sexual activity
• High surgical risk preventing more extensive prolapse repair

Preparation

• Fasting for at least 8 hours prior to surgery
• Stopping blood thinners or anticoagulant medications as advised
• Undergoing pre-operative assessments, such as blood tests and EKG

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Vaginal Canal Preparation: The surgeon makes incisions on the anterior (front) and posterior (back) walls of the vagina.
3. Closure: The walls of the vagina are then sutured together, closing off the vaginal canal effectively.
4. Final Steps: Any excess tissue is removed, and the remaining sutures are closed.

Special surgical instruments such as retractors, surgical scissors, and sutures are used. The procedure usually requires general or regional anesthesia.

Duration

The procedure typically takes about 1-2 hours.

Setting

Colpocleisis is performed in a hospital operating room.

Personnel

• Surgeon (gynecologist or urogynecologist)
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding organs (bladder, rectum)
• Anesthesia-related risks
• Blood clots
• Rarely, fistula formation (an abnormal connection between organs)

Benefits

• Immediate relief from prolapse symptoms
• Improved quality of life
• Lower surgical risk compared to more extensive procedures

Recovery

• Hospital stay for 1-2 days post-surgery
• Pain management with prescribed medications
• Avoid strenuous activities and heavy lifting for approximately 4-6 weeks
• Follow-up appointments to monitor healing and manage any complications

Alternatives

• Pelvic floor exercises
• Pessary (a device inserted into the vagina to support the organs)
• More extensive reconstructive surgery
• Pros: Non-surgical options involve less risk; reconstructive surgery preserves vaginal canal
• Cons: Non-surgical options may be less effective; reconstructive surgery involves more recovery time and higher surgical risk

Patient Experience

• During Procedure: The patient will be under anesthesia and will not feel any pain.
• After Procedure: There may be mild to moderate pain managed by medications. Discomfort and swelling are common initially.
• Pain Management: Pain relief medication and comfort measures such as ice packs and gentle movements.

By and large, patients can expect significant relief from prolapse symptoms and improvement in their day-to-day comfort post-recovery.