COLPORRHAPHY.pptx

COLOPORRAPHY

1. COLPORRHAPHY BY RAJAH AMINA SULEIMAN

2. 2 To function normally, the vagina must have adequate length, elasticity, a well- estrogenated lining, and rest upon a responsive levator muscle plate. Symptoms of vaginal relaxation may include a sense of pelvic heaviness, recognition by the patient of a bulge or protrusion from the vagina, urinary incontinence, and dyspareunia.  Colporrhaphy is carried out to repair the anterior or posterior vaginal walls. INTRODUCTION

3. 3 Colporrhaphy is a surgical procedure that repairs a defect in the wall of the vagina. It is the surgical intervention for both cystocele and rectocele. The repair may be to either or both of the anterior or posterior vaginal walls . The colporrhaphy procedure aims to effectively restore prolapsed organs back to their normal position and relieve symptoms such as urinary incontinence and pelvic pain. INTRODUCTION

4. 4 The colporrhaphy procedure repairs and strengthens the vaginal wall, which can then support the prolapsed organs. Prolapse symptoms, such as pain, particularly during sexual intercourse, pressure, stress incontinence, and frequent bladder infections, will normally subside after a colporrhaphy . INTRODUCTION

5. 5 Colporrhaphy is a surgical procedure to repair pelvic organ prolapse such as cystocele (prolapsed bladder) or rectocele (prolapsed rectum). Colporrhaphy , also known as vaginal wall repair, is a surgical procedure performed to correct defects in the vaginal wall, or pelvic-organ prolapse, including cystoceles and rectoceles. DEFINITION

6. 6 Colporrhaphy is a minimally invasive surgical procedure that repairs and strengthens the vaginal wall after a pelvic organ prolapse (POP). DEFINITION

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8. 8 Approximately one in 10 women will require surgery to repair pelvic organ prolapse at some point in their lives. INCIDENCE

9. 9 A cystocele, also known as a prolapsed bladder, occurs when the supportive tissue between the bladder and the vagina weakens, causing the bladder to fall or prolapse into the vagina. A rectocele occurs when the wall between the rectum and the vagina weakens, causing the rectum to push into the vagina. INDICATION

10. 10 Anterior colporrhaphy (also known as anterior vaginal repair) treats prolapses that affect the front wall of the vagina, such as cystocele (prolapsed bladder). Posterior colporrhaphy (also known as posterior vaginal repair) addresses issues affecting the back wall of the vagina, such as rectocele (prolapse of the rectum). TYPES OF COLPORRHAPHY

11. 11 There are two ways of performing a colporrhaphy . The anterior colporrhaphy is performed to repair an abnormality the front of the vaginal wall, such as a cystocele or urethrocele . The posterior colporrhaphy repairs problems in the back of the vaginal wall or rectum, including rectoceles. THE COLPORRHAPHY PROCEDURE

12. 12 The procedure can be performed under regional or general anaesthesia. Anterior vaginal repair: A speculum is inserted into the vagina to hold it open. Midline incision to the vagina overlying the bladder and urethra. Dissection in a plane directly below the vagina and lateral of the bladder allows the damaged fascia supporting the bladder to be exposed. The fascia is plicated in the midline using sutures. Permanent mesh reinforces the repair and is anchored through the obturator foramen and exits through small incisions at both sides of the upper inner thigh. The vaginal skin is closed. PROCEDURE

13. 13 Posterior and vault repair: A speculum is inserted into the vagina to hold it open . An incision is made to the posterior wall of the vagina. Dissection below the vagina identifies the rectovaginal fascia and opens the space between the rectum and the pelvic floor muscle to the sacrospinous ligaments. Defects in the fascia are corrected by centrally plicating the fascia using sutures. Permanent mesh reinforces the repair and is anchored bilaterally to the pelvic side wall and exits through a small incision approximately 3cm lateral and down from the anus. The vaginal skin is then closed. PROCEDURE

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17. 17 The patient can expect to stay in hospital between 3-6 days. The vaginal pack is removed on the first day and the bladder catheter after the first few days. In the early postoperative period, the patient should avoid situations where excessive pressure is placed on the repair i.e lifting, straining, coughing and constipation.  P atients are able to fully return to their normal activities upon healing, including sexual intercourse after 6 weeks. NURSING MANAGEMENT

18. 18 Success rate of the surgery is about 85 – 90%. Serious complications are rare with this type of surgery. PROGNOSIS

19. 19 Recurrent prolapse . Mesh erosion Infection. Urinary tract infection. Urinary Incontinence Difficulties passing urine Inadvertent damage to bladder, urethra, bowel or Fistula Hemorrhage Clots can form in the legs or lungs after surgery Ongoing vaginal pain and/or persistent pain during intercourse COMPLICATIONS

20. Thank You for listening