Colpoclesis (Le Fort Technique)-Treat Vaginal Vault Prolapse

Colpoclesis (Le Fort Technique)-Treat Vaginal Vault Prolapse

Colpocleisis (Le Fort Technique) is a surgery to correct Vaginal Vault Prolapses. This is when the pelvic organ has (“fallen womb, bladder”, etc.) for women who do not desire future vaginal intercourse and/or are in poor general health.
For older women who are no longer sexually active, a simple procedure for reducing prolapse is a partial colpocleisis. The procedure was described by the  ‘Le Fort’ Technique and involves the removal of a strip of the anterior and posterior vaginal wall, with closure of the margins of the anterior and posterior wall to each other. This procedure may be performed whether or not the uterus and cervix are present. When it is completed, a small vaginal canal exists on either side of the septum, produced by the suturing of the lateral margins of the excision.

FAQS

Frequently asked questions about surgical procedures

What’s not included:

• Lab testing before and after the surgery, as needed
• Electrocardiogram (EKG), depending on age. If you had one elsewhere in the past 6 months and it read “normal”, we can forego this expense.
• Imaging costs. X-rays and MRIs can be obtained anywhere.
• Physical therapy services
• Medications you’ll need (oral or IV antibiotic infusions if an infection arises)
• Wound care
• Bracing supplies
• Additional doctor visits (a pre-operative visit with the surgeon, in person, and any required post-op follow-ups after the suture removal to monitor your progress
• Additional surgical intervention if a complication arises
• Additional imaging or hospital care if a blood clot develops

Before the Procedure

If you have any medical problems, make sure that you are cleared for surgery (medicine or anesthesia). Make sure you have all the necessary lab work, EKG, or chest x-rays done at least 3 days before surgery.
Make sure your physician knows what medications, including herbal supplements, you are currently taking. Some Medications need to be stopped for some time before the procedure. Women seeking care for pelvic floor symptoms should undergo a thorough evaluation before having surgery. Those with pelvic organ prolapse may have coexisting pelvic floor disorders that may include defecatory dysfunction or urinary symptoms such as stress incontinence. Patients must therefore be questioned about any associated bothersome urinary or bowel symptoms because this may affect surgical planning.
In addition, a thorough physical examination should be conducted. Typically, a speculum and bimanual examination are performed.

Before the Procedure

If you have any medical problems, make sure that you are cleared for surgery (medicine or anesthesia). Make sure you have all the necessary lab work, EKG, or chest x-rays done at least 3 days before surgery.
Make sure your physician knows what medications, including herbal supplements, you are currently taking. Some Medications need to be stopped for some time before the procedure. Women seeking care for pelvic floor symptoms should undergo a thorough evaluation before having surgery. Those with pelvic organ prolapse may have coexisting pelvic floor disorders that may include defecatory dysfunction or urinary symptoms such as stress incontinence. Patients must therefore be questioned about any associated bothersome urinary or bowel symptoms because this may affect surgical planning.
In addition, a thorough physical examination should be conducted. Typically, a speculum and bimanual examination are performed.

Colpoclesis (Le Fort Technique) Surgical Procedure

The surgery is performed by making an opening in the vagina, and the tissue layer under the vaginal skin is reinforced with strong sutures in order to “fix the bulge”. The vaginal opening is also narrowed. The stitches will dissolve over a period of
Few months, and will not need to be removed.

Recovery for the Colpoclesis (Le Fort Technique)

This procedure requires only an overnight stay in the hospital; Patients typically stay within the hospital for 23-hour observation and are discharged on postoperative day 1. Prior to discharge, a voiding trial is performed.
For patients with preoperative urinary retention, the authors use a suprapubic catheter. Those going home with a catheter are given antibiotics to prevent infection and are seen in the office within 5-6 days for catheter removal and subsequent bladder challenge. Pain control is usually accomplished with oral medications. Patients are discharged home with ibuprofen and acetaminophen, with hydrocodone.
A follow-up postoperative visit is scheduled at 2 weeks. At this time, uterine pathology is reviewed if the patient had concomitant cervical dilation and curettage. A postvoid residual is also assessed to evaluate for urinary retention. Patients then have subsequent visits at 6 weeks, 3 months, and 1 year, and as needed thereafter.

Risks

As with any surgery, there are risks; however, this procedure carries the lowest risk of complications than any other for prolapse. What are the possible risks from this surgery?

• Bleeding
• Infection
• Damage to the bowel
• Difficulty with bowel movements
• Failure of the surgery
• Rare risks include:
• Blood clot in the legs or lungs
• Complications from anesthesia

How are follow-up and initial consultations handled?

In-person and telehealth consultations are possible with the surgeon to whom your case is assigned. The initial visit is included in the surgical package and is valued at $375.
We can also obtain the flights from the volunteer pilot nonprofit if you’d like to come for initial and follow-up visits in person. One follow-up visit is included in the surgical package at a value of $175. Any additional visits are charged at the time of service to your credit or debit card.