Posterior Colporrhaphy in Israel

Doctor Ran Keidar

Gynecologist, Reproductive Specialist

In what cases is posterior colporrhaphy performed?

The surgery for reconstructing the posterior wall of the vagina (posterior colporrhaphy, POSTERIOR COLPORRHAPHY / POSTERIOR VAGINAL WALL REPAIR) is performed to correct the prolapse of the rectum into the back part of the vagina (rectocele, RECTOCELE).

Due to the weakening of the posterior wall of the vagina, it bulges into the vagina, and during straining (for example, during chronic coughing), the rectocele protrudes backward, sometimes so much that it interferes with the emptying of the rectum. Among the main symptoms of rectocele are pain during sexual intercourse and back pain.

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Typically, rectocele occurs after multiple childbirths, but it can appear many years after childbirth under the influence of additional factors such as:

• hormonal changes
• constant increased pressure within the abdominal cavity, for example, during chronic diarrhea or as a result of lifting heavy weights

Prolapse of the vaginal walls or other pelvic organs is a problem most common among women who are overweight and do not engage in exercises that strengthen the pelvic floor muscles. Such exercises can be part of physiotherapy to strengthen the pelvic floor in cases of mild prolapse. An additional method is the insertion of a special ring into the vagina. In cases of more serious prolapse of the vaginal walls, appropriate surgery is performed.

Posterior Colporrhaphy: The Course of the Surgery

Posterior colporrhaphy is performed under general or local anesthesia (epidural or spinal injection).

• a cut is made in the posterior wall of the vagina
• excess vaginal mucosa is removed
• the rectum is returned to its natural position
• stitches made of self-dissolving materials are applied to the muscles of the posterior wall of the vagina
• the incision is closed

After the surgery, hospitalization is required for one to two days; sometimes a catheter is inserted into the bladder to facilitate urination. It is recommended to refrain from physical strain on the abdominal muscles for the next 6 weeks after the surgery.