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Ambulatory Procedure >>

Surgical Technique of Colpocleisis

Colpocleisis Figure: 1	Colpocleisis Figure: 2 Complete vaginal vault prolapse (direct view of the vaginal opening) - The vagina has fallen completely inside out.
Colpocleisis Figure: 3	Colpocleisis Figure: 4
Incision and removal of skin - skin is removed from the prolapse of expose the anterior fascia(pubocervical fascia) and posterior fascia) rectovaginal fascia. The fascia is identified because it is the supportive layer.	Suturing - the skin has been removed and the underlying strong tissue (pubocervical and rectovaginal fascia) are identified. The tissue is sewn together in a circular fashion (like the drawstrings on a purse).
Colpocleisis Figure: 5	Colpocleisis Figure: 6
Sewing the skin - after multiple circular sutures are placed and the prolapse is progressively reduced, the prolapse is completely reduced back into the patients vagina and pelvis. The kin edges from the original incision are then closed using suture.	Reducing the prolapse - the most protruding portion of the vagina is inverted (pushed in upon itself) and the last suture placed is tied. The suture holds the rest of the vagina from coming back out or prolapsing.
Colpocleisis Figure: 7

The completed procedure usually leaves the patients with a very shortened vagina... thus making the patient incapable of engaging in sexual intercourse. Dr. Miklos recommends this operation to patients who are no longer sexually active nor have plans for future sexual intercourse.

Perineoplasty

Having a baby may disrupt muscles that keep the opening of the vagina (vaginal introitus) narrow. The superficial transverse perineal muscle will often tear and retract. Patients often complain their vaginal introitus is "gaping" or sexual intercourse is not the same as it was prior to giving birth to her children.

In patients who have the above concerns or complaints and where the superficial transverse perineal muscles are no longer together, these patients are excellent candidates for perineoplasty. The goal of the perineoplasty surgery is to restore the normal structure of the external aspect of the vaginal opening in hope of addressing patients concerns mentioned above.