Atrium Health Navicent Women's Care Urogynecology & Pelvic Surgery

Colpocleisis / Total Vaginectomy

What is a colpocleisis or total vaginectomy?

Elderly woman standing and smiling with her arms crossedColpocleisis is a vaginal procedure that is classified as an obliterative procedure. This means that after undergoing the procedure, a woman no longer has a functional vagina. Therefore patients who are considering this procedure must fulfill two criteria:

  • Not currently or have future plans for penetrative intercourse
  • Understand that this is a permanent procedure

It is a highly effective treatment option (90-95%) for women who choose to undergo this prolapse procedure. Furthermore, it is safe procedure that can be performed in a short amount of time, making it an excellent procedure for patients who have additional medical comorbidities.

How is the procedure performed?

Colpocleisis or total vaginectomy can be performed in women who develop prolapse after having undergone a prior hysterectomy or can be performed in conjunction with a hysterectomy. It involves removing the vaginal epithelium (lining of the vagina) with subsequent closure of the vagina. Permanent sutures are used to to place sequential purse-string stitches that ultimately reduce the vaginal prolapse. In the case of a woman with a uterus, it is performed after completion of a vaginal hysterectomy.

What to Expect?

Elderly woman smilingAfter initial consultation with Dr. Kow, you may be asked to undergo some bladder testing (urodynamics) prior to surgery. Prior to surgery, you will need to attend a preoperative visit with Dr. Kow and draw some basic lab work. Should you need surgical clearance, you will be asked to obtain this prior to surgery.

The surgical procedure takes approximately 1 hour to perform when performed with additional procedures to correct a cystocele or rectocele. You will be under general anesthesia during the procedure.

What is my recovery time?

Typical recovery time is one overnight stay at the hospital. While pain tolerance is variable among patients, most patients report minimal pain after a colpocleisis. Overall recovery time includes six weeks with some activity restrictions, however patients are often able to return to a normal routine shortly after surgery. Restrictions including the following:

  • No heavy lifting of more than 10 lbs for 6 weeks
  • No tub baths for 6 weeks
  • No driving while on narcotic pain medications

What are the risks of the procedure?

Complications from a colpocleisis are typically very low. However with every procedure there always some risks including anesthesia problems, postoperative pain, intraoperative bleeding, infection, blood clots and damage to adjacent organs. With regards to the colpocleisis, some specific risks include the following:

  • 5-10% risk of postoperative urinary tract infection
  • Feelings of regret

Will my insurance company cover the procedure?

Most insurance policies will cover colpocleisis. Our office will help you with obtaining prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier to determine the details regarding your coverage.