Atrium Health Navicent Women's Care Urogynecology & Pelvic Surgery

Posterior colporrhaphy

What is a posterior colporrhaphy?

Middle aged woman standing and smiling with her arms crossedA posterior colporrhaphy is a vaginal procedure commonly performed to correct a rectocele or herniation of the rectum into the vagina. While it can be performed alone, it is often combined with additional prolapse procedures in order to correct all the areas of prolapse in the vagina.

A rectocele occurs when the fibromuscular layer or support layer between the rectum and vagina is weakened from heavy lifting, vaginal delivery, age, or diseases that affect the connective tissue. When a rectocele forms, women can feel pressure or bulge symptoms in their vagina, and occasionally it can also affect they have a bowel movement.

How is the procedure performed?

Posterior colporrhaphy is performed through the vagina by making an incision in the posterior wall of the vagina in order to identify the weaknesses in the fibromuscular layer. When those weaknesses are identified, sutures are placed to strengthen the fibromuscular layer of the vagina that separates the rectum and vagina. A perineorrhaphy (reconstruction of the perineal body) is typically performed at the same time and further helps to support the posterior vaginal wall. Excess vaginal skin can be removed and then incision is closed with absorbable sutures.

What to Expect?

Middle aged woman standing and smiling with her arms crossedAfter 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 30 minutes to perform. If performed by itself, it is an outpatient procedure and does not require an overnight stay. However, it is often performed with other types of prolapse surgeries to address all the areas of prolapse. If it is performed with other procedures, you may require an overnight stay and be discharged the following day.

What is my recovery time?

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 sexual intercourse for 6 weeks
  • No driving while on narcotic pain medications

What are the risks of the procedure?

Complications from a posterior colporrhaphy 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 an anterior colporrhaphy, some specific risks include the following:

  • 5-10% risk of postoperative urinary tract infection

Will my insurance company cover the procedure?

Most insurance policies will cover posterior colporrhaphy. 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.