As the table shows the predominant method of surgical treatment of genital prolapse in women of reproductive age is a front and back colpoperineorrhaphy. Restoration of the pelvic floor was performed in all women using their own tissues.
% Front colporraphy, back colpoperineorrhaphy with 40 50 levatoroplastics and sterilization by Pomeroy transvaginal access Hysterotrachelectomy with transfer the vaults and 10 12.5 sterilization by Pomeroy transvaginal access Front colporraphy, back colpoperineorrhaphy with 30 37.5 levatoroplastics + minilaparotomy sterilization by Pomeroy Total 80 100 TABLE 3.
Some surgical procedures such as posterior colpoperineorrhaphy, colpoperineoplasty, or perineorrhaphy can be useful to solve this problem 6].
In a retrospective observational study to assess the effect of fascial posterior colpoperineorrhaphy over the five-year period, results showed that vaginal pain, dyspareunia, and vaginal laxity were all significantly reduced; however, there was no significant difference in sexual activity .
After colpoperineorrhaphy, dyspareunia may happen due to the narrowing of the vagina .
In a study by Robinson et al., in which 34 women underwent posterior colpoperineorrhaphy and followed 41 months, the results showed that vaginal pain, dyspareunia, and vaginal laxity were all significantly reduced .
Balmforth, "Fascial posterior colpoperineorrhaphy : a five year follow-up study," Journal of Pelvic Medicine and Surgery, vol.
has been the major cause of vaginal stenosis after prolapse repair.
Depending on the aggressiveness of the repair, approximately 15% of patients may experience some discomfort with intercourse after a colpoperineorrhaphy. Not plicating the levators can decrease but not totally alleviate this risk (Obstet.
Often, at the end of a long reconstructive case, the relative importance of a good colpoperineorrhaphy can be hard to appreciate.
Techniques to avoid vaginal shortening and constriction during vaginal reconstructive surgery include appropriate use of levatorplasty during posterior colpoperineorrhaphy
. Although levatorplasty is, at times, the only way to decrease the size of a large vaginal hiatus, it should be used only in the distal third of the vagina.
For reference, a full description of the normal vaginal axis and its vital role in good pelvic support can be found in my chapter on colpoperineorrhaphy
in the ninth edition of TeLinde's Operative Gynecology (Philadelphia: Lippincott Williams & Wilkins, 2003, p.