Colpocleisis is a procedure to close the vagina without removing the muscular wall. Although a few techniques have been described, our approach is the cauterize the inner lining (mucosa) of the vagina and place in a few helical or spiral sutures of absorbable material around a central drain bringing the cavity together. The drain is ultimately removed once adhesions are well formed.
This should be proceeded by a total hysterectomy, removal of the uterus and cuff of vagina (done by others). At that time your tubes and ovaries are also removed. Allow several months following bilateral salpingo oophorectomy with laparoscopically assisted hysterectomy before proceeding to colpocleisis. An advantage of the laparoscopic approach is minimization of any abdominal incision.
Vaginal closure will provide a floor for the scrotum and subsequent insertion of testicular implants. Also when the vagina is closed there is more support for healing at the base of the urethra. You will undoubtedly want urethral extension for a stand to void result. Closure of the vagina reduces (but does not completely preclude) the likelihood fistularizaiton or urinary leakage through small opening that has not healed.
Occasionally a patient may wish to preserve bisexual capabilities. Please give careful consideration and confer with your therapists and surgeons.
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