Colpotomy Health Article

Definition

A colpotomy, also known as a vaginotomy, is a procedure by which an incision is made in the vagina.

Purpose

A colpotomy is performed either to visualize pelvic structures or to perform surgery on the fallopian tubes or ovaries.

Role of colpotomy in gynecologic surgery

Several gynecologic surgery protocols require a colpotomy as part of the overall surgical procedure. It is performed whenever the surgeon needs to access the vagina. Several of these surgeries include:

• Tubal sterilization. Sterilization is a procedure that can be performed using either abdominal or vaginal procedures. When a vaginal procedure is selected by the surgeon, he performs a colpotomy and may also insert a culdoscope to locate the tubes (culdoscopy), and close them off.
• Removal of myomas. Myomas are fibroid tumors of the muscle tissue of the uterus and they are sometimes removed vaginally by colpotomy.
• Removal of pelvic cysts and masses. In one treatment variant, patients may undergo a laparoscopy followed by a colpotomy for the vaginal extraction of the pelvic cyst or mass.
• Hysterectomy. One technique used to surgically remove the uterus combines three steps, an initial laparoscopic stage, followed by a vaginal stage, and a final laparoscopic stage. The colpotomy is performed during the second step to deliver the uterus into the vagina.
• Dysmenorrhea. Separation of the uterosacral ligaments via colpotomy is an approach that has been used for the relief of dysmenorrhea (painful menstruation).
• Complications in pregnancy and childbirth. Colpotomy may be used in the management of difficult pregnancies and childbirths.

Demographics

According to Professor V. Base-Smith at the University of Cincinnati College of Nursing, removal of the uterus is the second most commonly performed surgical procedure in the United States after cesarean delivery. Analysis of the demographics show that:

• 650,000 hysterectomies are performed annually, expected to reach approximately 834,000 by 2005.
• 6.1–8.6 per 1,000 women undergo hysterectomy per year.
• In the United States, the Northeast has the lowest hysterectomy rate, while the South has the highest rate.
• African-American women experience hysterectomy more frequently than European-American women.

The ratio of abdominal to vaginally performed hysterectomies is 3:1, meaning that colpotomy is performed in one out of four hysterectomy procedures.

Female sterilization is a common contraception method. About 20,000 female sterilizations are carried out each year in Canada and nearly 10% of North American women 30 years or older have been sterilized in a procedure that involved colpotomy.