Vaginoplasty & Tightening · Treatment

Posterior Colporrhaphy (Posterior Vaginal Wall Repair) in Seoul

Posterior colporrhaphy is the surgical repair of the back (posterior) wall of the vagina and the pelvic floor muscles beneath it. It treats a widened vagina, a rectocele and the laxity that follows childbirth or aging. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo performs it from the posterior fornix outward, peeling the mucosa to under 1 mm and closing it in two layers with your own tissue, with same-day discharge.

Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026

At a glance

Key facts

The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.

• Procedure time: 50 minutes to 1 hour
• Anesthesia: Sedation with long-acting local anesthesia, or local alone
• Hospital stay: None; discharge after urinating
• Back to work: Immediately or the next day
• Intercourse: After 7–8 weeks
• Materials: Own tissue and absorbable sutures only; no mesh
• Performed by: Dr. Yoon Ho-joo, MD, PhD, member of the Korean Society of Urogynecology

What is posterior colporrhaphy?

Posterior colporrhaphy is a textbook gynecologic operation that repairs the posterior vaginal wall, the wall that lies against the rectum, and brings the separated pelvic floor muscles back together beneath it. It is the standard treatment for a rectocele (the rectum bulging forward into the vagina) and is the surgical basis of what patients usually call vaginoplasty or vaginal tightening.

Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD, a member of the Korean Society of Urogynecology. Posterior colporrhaphy, in the modified form described below, is the clinic's core procedure. When the perineum is repaired at the same time the operation is called posterior colpoperineorrhaphy, which was the subject of Dr. Yoon's 2005 paper in the Korean Journal of Obstetrics and Gynecology.

Who is a good candidate?

• A widened or lax vagina after childbirth, with reduced friction and sensation
• A rectocele: a bulge at the back of the vagina, difficulty emptying the bowel, or needing to press on the perineum to pass stool
• A feeling of pressure or "falling out," especially late in the day
• Recurrent vaginitis or odor from secretions pooling in a wide, ladle-shaped canal
• Mild uterine descent found on examination, which can be corrected in the same operation
• Laxity that has not responded to pelvic floor exercises

Women whose main problem is at the front wall, such as a cystocele or severe stress incontinence, may need a different or additional procedure, and Dr. Yoon will say so. Our guide to what vaginoplasty repairs explains the anatomy.

Te Linde's Operative Gynecology advises that vaginal relaxation should be repaired, including minor cases, because untreated laxity tends to progress. A widened, shortened vagina offers less support to the uterus, and over the years the cervix descends further. Repairing the posterior wall while the uterus is still well supported is a smaller operation than treating established prolapse later.

How Somssi performs posterior colporrhaphy

Measurement and design

Before surgery, vaginal length, width and wall thickness are measured and the pelvic floor is assessed for contraction strength. In a lax vagina the posterior wall may be only 2 to 3 mm thick near the cervix, with the muscle layer thinned to 3 to 4 mm, which is why exercises alone often cannot restore tone. The area to be repaired is marked from the opening to the front of the cervix, usually 2, 3 or 4 cm wide.

Posterior vaginal dissection from the fornix

A retractor protects the anterior wall. Starting at the posterior fornix, the mucosa is peeled to under 1 mm thickness with ophthalmic micro-scissors rather than being cut away. Peeling keeps the underlying nerves and vessels intact and limits bleeding, and it treats the upper vagina that opening-first techniques leave untouched.

Hysteropexy and culdoplasty

If the uterus has descended, its supporting tissues are gathered and sutured so that it is lifted by roughly 2 to 4 cm, and the cul-de-sac behind the cervix is closed to support the upper vagina. The uterus is kept. This step is described in more detail under Uterine Prolapse Surgery.

Two-layer closure

The pelvic floor muscles on both sides are approximated toward the midline first. The peeled tissue is then folded with a primary fold suture and reinforced with a second fusiform (spindle-shaped) suture, working from the inside toward the opening. The posterior wall becomes about 2 to 3 cm thick and the inside takes on a ridged, washboard-like texture. The clinic calls this sequence Posterior Vaginal Dissection, or PVD.

Figure-8 pelvic floor reinforcement

At the vaginal opening the pubococcygeus muscles are reinforced in a figure-8 pattern so the entrance matches the canal. Where the perineum is short or scarred, a perineoplasty is added. Only absorbable sutures are used; no mesh or implants.

Anesthesia, duration and hospital stay

The operation takes about 50 minutes to 1 hour under sedation combined with a mixture of long-acting local anesthetics; local anesthesia alone is an option. A non-narcotic anti-inflammatory is injected at the end. You walk straight out of the operating room and are discharged once you have urinated.

Before surgery there is a short pre-operative assessment: a review of your medical history, medications and any previous reactions to anesthesia. Fast for 2 hours before your visit, wear loose clothing and remove nail polish, which can interfere with oxygen monitoring during sedation.

Recovery timeline

Keep stools soft during the first weeks; straining puts tension on a posterior repair. Follow-up treatments range from none to five depending on symptoms and can be arranged remotely for patients abroad.

Results and what to expect

A successful posterior colporrhaphy produces a narrower, thicker posterior wall, a stronger pelvic floor squeeze and relief of rectocele symptoms such as incomplete emptying. Because the repair restores the vagina's normal length and direction, it also reduces the chance of later prolapse; the textbook principle is that a shortened vagina is more likely to prolapse again, so length is preserved rather than sacrificed.

In the clinic's experience sensation and lubrication are maintained and often improve over five to six months as the thickened wall gains blood supply. Results vary, particularly with later childbirth and with tissue quality after menopause.

Dr. Yoon's 2005 study followed women after colpoperineoplasty and reported on their sexual function, and his later conference presentations at ISSWSH and SMSNA examined pelvic floor dysfunction and posterior colpoperineorrhaphy in larger groups. These are the clinic's own data, not a guarantee for any individual patient.

Risks and how we reduce them

Specific risks of posterior repair are injury to the rectum and to the peritoneal cul-de-sac, bleeding and hematoma. General risks include infection, wound separation, over- or under-correction, scarring, painful intercourse, altered sensation and recurrence. Cutting too deeply into the wall can reduce sensation and cause dryness, and over-narrowing the entrance can make intercourse painful; both are avoided by peeling rather than excising and by sizing the canal to the cervix.

The clinic reports that its micro-scissor peeling technique was developed specifically to protect the rectum, and that no foreign material is used, which removes the risk of mesh erosion or infection. Anesthesia risks are discussed individually before surgery.

Why international patients choose Somssi

Dr. Yoon has presented research on posterior colpoperineorrhaphy and pelvic floor function at ISSWSH, WAS, ESSM and SMSNA meetings and has operated since 2000. The clinic has been registered for foreign patients with the Ministry of Health and Welfare since 2011, offers English consultations and same-day discharge, and is 100 meters from Gangnam Station Exit 1. Visit our international patients page or contact us to begin.

Questions patients ask

Frequently asked questions

Short, honest answers. For anything personal, a consultation is the right place to ask.

See the full FAQ →

Is posterior colporrhaphy the same as vaginoplasty?

Posterior colporrhaphy is the surgical name for the repair of the back vaginal wall and pelvic floor; vaginoplasty and vaginal tightening are the everyday names for the same operation when it is done to restore tone. At Somssi the term also covers the added steps of uterine suspension and figure-8 reinforcement at the opening when they are needed.

Does posterior colporrhaphy fix a rectocele?

Yes. A rectocele is a weakness in the posterior wall that lets the rectum bulge into the vagina, causing a sense of fullness and difficulty emptying the bowel. Posterior colporrhaphy closes that defect by bringing the supporting tissue and pelvic floor muscles back together and thickening the wall. Symptoms of incomplete emptying usually improve once the bulge is corrected.

Why does the surgery start inside instead of at the opening?

Because the widest, thinnest part of a lax vagina is usually the upper canal near the cervix. Procedures that begin at the opening narrow the entrance but cannot reach that upper section, so the inside still feels wide. Starting at the posterior fornix and working outward lets the whole canal be treated and keeps the entrance and interior the same size.

Is mesh used in posterior colporrhaphy?

Not at Somssi. The repair uses your own tissue and absorbable sutures only. Synthetic mesh placed through the vagina has been associated with erosion, pain and infection and has been restricted by several regulators, including the US FDA for prolapse repair. Native tissue repair avoids those specific complications, although like any repair it can recur over time.

Can the uterus be kept?

In most cases, yes. Where the uterus has descended, a hysteropexy lifts and fixes it during the same operation. Hysterectomy is reserved for genuine uterine disease rather than used as a treatment for descent. The clinic's recent review of its prolapse patients found that most women chose uterus-preserving surgery when it was offered.

What should I avoid after a posterior repair?

Avoid constipation and straining, heavy lifting and vigorous lower-body exercise for six weeks, and intercourse for seven to eight weeks. Showering is fine from the first day; bathing, swimming and saunas wait six weeks. Take the prescribed medication for about five days and contact the clinic if you have fever, heavy bleeding or worsening pain.

Keep reading

Related treatments and guides

• Vaginoplasty (Vaginal Tightening Procedure) — the patient-facing overview of this operation
• What Does Vaginoplasty Actually Repair? — the anatomy behind the repair
• Is Vaginoplasty in Korea Safe? — risks of posterior repair and how they are managed
• How Long Does Vaginoplasty Recovery Take? — recovery after posterior repair
• Perineoplasty — the perineal step often combined with posterior repair
• Pelvic Organ Prolapse Repair — rectocele, cystocele and uterine descent
• Dr. Yoon Ho-joo — the surgeon's research on colpoperineorrhaphy

Sources and medical review

• Yoon H.J. Perineal plastic surgery (colpoperineoplasty) and female sexual function. Korean Journal of Obstetrics and Gynecology, vol. 48, no. 6, 2005.
• Te Linde's Operative Gynecology (textbook), posterior colporrhaphy and perineorrhaphy.
• International Urogynecological Association (IUGA) and International Continence Society (ICS), terminology and patient information on posterior compartment prolapse.
• US Food and Drug Administration, safety communications on transvaginal mesh for pelvic organ prolapse.

Next step

A consultation first. A decision only when you are ready.

Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.