Conservative coloprotectomy for the sexually active woman

The procedure described herein, capitalizes on a knowledge of the relationships between the pelvic viscera, its autonomic innervation and its tissue support. Operative time is shorter, not only because of the presence of a simultaneous second surgical team, but also because the improved exposure and use of bloodless planes facilitates dissection and reduces blood loss. The careful treatment of the cul-de-sac peritoneum helps protect the autonomic innervation of the pelvis, preserving the function of the bladder and sexual response. Preserving the perineal body and obliterating the dead space behind the posterior vaginal wall with the levator ani muscle provides a muscular cushion for the vagina, preserving maximum coital function. For the woman who is sexually active, these are important goals. Her improved sense of well-being following successful surgical therapy of the disease will result in increasing libido, and her successful adaptation to her new condition will be influenced favorably by her ability to function sexually.