Female UrologyColpocleisis for Advanced Pelvic Organ Prolapse
Section snippets
Material and Methods
We performed an institutional review board–approved retrospective review of patients undergoing colpocleisis from 2001-2010. We documented patient demographics, presenting symptoms, preoperative urodynamic findings, concomitant procedures, complications, postoperative symptoms, and examination findings. Stress urinary incontinence (SUI) was objectively assessed at the surgeon's discretion by either urodynamics (UDS) or cough stress testing with the prolapse reduced.
Surgery was performed by 1 of
Results
Fifty-three patients were identified, with a mean office follow-up of 9.3 months (range 2-72). Demographics are listed in Table 1. All patients were POP-Q stage 3 or greater or Baden-Walker grade 3 or higher. No patients were sexually active. Of 19 patients with a recorded reason for sexual inactivity, 14 cited a deceased partner, 3 cited a partner with erectile dysfunction, and 2 cited strong religious beliefs.
Nine patients (17%) complained of urge urinary incontinence (UUI) preoperatively.
Comment
In our experience in a urologic setting, colpocleisis was safe and efficacious. Efficacy rates were high, with 91% reporting improvement on PGII, no recurrence of prolapse on examination, and no requirement of subsequent prolapse repairs. This is consistent with the prior literature,3, 4, 11 which reports success rates between 91% and 100% in follow-up periods of 2 weeks to 15 years. In our group, patients responding to the questionnaire reported a very low rate of prolapse symptoms on the
Conclusions
Colpocleisis is safe and efficacious. In our cohort there were few operative or postoperative complications. Patient satisfaction is high, with most patients reporting improved body appearance and sensation as well as improvement on PGII. Lower urinary tract symptomatology is frequently present in these patients and has significant risk of persistence after surgery. Lower urinary tract symptoms comprise the highest frequency of complaints after colpocleisis, and this must be included in patient
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Financial Disclosure: The authors declare that they have no relevant financial interests.