Skip to main content
Erschienen in: International Urogynecology Journal 4/2021

29.06.2020 | Original Article

Long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse

verfasst von: Yi-ting Wang, Kun Zhang, Hui-fang Wang, Jun-fang Yang, Yao Ying, Jin-song Han

Erschienen in: International Urogynecology Journal | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

The objective was to investigate the long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse.

Methods

This was a retrospective study of patients who underwent Le Fort colpocleisis from January 2007 to August 2018 in our hospital. Follow-up was conducted via outpatient visits or the telephone. Records were reviewed for anatomical recurrence, complications, urinary and intestinal symptoms post-operation, reoperation rate, patient satisfaction, Patient Global Impression of Improvement (PGI-I) score, regret rate etc.

Results

A total of 208 patients underwent follow-up. The follow-up time was 60.7 ± 34.18 (12–140) months. There were no intraoperative complications. Postoperative urinary retention occurred in 3.8% of patients (8 out of 208). There was no anatomical recurrence. New or more severe urinary symptoms occurred in 8.7% of patients (18 out of 208); new or more severe intestinal symptoms occurred in 1.9% of patients (4 out of 208). The reoperation rate was 1.44% (3 out of 208). Three cases of reoperation occurred for the following reasons: a case of severe stress urinary incontinence, a case of abscess in the vaginal septum, and a case of uterine malignancy after 2 years of colpocleisis. Patient satisfaction was as follows: 98.6% (205 out of 208) of patients were very satisfied. The PGI-I score was very much improved or improved in 99.5% (207 out of 208) of patients. A total of 0.96% (2 out of 208) of patients regretted undergoing colpocleisis.

Conclusions

The long-term follow-up results showed that Le Fort colpocleisis was a safe and effective surgical procedure associated with high satisfaction. There was a very low regret rate, but the procedure should be taken seriously.
Literatur
1.
Zurück zum Zitat Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6.CrossRef Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6.CrossRef
2.
Zurück zum Zitat Stepp KJ, Barber MD, Yoo E-H, et al. Incidence of perioperative complications of urogynecological surgery in elderly women. Am J Obstet Gynecol. 2005;192(5):1630–6.CrossRef Stepp KJ, Barber MD, Yoo E-H, et al. Incidence of perioperative complications of urogynecological surgery in elderly women. Am J Obstet Gynecol. 2005;192(5):1630–6.CrossRef
3.
Zurück zum Zitat LeFort L. Nouveau procédé pour la guérison du prolapsus utérin. Bull Gen Ther. 1877;92:237. LeFort L. Nouveau procédé pour la guérison du prolapsus utérin. Bull Gen Ther. 1877;92:237.
4.
Zurück zum Zitat Zebede S, Smith AL, Plowright LN, et al. Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol. 2013;121(2):279–84.CrossRef Zebede S, Smith AL, Plowright LN, et al. Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol. 2013;121(2):279–84.CrossRef
5.
Zurück zum Zitat Wang X, Hua K. Pelvic symptoms, body image, and regret after LeFort colpocleisis: a long-term follow-up. J Minima Invasive Gynecol. 2017;24(3):415–9.CrossRef Wang X, Hua K. Pelvic symptoms, body image, and regret after LeFort colpocleisis: a long-term follow-up. J Minima Invasive Gynecol. 2017;24(3):415–9.CrossRef
6.
Zurück zum Zitat Walters MD, Karram MM. Urogynecology and reconstructive pelvic surgery. Philadelphia: Elsevier Saunders;1999. Walters MD, Karram MM. Urogynecology and reconstructive pelvic surgery. Philadelphia: Elsevier Saunders;1999.
7.
Zurück zum Zitat Toozs-Hobson P, Freeman R, Barber M, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Int Urogynecol J. 2012;23(5):527–35.CrossRef Toozs-Hobson P, Freeman R, Barber M, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Int Urogynecol J. 2012;23(5):527–35.CrossRef
8.
Zurück zum Zitat Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21:523–8.CrossRef Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement (PGI-I) for urogenital prolapse. Int Urogynecol J. 2010;21:523–8.CrossRef
9.
Zurück zum Zitat Sung VW, Weitzen S, Sokol ER et al. Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol 2006;194(5):1411–1417.CrossRef Sung VW, Weitzen S, Sokol ER et al. Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol 2006;194(5):1411–1417.CrossRef
10.
Zurück zum Zitat Park JY, Han SJ, Kim JH, et al. Le Fort partial colpocleisis as an effective treatment option for advanced apical prolapse in elderly women. Taiwan J Obstet Gynecol. 2019;58(2):206–11.CrossRef Park JY, Han SJ, Kim JH, et al. Le Fort partial colpocleisis as an effective treatment option for advanced apical prolapse in elderly women. Taiwan J Obstet Gynecol. 2019;58(2):206–11.CrossRef
11.
Zurück zum Zitat Kyoung M, Cho JHM, Kim CH. Factors associated with recurrence after colpocleisis for pelvic organ prolapse in elderly women. Int J Surg. 2017;44:274–7.CrossRef Kyoung M, Cho JHM, Kim CH. Factors associated with recurrence after colpocleisis for pelvic organ prolapse in elderly women. Int J Surg. 2017;44:274–7.CrossRef
12.
Zurück zum Zitat Vij M, Bombieri L, Dua A, et al. Long-term follow-up after colpocleisis: regret, bowel, and bladder function. Int Urogynecol J. 2014;25(6):811–5.CrossRef Vij M, Bombieri L, Dua A, et al. Long-term follow-up after colpocleisis: regret, bowel, and bladder function. Int Urogynecol J. 2014;25(6):811–5.CrossRef
13.
Zurück zum Zitat Katsara A, Wight E, Heinzelmann-Schwarz V, Kavvadias T. Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis. Arch Gynecol Obstet. 2016;294(5):999–1003.CrossRef Katsara A, Wight E, Heinzelmann-Schwarz V, Kavvadias T. Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis. Arch Gynecol Obstet. 2016;294(5):999–1003.CrossRef
14.
Zurück zum Zitat Jones K, Wang G, Romano R, et al. Colpocleisis: a survey of current practice patterns. Female Pelvic Med Reconstr Surg. 2017;23(4):276–80.CrossRef Jones K, Wang G, Romano R, et al. Colpocleisis: a survey of current practice patterns. Female Pelvic Med Reconstr Surg. 2017;23(4):276–80.CrossRef
15.
Zurück zum Zitat Song X, Zhu L, Ding J, et al. Long-term follow-up after Le Fort colpocleisis: patient satisfaction, regret rate, and pelvic symptoms. Menopause. 2016;23(6):621–5.CrossRef Song X, Zhu L, Ding J, et al. Long-term follow-up after Le Fort colpocleisis: patient satisfaction, regret rate, and pelvic symptoms. Menopause. 2016;23(6):621–5.CrossRef
16.
Zurück zum Zitat Bochenska K, Leader-Cramer A, Mueller M, et al. Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy. Int Urogynecol J. 2017;28(11):1671–5.CrossRef Bochenska K, Leader-Cramer A, Mueller M, et al. Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy. Int Urogynecol J. 2017;28(11):1671–5.CrossRef
17.
Zurück zum Zitat Von Pechmann WS, Mutone M, Fyffe J, et al. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2003;189(1):121–6.CrossRef Von Pechmann WS, Mutone M, Fyffe J, et al. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2003;189(1):121–6.CrossRef
18.
Zurück zum Zitat Frick AC, Walters MD, Larkin KS, et al. Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapse. Am J Obstet Gynecol. 2010;202(5):507.e1–4.CrossRef Frick AC, Walters MD, Larkin KS, et al. Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapse. Am J Obstet Gynecol. 2010;202(5):507.e1–4.CrossRef
19.
Zurück zum Zitat Elkattah R, Brooks A, Huffaker RK. Gynecologic malignancies post-LeFort colpocleisis. Case Rep Obstet Gynecol. 2014;2014:846745.PubMedPubMedCentral Elkattah R, Brooks A, Huffaker RK. Gynecologic malignancies post-LeFort colpocleisis. Case Rep Obstet Gynecol. 2014;2014:846745.PubMedPubMedCentral
20.
Zurück zum Zitat Keisha A, Jones Y, Senay Solak OH. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016;27(5):805–10.CrossRef Keisha A, Jones Y, Senay Solak OH. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016;27(5):805–10.CrossRef
22.
Zurück zum Zitat Rui J, Xiuli S, Guijun Z, et al. Comparison of perioperative conditions between total and partial colpocleisis for elderly patients. Zhonghua Fu Chan Ke Za Zhi. 2019;54(1):33–7. Rui J, Xiuli S, Guijun Z, et al. Comparison of perioperative conditions between total and partial colpocleisis for elderly patients. Zhonghua Fu Chan Ke Za Zhi. 2019;54(1):33–7.
23.
Zurück zum Zitat Jameel S, Khaja A. A service evaluation of the colpocleisis procedure at the heart of England NHS Foundation Trust. BJOG. 2018;125(special S1):173–4. Jameel S, Khaja A. A service evaluation of the colpocleisis procedure at the heart of England NHS Foundation Trust. BJOG. 2018;125(special S1):173–4.
24.
Zurück zum Zitat FitzGerald MP, Brubaker L. Colpocleisis and urinary incontinence. Am J Obstet Gynecol. 2003;189:1241–4.CrossRef FitzGerald MP, Brubaker L. Colpocleisis and urinary incontinence. Am J Obstet Gynecol. 2003;189:1241–4.CrossRef
25.
Zurück zum Zitat Ng S-C, Chen G-D. Obliterative LeFort colpocleisis for pelvic organ prolapse in elderly women aged 70 years and over. Taiwan J Obstet Gynecol. 2016;55(1):68–71.CrossRef Ng S-C, Chen G-D. Obliterative LeFort colpocleisis for pelvic organ prolapse in elderly women aged 70 years and over. Taiwan J Obstet Gynecol. 2016;55(1):68–71.CrossRef
Metadaten
Titel
Long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse
verfasst von
Yi-ting Wang
Kun Zhang
Hui-fang Wang
Jun-fang Yang
Yao Ying
Jin-song Han
Publikationsdatum
29.06.2020
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 4/2021
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04380-8

Weitere Artikel der Ausgabe 4/2021

International Urogynecology Journal 4/2021 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.