Evaluation of Patients Undergoing Colpocleisis: A Single-Center Experience

Year 2022, Volume: 39 Issue: 4, 971 - 974, 29.10.2022

Selim Gülücü , Neşet Gümüşburun

Abstract

The aim was to evaluate patients who underwent colpoclesis due to pelvic organ prolapse (POP). This cross-sectional study included patients who had undergone colpoclesis surgery. Age, gravity, parity, systemic diseases, examination findings, anesthetic methods used, surgical complications, additional operations, and length of hospital stay were recorded. At evaluation, patients were divided into two groups: partial colpoclesis and total colpoclesis. The mean age of patients was 73.25±5.45 (60-80), gravidity was 4.58±2.38 (2-11), and parity was 4.08±1.45 (2-7). While uterine prolapse was observed in 47 (97.9%) patients, one patient was found to have vaginal cuff prolapse. Partial colpoclesia was performed in 28 (58.3%) of the patients. While 16 of the patients (33.3%) had no additional systemic disease, the remaining patients had at least one systemic disease, with hypertension being the most common at 58.3%. Twenty-eight of the patients (58.3%) underwent surgery under general anesthesia and the rest under spinal anesthesia. While no postoperative complication occurred in 46 (95.8%) of the patients, blood transfusion (erythrocyte suspension) was observed in one patient and delirium was observed in another patient after surgery. The postoperative discharge time of patients was 3.66±2.10 (2-9) days. Statistically significant differences were found between the partial and total colpoclesis groups in terms of age, gravity and parity (p=0.002, p=0.022, and p=0.030, respectively). There were no significant differences between groups in discharge time (p = 0.143) and type of anesthesia (p=0.104). Colpoclesis surgery can be safely performed in elderly patients diagnosed with pelvic organ prolapse who are not sexually active. This method should be recommended as an option, especially in patients with complicated systemic diseases. Although short-term serious complications are not uncommon in patients, routine follow-up of patients with partial colpoclesis for long-term complications should be continued.

Keywords

Colpoclesis, pelvic organ prolapse, hysterectomy, pelvic floor disorder., LeFort

References

• 1. Raju R., Occhino JA, Linde BJ. LeFort partial colpocleisis: tips and technique. Int Urogynecol J. 2020;31:1697-99.
• 2. Grzybowska ME, Futyma K, Kusiak A, Wydra DG. Colpocleisis as an obliterative surgery for pelvic organ prolapse: is it still a viable option in the twenty-first century? Narrative review. Int Urogynecol J. 2022;33(1):31-46.
• 3. Farghali MM, Abdelzaher A, Abdelazim IA. Surgical and quality of life outcomes after pelvic organ prolapse surgery in older postmenopausal women. Prz Menopauzalny. 2021;20(1):21-28.
• 4. Buchsbaum GM, Lee TG. Vaginal Obliterative Procedures for Pelvic Organ Prolapse: A Systematic Review. Obstet Gynecol Surv. 2017;72(3):175-83.
• 5. Hong MK, Ding DC. Current Treatments for Female Pelvic Floor Dysfunctions. Gynecol Minim Invasive Ther. 2019;8(4):143-48.
• 6. Joukhadar R, Radosa J, Paulus V, Hamza A, Solomayer EF, Herr D, Wöckel A, Baum S. Influence of Patient's Age on the Outcome of Vaginal and Laparoscopic Procedures in Urogynaecology. Geburtshilfe Frauenheilkd. 2019;79(9):949-58.
• 7. Oh S, Namkung HR, Yoon HY, Lee SY, Jeon MJ. Factors associated with unsuccessful pessary fitting and reasons for discontinuation in Korean women with pelvic organ prolapse. Obstet Gynecol Sci. 2022;65(1):94-99.
• 8. Braga A, Serati M, Salvatore S, Torella M, Pasqualetti R, Papadia A, Caccia G. Update in native tissue vaginal vault prolapse repair. Int Urogynecol J. 2020 Oct;31(10):2003-2010.
• 9. Pizarro-Berdichevsky J, Clifton MM, Goldman HB. Evaluation and Management of Pelvic Organ Prolapse in Elderly Women. Clin Geriatr Med. 2015;31(4):507-21.
• 10. 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;58:206-211.
• 11. Petcharopas A, Wongtra-Ngan S, Chinthakanan O. Quality of life following vaginal reconstructive versus obliterative surgery for treating advanced pelvic organ prolapse. Int Urogynecol J. 2018;29(8):1141-46.
• 12. Manonai J, Wattanayingcharoenchai R. Surgical treatment for pelvic organ prolapse in elderly women. Journal of Obstetrics and Gynaecology. 2015;35(1):82-4.
• 13. Alshankiti H, Houlihan S, Robert M; Calgary Women’s Pelvic Health Research Group. Incidence and contributing factors of perioperative complications in surgical procedures for pelvic organ prolapse. Int Urogynecol J. 2019;30(11):1945-53.
• 14. Haya N, Feiner B, Baessler K, Christmann-Schmid C, Maher C. Perioperative interventions in pelvic organ prolapse surgery. Cochrane Database Syst Rev. 2018;8(8):CD013105.
• 15. Solomon ER, Frick AC, Paraiso MFR, et al. Risk of deep venous thrombosis and pulmonary embolism in urogynecologic surgical patients. American journal of obstetrics and gynecology. 2010;203(5):510.e1-e4.
• 16. Pratt JH, Baker RK. Urinary incontinence following the Le Fort operation: report of a case. Obstetrics & Gynecology. 1960;16(6):722-3.
• 17. Hoffman MS, Cardosi RJ, Lockhart, et al. Vaginectomy with pelvic herniorrhaphy for prolapse. American journal of obstetrics and gynecology. 2003;189(2):364-70.
• 18. Hanson GE, Keettel WC. The Neugebauer-Le Fort operation: a review of 288 colpocleises. Obstetrics & Gynecology. 1969;34(3):352-7.
• 19. von Pechmann WS, Mutone M, Fyffe J, et al. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. American journal of obstetrics and gynecology. 2003;189(1):121-6.
• 20. Stentagg M, Skär L, Berglund JS, Lindberg T. Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age. Sex Med. 2021;9(2):100316.
• 21. Huang AJ, Subak LL, Thom DH, et al. Sexual function and aging in racially and ethnically diverse women. Journal of the American Geriatrics Society. 2009;57(8):1362-8.