Colpectomy or Le Fort colpocleisis?a good option in selected elderly patients

Abstract

The aim of this study was to describe the results of and complications after colpectomy and colpocleisis in selected elderly women with no wish for future coitus. Forty-two patients were operated by either colpectomy or colpocleisis during which special care was taken not to involve the area beneath the urethra. Patients were evaluated before and 3 months after the operation. No severe complications of the operations were observed. No cases of recurrence of the vault prolapse and no cases of de novo incontinence were observed after 3 months. A telephone interview performed after a mean of 46 months showed satisfaction with the operation in 90% of cases. Colpectomy and colpocleisis are important operations in the armamentarium of the urogynecological surgeon. The operations can be used in selected cases.

Chirurgie du prolapsus génital de la femme âgée de plus de 70 ans : revue de la littérature

“…Certaines séries présentent dans leur cohort des patientes d'âge supérieur ou égal à 70 ans. Mais les données publiées sont insuffisamment détaillées pour différencier les complications corrélées à cette classe d'âge [23][24][25][26][27][28]. Ces séries ont donc été exclues de ce travail.…”

How can we manage urinary incontinence following radical colpectomy? Literature review apropos of a rare entity

“…Only a few papers investigated postoperative SUI and bladder function. Glavind (2005) and Hoffman (2003) included 17 and 41 patients, respectively, with total colpectomies [11,12]. Total colpectomy was often synonymously used to total colpocleisis.…”

“…To our understanding, while the first refers to a full oncologic excision of all vaginal and paravaginal tissues down to the vulva, the latter refers to a removal of the vaginal skin with surgical closure of the limbs of the levator ani muscle for prolapse surgery. So far, all reports focused on surgical techniques preserving the integrity of the suburethral tissue (usually the first 3cm of the anterior vaginal wall), even when total colpectomy was performed for pelvic organ prolapse [4,5,11,12]. Some authors reported on combined prolapse and incontinence surgery, where up to 100% of their patients underwent concomitant midurethral sling placement at time of colpocleisis [1,9,13,14].…”

“…Some authors reported on combined prolapse and incontinence surgery, where up to 100% of their patients underwent concomitant midurethral sling placement at time of colpocleisis [1,9,13,14]. The incidence of de novo urinary incontinence -if at all quoted -varied between 0-27% [3,4,10,11]. No report was dealing with the management of urinary incontinence following colpocleisis or radical oncologic colpectomy with the subsequent need of incontinence therapy.…”

Pyometra complicating a LeFort colpocleisis

“…Colpocleisis is associated with shorter operative time and less surgical risk and is technically easier than vaginal reconstructive procedures. It has been associated with high levels of patient satisfaction and low rates of both surgical complications and failure [1]. Complications requiring surgical intervention are uncommon.…”