Abstract
Aim: The objective of this study was to present the clinical experience with colpocleisis by evaluating patient characteristics and long-term follow-up data.
Materials and Methods: This is a retrospective cohort study evaluating patients who underwent obliterative surgery for pelvic organ prolapse (POP) between 2010 and 2017. Patients who underwent
colpocleisis without hysterectomy (C) (n=68) and colpocleisis of vaginal vault (CVV) (n=22) were included in this study.
Results: The mean age of the study population was 72.7 years (range 55-89). The majority of the patients underwent colpocleisis as their primary surgical procedure for POP, as only 5.6% of the study group had a history of previous prolapse surgery. The mean follow-up duration was 49.5 months (range 1.5-109). Patient satisfaction with the surgery was high, with 98.9% of patients expressing they were “very satisfied” and 1.1% “satisfied”. There were two cases of recurrence (2.2%), and both were in the C group. One patient (1.1%) reported regret after surgery due to her husband's remorse about choosing an obliterative procedure. The recurrence rates, patient satisfaction, and regret were comparable between C and CVV groups.
Conclusion: Colpocleisis is a viable option for the surgical treatment of POP, offering a high rate of success and patient satisfaction in long-term. Despite being an obliterative procedure, colpocleisis has acceptance as the primary surgical procedure by patients regardless of their marital status, and regret rate after surgery is low. Therefore, colpocleisis should be thoroughly discussed and included in the preoperative counseling and surgical planning of all patients with POP.
References
- Lu M, Zeng W, Ju R, Li S, Yang X. Long-Term Clinical Outcomes, Recurrence, Satisfaction, and Regret After Total Colpocleisis With Concomitant Vaginal Hysterectomy: A Retrospective Single-Center Study. Female Pelvic Med Reconstr Surg. 2021 Apr; 27 (4): e510–5.
- Felder L, Heinzelmann-Schwarz V, Kavvadias T. How does colpocleisis for pelvic organ prolapse in older women affect quality of life, body image, and sexuality? A critical review of the literature. Womens Health (Lond Engl). 2022 Jan; 18: 174550572211110.
- Wang Y ting, Zhang K, Wang H fang, Yang J fang, Ying Y, Han J song. Long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse. Int Urogynecol J. 2021 Apr; 32 (4): 879–84.
- Cengiz H, Ekin M, Yeşil A, Yıldız Ş, Yaşar L. Kolpokleizis: Türkiye'de Bir Üçüncü Basamak Merkezin Deneyimi. J Clin Obstet Gynecol. 2014; 24 (2): 80-83.
- Güngör Uğurlucan F, Alper N, Ayyıldız Erkan H, Yücesoy B, Nehir A, Yalçın Ö. Pelvik Organ Prolapsus Cerrahisinde Lefort Kolpokleizis-İstanbul Tıp Fakültesi Deneyimi. J Clin Obstet Gynecol. 2013; 23 (2): 76-79.
- Developed by the Joint Writing Group of the American Urogynecologic Society and the International Urogynecological Association. Joint report on terminology for surgical procedures to treat pelvic organ prolapse. Int Urogynecol J. 2020 Mar; 31 (3): 429–63.
- 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 Jan; 33 (1): 31–46.
- Ugianskiene A, Glavind K. Follow-up of patients after colpectomy or Le Fort colpocleisis: Single center experience. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021 Jul; 262: 142–6.
- Zebede S, Smith AL, Plowright LN, Hegde A, Aguilar VC, Davila GW. Obliterative LeFort Colpocleisis in a Large Group of Elderly Women. Obstetrics & Gynecology. 2013 Feb; 121 (2): 279–84.
- Jones KA, Zhuo Y, Solak S, Harmanli O. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016 May; 27 (5): 805–10.
Abstract
Amaç: Bu çalışmanın amacı, hasta özelliklerini ve uzun süreli takip verilerini analiz ederek kolpokleizis ile ilgili klinik deneyimi sunmaktır.
Gereç ve Yöntem: Mevcut çalışma, 2010 ve 2017 yılları arasında pelvik organ prolapsusu (POP) için obliteratif cerrahi uygulanan hastaları değerlendiren retrospektif bir kohort çalışmasıdır. Histerektomisiz kolpokleizis (C) (n=68) ve vajinal kaf kolpokleizisi (CVV) (n=22) uygulanan hastalar bu çalışmaya dahil edilmiştir.
Bulgular: Çalışma popülasyonunun ortalama yaşı 72.7 idi (aralık 55-89). Çalışma grubunun sadece %5,6'sında daha önce prolapsus cerrahisi öyküsü olup kolpokleizis hastaların çoğuna POP için birincil cerrahi prosedür olarak uygulandı. Ortalama takip süresi 49.5 aydı (aralık 1.5-109). Ameliyattan hasta memnuniyeti yüksek olup hastaların %98.9'u “çok memnun” ve %1.1'i “memnun”
olduklarını belirttiler. İki nüks vakası (%2.2) vardı ve ikisi de C grubundaydı. Bir hasta (%1.1) ameliyattan sonra pişmanlık bildirmiş olup bu kocasının obliteratif bir prosedür seçiminden dolayı
pişmanlığından kaynaklıydı. Nüks oranları, hasta memnuniyeti ve pişmanlık, C ve CVV grupları arasında karşılaştırılabilirdi.
Sonuç: Kolpokleizis, POP'un cerrahi tedavisi için uygun bir seçenek olup uzun dönemde yüksek başarı oranı ve hasta memnuniyeti sunar. Kolpokleizis, obliteratif bir işlem olmasına rağmen, hastalar
tarafından medeni durumlarından bağımsız olarak birincil cerrahi işlem olarak kabul görmektedir ve cerrahi sonrası sonrası pişmanlık oranı düşüktür. Bu nedenle, kolpokleizis, POP'lu tüm hastaların preoperatif danışmanlığında ve cerrahi planlamasında kapsamlı bir şekilde tartışılmalı ve dahil edilmelidir.
References
- Lu M, Zeng W, Ju R, Li S, Yang X. Long-Term Clinical Outcomes, Recurrence, Satisfaction, and Regret After Total Colpocleisis With Concomitant Vaginal Hysterectomy: A Retrospective Single-Center Study. Female Pelvic Med Reconstr Surg. 2021 Apr; 27 (4): e510–5.
- Felder L, Heinzelmann-Schwarz V, Kavvadias T. How does colpocleisis for pelvic organ prolapse in older women affect quality of life, body image, and sexuality? A critical review of the literature. Womens Health (Lond Engl). 2022 Jan; 18: 174550572211110.
- Wang Y ting, Zhang K, Wang H fang, Yang J fang, Ying Y, Han J song. Long-term efficacy and patient satisfaction of Le Fort colpocleisis for the treatment of severe pelvic organ prolapse. Int Urogynecol J. 2021 Apr; 32 (4): 879–84.
- Cengiz H, Ekin M, Yeşil A, Yıldız Ş, Yaşar L. Kolpokleizis: Türkiye'de Bir Üçüncü Basamak Merkezin Deneyimi. J Clin Obstet Gynecol. 2014; 24 (2): 80-83.
- Güngör Uğurlucan F, Alper N, Ayyıldız Erkan H, Yücesoy B, Nehir A, Yalçın Ö. Pelvik Organ Prolapsus Cerrahisinde Lefort Kolpokleizis-İstanbul Tıp Fakültesi Deneyimi. J Clin Obstet Gynecol. 2013; 23 (2): 76-79.
- Developed by the Joint Writing Group of the American Urogynecologic Society and the International Urogynecological Association. Joint report on terminology for surgical procedures to treat pelvic organ prolapse. Int Urogynecol J. 2020 Mar; 31 (3): 429–63.
- 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 Jan; 33 (1): 31–46.
- Ugianskiene A, Glavind K. Follow-up of patients after colpectomy or Le Fort colpocleisis: Single center experience. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021 Jul; 262: 142–6.
- Zebede S, Smith AL, Plowright LN, Hegde A, Aguilar VC, Davila GW. Obliterative LeFort Colpocleisis in a Large Group of Elderly Women. Obstetrics & Gynecology. 2013 Feb; 121 (2): 279–84.
- Jones KA, Zhuo Y, Solak S, Harmanli O. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016 May; 27 (5): 805–10.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 15, 2023 |
| Submission Date | August 18, 2022 |
| Published in Issue | Year 2023Volume: 62 Issue: 1 |
