Colpocleisis surgery in women over 80 years old with severe triple compartment pelvic organ prolapse

Haim Krissi, Amir Aviram, Edward Ram, Ram Eitan, Arnon Wiznitzer, Yoav Peled
European Journal of Obstetrics, Gynecology, and Reproductive Biology 2015, 195: 206-9

OBJECTIVE: To compare outcomes of Le Fort colpocleisis surgery, between women over 80 years old and younger women.

STUDY DESIGN: We searched the medical files for all consecutive women who underwent Le Fort colpocleisis as a primary or recurrent surgery for severe pelvic organ prolapse at our university-affiliated tertiary center between February 2007 and July 2013. Exclusion criteria for performance of the procedure were post-menopausal bleeding, pelvic malignancy, pelvic irradiation, and the desire to preserve coital function. The objective and subjective recurrence of prolapse, intraoperative and postoperative complications, and patient satisfaction were measured.

RESULTS: Forty-seven women underwent Le Fort colpocleisis. Of them, 23 were above 80 years, mean age 84.0±3.3, oldest: 91; and 24 were 80 years old and younger, mean age 70.8±6.1, youngest: 61. There were no intraoperative complications. Postoperative complications were recorded for 2 women with lower urinary tract infection and one woman had longer hospitalization time for warfarin treatment adjustment (9 days). Objective cure rates were 82.7% (19/23) and 83.3% (20/24), p=0.32, for women over 80, and women aged 80 and younger, respectively. The subjective cure rate was 86.7% (20/23) and 91.6% (22/24), respectively, p=0.28.

CONCLUSIONS: Objective and subjective cure rates of Le Fort colpocleisis in women over age 80 years were similar to those for younger women. The complications were mild and few, and unrelated to age. This procedure may be offered for women over 80 years old with severe symptomatic pelvic organ prolapse and medical comorbidities.

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