Le Fort partial colpocleisis as an effective treatment option for advanced apical prolapse in elderly women

Jung Yeon Park, Soo Jin Han, Jun Hwan Kim, Kyoung Chul Chun, Taek Sang Lee
Taiwanese Journal of Obstetrics & Gynecology 2019, 58 (2): 206-211

OBJECTIVE: The aim of this study was to evaluate the outcomes of women with advanced apical prolapse who were treated with the obliterative LeFort partial colpocleisis (LFC) procedure.

MATERIALS AND METHODS: We reviewed the medical records of patients who underwent LFC for advanced apical prolapse. We collected data for baseline patient characteristics, co-morbidities, severity of prolapse, operating time, intraoperative injuries, and postoperative complications. Subjective postoperative outcomes and patient satisfaction levels were also assessed.

RESULTS: Ninety-five patients underwent LFC during the study period. Median age of patients at operation was 76.0years. Mean operation time was 121.5 ± 31.9 min. Mean postoperative hospital stay was 3.5 ± 1.6 days. Postoperative complications, which were virtually all urinary symptoms, were present in 29.8% of patients, and 89.3% of patients have been in spontaneous remission. There was one case with perineal wound infection, one case of prolapse recurrence, and one case of de novo rectal prolapse after LFC. The objective success rate of the LFC procedure for all patients was 98.9% (94/95). Most (96%) patients were satisfied with the LFC results and pleased with the improvement in body image.

CONCLUSION: The obliterative LFC procedure had a high success rate and was associated with minimal adverse events for the elderly patients with advanced apical prolapse. This procedure should be considered as a treatment option for the advanced apical prolapse in selected elderly women who do not want to conserve vaginal intercourse, as it offers improvement in quality of life and is associated with a low regret rate.

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