Long-Term Clinical Outcomes, Recurrence, Satisfaction, and Regret After Total Colpocleisis With Concomitant Vaginal Hysterectomy: A Retrospective Single-Center Study.

OBJECTIVE: This study aimed to investigate long-term study outcomes of colpocleisis along with concomitant vaginal hysterectomy for pelvic organ prolapse (POP).

METHODS: A retrospective cohort study was conducted in elderly women with advanced POP who underwent total colpocleisis with or without hysterectomy from 2012 to 2017.

RESULTS: A total of 242 elderly women were included in this study, of which 172 underwent total colpocleisis along with concomitant vaginal hysterectomy (CH group) and 70 underwent partial colpocleisis-retained uterus (LeFort group). More than one comorbidity was observed among 154 (85.9%) patients in the CH group and 56 (81.4%) patients in the LeFort group. The difference between 2 groups (CH and LeFort) in mean length of hospital staying, mean day of removing urinary catheter, mean day of farting time after operation, and postoperative complications was not statistically significant. In total colpocleisis along with hysterectomy group, a case (0.6%) of early asymptomatic endometrial cancer was diagnosed unexpectedly by pathology after hysterectomy. Median follow-up was 43.0 (19.0-85.0) months in the CH group and 45.0 (26.0-79.0) months in the LeFort group. Only one patient reported recurrence. Subjective satisfaction rate was 98.8% (CH group) versus 98.6% (LeFort group). Regret rate was 0.58% (CH group) versus 0% (LeFort group). No significant difference was observed between the 2 groups.

CONCLUSIONS: Both colpocleisis along with hysterectomy and partial colpocleisis-retained uterus are safe, with fewer complications and high long-term satisfaction. Colpocleisis along with hysterectomy is more conducive to discovery of early asymptomatic malignant tumors of the uterus, which is a suitable alternative for elderly frail women with severe POP.