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Rouhier’s colpocleisis with concomitant vaginal hysterectomy: an instructive video for female pelvic surgeons

  • Florin Constantin
  • Nikolaus Veit-Rubin
  • Lauriane Ramyead
  • Jean Dubuisson
IUJ Video

Abstract

Introduction and hypothesis

The treatment of pelvic organ prolapse (POP) in elderly women can be challenging. The vaginal operation known as colpocleisis, the total occlusion of the urogenital hiatus, with concomitant hysterectomy was described by Rouhier and represents a safe, time-saving, and reproducible procedure in the case of POP associated with uterine pathological conditions. It is suitable for elderly women who do not require preservation of coital function. The objective of this video is to provide anatomical illustrations and a precise description of the surgical steps.

Methods

We present the case of a 62-year-old woman who was referred for hysterectomy in the context of metastatic endometrial cancer. She complained about vaginal bulge and was diagnosed with a POP-Q stage 4 genital prolapse on physical examination. Due to important comorbidities such as arterial hypertension, obesity, and three-site metastatic disease, we suggested a colpocleisis with concomitant vaginal hysterectomy. This approach was intended to treat the prolapse and perform a palliative surgery to alleviate abnormal uterine bleeding.

Results

This video illustrates the different surgical steps of a colpohysterectomy according to Rouhier. No intraoperative complications occurred and the postoperative follow-up was uneventful. The patient was fully satisfied and POP has not recurred after a 17-month follow-up.

Conclusions

Colpocleisis should remain an exceptional approach, but could be offered to sexually inactive women of advanced age after thorough discussion and patient consent. If a hysterectomy is necessary, Rouhier’s operation offers a time-saving, reproducible, and efficient option for women with symptomatic POP who do not desire future vaginal intercourse.

Keywords

Colpocleisis Vaginal hysterectomy Pelvic organ prolapse Rouhier 

Notes

Compliance with ethical standards

Conflicts of interest

None.

Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Supplementary material

192_2018_3765_MOESM1_ESM.mp4 (100.5 mb)
ESM 1 (MP4 102869 kb)

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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity Hospitals GenevaGenevaSwitzerland
  2. 2.Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria

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