Abstract
Introduction and hypothesis
Colpocleisis is not a popular option amongst surgeons, possibly due to concern about long-term regret. This study assessed a cohort of women who underwent colpocleisis 2–5 years previously to determine the regret rate, the effect on quality of life (QOL) and bladder and bowel function.
Methods
This was a longitudinal study of patients who underwent colpocleisis at least 2 years previously. Participants were asked to complete the Prolapse QOL (P-QOL), International Consultation on Incontinence–Urinary Incontinence (ICIQ-UI Short Form) and Colorectal Anal Distress Inventory questionnaires (CRADI). Two additional questions were asked: (1) Do you regret having vaginal closure surgery for prolapse? (never, sometimes, often, all the time), and (2) Would you recommend this surgery to a relative or friend who is not sexually active? (yes, no.)
Results
Thirty-four women were identified. Six had died by the time of follow-up, and five declined to answer the questionnaires because of ill health. Twenty-three women responded (67 %). Mean age was 78.68 years. One woman regretted having had the surgery, as the colpocleisis had failed. Twenty-one women (91.3 %) would recommend this surgery; one would not (4.3 %), and another was not sure (4.5 %). Low P-QOL [8 (0–37) ± 9.41), ICIQ-UI (7 (0–17) ± 5.44) and CRADI (10; 0–28 ± 8.13] scores suggest a positive impact on QOL, bladder and bowel function.
Conclusion
In this cohort, colpocleisis produced a good outcome with low regret rate (4.3 %), good QOL and minimal effect on bladder and bowel function at 2–5 years.
Similar content being viewed by others
References
US Census Bureau. Projections of the population by selected age groups and sex for the United States: 2015–2060. Available at: http://www.census.gov/population/projections/data/national/2012/summarytables.html
Luber KM, Boero S, Choe JY (2001) The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynaecol 184:1496–1503
Stepp KJ, Barber MD, Eun-Hee Y et al (2005) Incidence of perioperative complications of urogynecological surgery in elderly women. Am J Obstet Gynecol 192:1630–1636
Erekson EA, Yip SO, Ciarleglio MM, Terri (2011) Postoperative complications after gynaecologic surgery. Obstet Gynecol 118(4):785–793
LeFort L (1877) Nouveau procede pour la guerison du prolapses uterin. Bull Gene Ther 92:337–346
FitzGerald MP, Richter HE, Siddique S, Thompson P, Zyczynski H, Ann Weber for the Pelvic Floor Disorders Network (2006) Colpocleisis: a review. Int Urogynecol J Pelvic Floor Dysfunct 17(3):261–271
Wheeler TL, Gerten KA, Garris J (2009) Obliterative vaginal surgery for pelvic organ prolapse. Obstet Gynecol Clin N Am 36:637–658
Hullfish KL, Boubjerg VE, Steers WD (2007) Colpocleisis for pelvic organ prolapse: patient goals, quality of life and satisfaction. Obstet Gynecol 110:341–345
Zielinski R, Miller J, Low LK, Sampselle C, Delancey JO (2012) The relationship between pelvic organ prolapse, genital body image, and sexual health. Neurourol Urodyn 31:1145–1148
Boyles S, Weber A, Meyn L (2003) Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol 188(1):108–115
Woloski-Wruble AC, Oliel Y, Leefsma M, Hochner-Celnikier D (2010) Sexual activities, sexual and life satisfaction, and successful aging in women. J Sex Med 7:2401–2410
Von Pechmann WS et al (2003) Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynaecol 189:121–126
Latthe PM, Kamakshi K, Arunkalaivanan AS (2008) Colpocleisis revisited. Obstet Gynaecol 10(3):133–138
Alessandro Digesu G, Khullar V, Cardozo L, Robinson D, Salvatore S (2005) P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J 16:176–181
Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M et al (2004) ICIQ: a brief and robust measure for evaluating symptoms and impact of urinary incontinence. Neurourol Urodyn 23:322–330
Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific; quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395
Toozs-Hobson P, Freeman R, Barber M, Maher C, Haylen B, Athanasiou S, Swift S, Whitmore K, Ghoniem G, de Ridder D (2012) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures for pelvic organ prolapse. Int Urogynecol J 23(5):527–535
Sung VW, Weitzen S, Sokol ER, Rardin CR, Myers DL (2006) Effect of patient age on increasing morbidity and mortality following urogynecologic surgery. Am J Obstet Gynecol 194(5):1411–1417
Zebede S, Smith AL, Plowright LN, Hegde A, Aguilar VC, Davila GW (2013) Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol 121(2 Pt 1):279–284
Lindau ST, Schumm LP, Laumann EO et al (2007) A study of sexuality and health among older adults in United States. N Engl J Med 357:762–774
Bancroft JH (2007) Sex and ageing. N Engl J Med 357:820–824
Fitzgerald MP, Richter HE, Bradley CS, Ye W, Visco AC, Cundiff GW, Zyczynski HM, Fine P, Weber AM (2008) Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct 19(12):1603–1609
Yeniel AÖ, Ergenoglu AM, Askar N, Itil İM, Meseri R (2012) Quality of life scores improve in women undergoing colpocleisis: a pilot study. Eur J Obstet Gynecol Reprod Biol 163(2):230–233
Wheeler TL, Richter HE, Burgio KL, Redden DT, Chen CC, Goode PS, Varner RE (2005) Regret, satisfaction, and symptom improvement: analysis of the impact of partial colpocleisis or the management of severe pelvic organ prolapse. Am J Obstet Gynecol 193(6):2067–2070
Crisp CC, Book NM, Smith AL, Cunkelman JA, Mishan V, Treszezamsky AD, Adams SR, Apostolis C, Lowenstein L, Pauls RN (2013) Body image, regret, and satisfaction following colpocleisis. Am J Obstet Gynecol. doi:10.1016/j.ajog.2013.05.019
Reisenauer C, Oberlechner E, Schoenfisch B, Wallwiener D, Huebner M (2013) Modified LeFort colpocleisis: clinical outcome and patient Satisfaction. Arch Gynecol Obstet. doi:10.1007/s00404-013-2930-9
Hanson GE, Keettel WC (1969) The Neugebauer-Le Fort operation: a review of 288 colpocleisis. Obstet Gynecol 34:352–357
Fitzgerald MP (2003) Colpocleisis and urinary incontinence. Am J Obstet Gynaecol 189:1241–1244
Gutman RE, Bradley CS, Ye W, Markland AD, Whitehead WE, Fitzgerald MP (2010) Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse. Int Urogynecol J 21(4):461–466
Acknowledgments
Prof. R Freeman is partially supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula. The views expressed in this piece are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.
Conflict of interest
Dr. Monika Vij, Dr. A. Dua, Mr. L. Bombieri declare no conflict of interest. Prof. R.M. Freeman receives speaker fees at educational meetings from Astellas and Pfizer and is vice president of the IUGA
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vij, M., Bombieri, L., Dua, A. et al. Long-term follow-up after colpocleisis: regret, bowel, and bladder function. Int Urogynecol J 25, 811–815 (2014). https://doi.org/10.1007/s00192-013-2296-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-013-2296-3