Geriatric Pelvic Organ Prolapse Surgery: Going the Extra Mile
To assess the quality of life in geriatric patients after reconstructive and obliterative vaginal surgery for advanced pelvic organ prolapse (POP).
Prospective observational study was conducted between January 2009 and December 2014 at the department of Urogynaecology, Government Kasturbha Gandhi Hospital. A total of 424 women (between the age group of 60 and 94 years) with advanced pelvic organ prolapse underwent vaginal hysterectomy along with vaginal apical suspension procedures which were McCalls culdoplasty (35.02%), sacrospinous ligament suspension (8.3%), high uterosacral ligament suspension (26.2%), iliococcygeus fixation (4.6%) for stage 3–4 POP. Abdominal sacrocolpopexy (3.2%) was done for stage 3–4 vaginal vault prolapse. Patients with medical comorbidities underwent Leeforts partial colpocleisis (8.1%) and total colpocleisis (2%) for stage 3 and 4 POP. Site-specific repair (12.5%) was done for stage 3/4 cystocele and rectocele. The main outcomes measured were subjective cure (no prolapse), subjective improvements in pelvic floor symptoms as per the pelvic floor impact questionnaire, and objective cure (no prolapse of vaginal segment on maximum straining).
Mean age of the patient was 64.29 years. The major complication rates were less than 1%. 85% were examined at 3 and 12 months. The subjective cure rate at 12 months is 92% and the objective cure rate is 94.5%.
The geriatric patients who underwent either reconstructive or obliterative procedures were relieved of their preoperative symptoms and their quality of life had greatly improved.
KeywordsGeriatric pelvic organ prolapse Apical suspension procedures Colpocleisis Quality of life
Compliance with Ethical Standards
Conflict of interest
Seethalakshmi Krishnan declares that she has no conflict of interest.
This prospective study was approved by Ethical Committee of Government Kasturbha Gandhi Hospital, Madras Medical College, Chennai.
Human and Animal Rights
This article does not contain any studies with animal subjects.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5). Informed consent was obtained from all patients for being included in the study.
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