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Female Pelvic Surgery: Obliterative Vaginal Procedures

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Female Pelvic Surgery
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Abstract

Colpocleisis is a successful operation with few complications, and postoperatively patients report minimal regret and significant improvement in quality of life. SUI should be evaluated preoperatively but may warrant postoperative reassessment based on patient symptoms. Concurrent procedures are associated with more risks and should be carefully chosen. Urgency urinary incontinence after these surgeries can be problematic and may require additional medical treatment. Overall, the procedure is an effective option in the properly selected patient.

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References

  1. Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol. 1997;104(5):579–85.

    Article  CAS  PubMed  Google Scholar 

  2. Hendrix SL, et al. Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160–6.

    Article  PubMed  Google Scholar 

  3. Nygaard I, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Olsen AL, et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–6.

    Article  CAS  PubMed  Google Scholar 

  5. U.S. Census Bureau Projections Show a Slower Growing, Older, More Diverse Nation a Half Century from Now. Accessed 6 Apr 2013; Available from: http://www.census.gov/newsroom/releases/archives/population/cb12-243.html.

  6. Wu JM, et al. Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–83.

    Article  PubMed  Google Scholar 

  7. Wu JM, et al. Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 2011;205(3):230 e1–5.

    Article  Google Scholar 

  8. Price N, et al. The incidence of reoperation for surgically treated pelvic organ prolapse: an 11-year experience. Menopause Int. 2008;14(4):145–8.

    Article  PubMed  Google Scholar 

  9. Fialkow MF, Newton KM, Weiss NS. Incidence of recurrent pelvic organ prolapse 10 years following primary surgical management: a retrospective cohort study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(11):1483–7.

    Article  PubMed  Google Scholar 

  10. Johnson P, et al. Self-reported natural history of recurrent prolapse among women presenting to a tertiary care center. Int J Gynaecol Obstet. 2013;120(1):53–6.

    Article  PubMed  Google Scholar 

  11. DeLancey JO, Morley GW. Total colpocleisis for vaginal eversion. Am J Obstet Gynecol. 1997;176(6):1228–32; discussion 1232–5.

    Article  CAS  PubMed  Google Scholar 

  12. Cespedes RD, Winters JC, Ferguson KH. Colpocleisis for the treatment of vaginal vault prolapse. Tech Urol. 2001;7(2):152–60.

    CAS  PubMed  Google Scholar 

  13. Harmanli OH, et al. Total colpocleisis for severe pelvic organ prolapse. J Reprod Med. 2003;48(9):703–6.

    PubMed  Google Scholar 

  14. von Pechmann WS, et al. Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2003;189(1):121–6.

    Article  Google Scholar 

  15. FitzGerald MP, Brubaker L. Colpocleisis and urinary incontinence. Am J Obstet Gynecol. 2003;189(5):1241–4.

    Article  PubMed  Google Scholar 

  16. Misrai V, et al. Colpocleisis: indications, technique and results. Prog Urol. 2009;19(13):1031–6.

    Article  CAS  PubMed  Google Scholar 

  17. Koski ME, et al. Colpocleisis for advanced pelvic organ prolapse. Urology. 2012;80(3):542–6.

    Article  PubMed  Google Scholar 

  18. Zebede S, et al. Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol. 2013;121(2 Pt 1):279–84.

    Article  PubMed  Google Scholar 

  19. Erekson E, et al. Major postoperative complications following surgical procedures for pelvic organ prolapse: a secondary database analysis of the American College of Surgeons National Surgical Quality Improvement Program. Am J Obstet Gynecol. 2017;217(5):608 e1–608 e17.

    Article  Google Scholar 

  20. Hill AJ, Walters MD, Unger CA. Perioperative adverse events associated with colpocleisis for uterovaginal and posthysterectomy vaginal vault prolapse. Am J Obstet Gynecol. 2016;214(4):501 e1–6.

    Article  Google Scholar 

  21. Ng SC, Chen GD. Obliterative LeFort colpocleisis for pelvic organ prolapse in elderly women aged 70 years and over. Taiwan J Obstet Gynecol. 2016;55(1):68–71.

    Article  PubMed  Google Scholar 

  22. Hullfish KL, Bovbjerg VE, Steers WD. Colpocleisis for pelvic organ prolapse: patient goals, quality of life, and satisfaction. Obstet Gynecol. 2007;110(2 Pt 1):341–5.

    Article  CAS  PubMed  Google Scholar 

  23. Fitzgerald MP, Kulkarni N, Fenner D. Postoperative resolution of urinary retention in patients with advanced pelvic organ prolapse. Am J Obstet Gynecol. 2000;183(6):1361–3. discussion 1363-4

    Article  CAS  PubMed  Google Scholar 

  24. Song X, et al. Long-term follow-up after LeFort colpocleisis: patient satisfaction, regret rate, and pelvic symptoms. Menopause. 2016;23(6):621–5.

    Article  PubMed  Google Scholar 

  25. Gutman RE, et al. Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse. Int Urogynecol J. 2010;21(4):461–6.

    Article  PubMed  Google Scholar 

  26. Barber MD, et al. Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(7):799–806.

    Article  PubMed  Google Scholar 

  27. Fitzgerald MP, et al. Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1603–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Lu YX, et al. Colpocleisis in elderly patients with severe pelvic organ prolapse. Zhonghua Fu Chan Ke Za Zhi. 2010;45(5):331–7.

    PubMed  Google Scholar 

  29. Katsara A, et al. Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis. Arch Gynecol Obstet. 2016;294(5):999–1003.

    Article  PubMed  Google Scholar 

  30. Wang X, Chen Y, Hua K. Pelvic symptoms, body image, and regret after LeFort colpocleisis: a long-term follow-up. J Minim Invasive Gynecol. 2017;24(3):415–9.

    Article  PubMed  Google Scholar 

  31. Murphy M, et al. Quality of life and surgical satisfaction after vaginal reconstructive vs obliterative surgery for the treatment of advanced pelvic organ prolapse. Am J Obstet Gynecol. 2008;198(5):573 e1–7.

    Article  Google Scholar 

  32. Chaikin DC, Groutz A, Blaivas JG. Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse. J Urol. 2000;163(2):531–4.

    Article  CAS  PubMed  Google Scholar 

  33. Reena C, Kekre AN, Kekre N. Occult stress incontinence in women with pelvic organ prolapse. Int J Gynaecol Obstet. 2007;97(1):31–4.

    Article  CAS  PubMed  Google Scholar 

  34. Smith AL, et al. LeFort colpocleisis and stress incontinence: weighing the risk of voiding dysfunction with sling placement. Int Urogynecol J. 2011;22(11):1357–62.

    Article  PubMed  Google Scholar 

  35. Wei JT, et al. A midurethral sling to reduce incontinence after vaginal prolapse repair. N Engl J Med. 2012;366(25):2358–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Hafidh BA, et al. De novo stress urinary incontinence after vaginal repair for pelvic organ prolapse: one-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2013;168(2):227–30.

    Article  PubMed  Google Scholar 

  37. Al-Mandeel H, et al. Incidence of stress urinary incontinence following vaginal repair of pelvic organ prolapse in objectively continent women. Neurourol Urodyn. 2011;30(3):390–4.

    Article  PubMed  Google Scholar 

  38. Davenport MT, et al. Does the degree of cystocele predict De Novo stress urinary incontinence after prolapse repair? Further analysis of the colpopexy and urinary reduction efforts trial. Female Pelvic Med Reconstr Surg. 2018;24(4):292–4.

    Article  PubMed  Google Scholar 

  39. Meschia M, et al. A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence. Am J Obstet Gynecol. 2004;190(3):609–13.

    Article  PubMed  Google Scholar 

  40. Jelovsek JE, et al. Validation of a model predicting De Novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery. Obstet Gynecol. 2019:1.

    Google Scholar 

  41. Jones KA, et al. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016;27(5):805–10.

    Article  PubMed  Google Scholar 

  42. Committee on Practice B-G. ACOG Practice Bulletin Number 131: Screening for cervical cancer. Obstet Gynecol. 2012;120(5):1222–38.

    Article  Google Scholar 

  43. National Cancer Institute. Surveillance, Epidemiology and End Results Program (SEER) Cancer Stat Facts: Uterine Cancer. https://seer.cancer.gov/statfacts/html/corp.html. (Accessed September 7, 2019).

  44. Zhang YH, et al. Impact of colpocleisis on body image in women with severe pelvic organ prolapse. Zhonghua Fu Chan Ke Za Zhi. 2011;46(6):431–4.

    PubMed  Google Scholar 

  45. Jones K, et al. Colpocleisis: a survey of current practice patterns. Female Pelvic Med Reconstr Surg. 2017;23(4):276–80.

    Article  PubMed  PubMed Central  Google Scholar 

  46. American College of, O. and Gynecologists. ACOG Committee Opinion No. 426: The role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding. Obstet Gynecol. 2009;113(2 Pt 1):462–4.

    Google Scholar 

  47. Elkattah R, Brooks A, Huffaker RK. Gynecologic malignancies post-LeFort colpocleisis. Case Rep Obstet Gynecol. 2014;2014:846745.

    PubMed  PubMed Central  Google Scholar 

  48. Trimble CL, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106(4):812–9.

    Article  PubMed  Google Scholar 

  49. Mueller MG, et al. Colpocleisis: a safe, minimally invasive option for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2015;21(1):30–3.

    Article  PubMed  Google Scholar 

  50. Krissi H, et al. Colpocleisis surgery in women over 80 years old with severe triple compartment pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2015;195:206–9.

    Article  PubMed  Google Scholar 

  51. Stepp KJ, et al. Incidence of perioperative complications of urogynecologic surgery in elderly women. Am J Obstet Gynecol. 2005;192(5):1630–6.

    Article  PubMed  Google Scholar 

  52. Liang J, Owens L, Gomelsky A. Vaginal evisceration following colpocleisis. Int Urogynecol J. 2017;28(8):1265–6.

    Article  PubMed  Google Scholar 

  53. Catanzarite T, et al. Risk factors for 30-day perioperative complications after Le Fort colpocleisis. J Urol. 2014;192(3):788–92.

    Article  PubMed  Google Scholar 

  54. FitzGerald MP, et al. Colpocleisis: a review. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(3):261–71.

    Article  PubMed  Google Scholar 

  55. Wheeler TL 2nd, et al. Regret, satisfaction, and symptom improvement: analysis of the impact of partial colpocleisis for the management of severe pelvic organ prolapse. Am J Obstet Gynecol. 2005;193(6):2067–70.

    Article  PubMed  Google Scholar 

  56. Buchsbaum GM, Lee TG. Vaginal obliterative procedures for pelvic organ prolapse: a systematic review. Obstet Gynecol Surv. 2017;72(3):175–83.

    Article  PubMed  Google Scholar 

  57. Krissi H, et al. Risk factors for recurrence after Le Fort colpocleisis for severe pelvic organ prolapse in elderly women. Int J Surg. 2015;20:75–9.

    Article  CAS  PubMed  Google Scholar 

  58. Cho MK, Moon JH, Kim CH. Factors associated with recurrence after colpocleisis for pelvic organ prolapse in elderly women. Int J Surg. 2017;44:274–7.

    Article  PubMed  Google Scholar 

  59. Hoffman MS, et al. Vaginectomy with pelvic herniorrhaphy for prolapse. Am J Obstet Gynecol. 2003;189(2):364–70; discussion 370–1.

    Article  PubMed  Google Scholar 

  60. Bochenska K, et al. Perioperative complications following colpocleisis with and without concomitant vaginal hysterectomy. Int Urogynecol J. 2017;28(11):1671–5.

    Article  PubMed  Google Scholar 

  61. Abbasy S, et al. Urinary retention is uncommon after colpocleisis with concomitant mid-urethral sling. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(2):213–6.

    Article  PubMed  Google Scholar 

  62. American College of Obstetricians and Gynecologists Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin Number 84. Prevention of deep vein thrombosis and pulmonary embolism. Obstet Gynecol. 2007;110(2Pt1):429–40.

    Google Scholar 

  63. Geerts WH, Pineo GR, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(suppl):338 s–400.

    Article  CAS  Google Scholar 

  64. Linder BJ, Gebhart JB, Occhino JA. Total colpocleisis: technical considerations. Int Urogynecol J. 2016;27(11):1767–9.

    Article  PubMed  Google Scholar 

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Correspondence to Ryan M. Krlin .

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Krlin, R.M., Hallner, B., Thompson, N., Winters, J.C. (2020). Female Pelvic Surgery: Obliterative Vaginal Procedures. In: Firoozi, F. (eds) Female Pelvic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-28319-3_6

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  • DOI: https://doi.org/10.1007/978-3-030-28319-3_6

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