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Patial colpocleisis (lefort) in elderly patients with severe pelvic organ prolapse

Authors:Dhananjaya B.S
Int J Biol Med Res. 2011; 2(4): 1173 – 1174  |  PDF File

Abstract

OBJECTIVE: To study the objective and subjective therapeutic effect of partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapse (POP) in selected elderly patients. METHODS: From Nov 2008 to April. 2011, 30 severe POP ( grade III Pelvic Organ Prolapse ) underwent partial colpocleisis. The mean age was (62+6) years (50-85 years). 1 out of 30 patients presented with medical disease. All 30 patients had prolapse of uterus. All the 30 patients underwent partial colpocleisis. Patients were followed up to evaluate therapeutic effect 2 months after the surgery. Objective evaluation included the length of vagina and perineal body. A Satisfaction Questionnaire was completed for subjective evaluation. RESULTS: The mean operating time of 30 patients was 50+9 minutes (40–75 mins). The mean blood loss was 98 + 38 (50-250 ml). No intraoperative injury or death occurred. The rate of postoperative complications was 3% (1/30). Mean follow-up time of 30 patients was 2 months. 1 (3%, 1/30) patient had mild urinary incontinence after the operation. No recurrence was observed 2 months after operation. The mean preoperative total vaginal length (TVL) of (6.5+/-1.1) cm was decreased to (3.1+/-1.1) (P<0.01); and perineal body (PB) measurements was increased from (2.2+/-0.8) to (3.2+/-0.8) cm (P<0.01). 2 months after the operation, 27 (90%) patients completed the Satisfaction Questionnaire. 26 (95%) patients said either 'very satisfied' or 'satisfied' with the outcome of their surgery, while 1 (5 %) reported unsatisfied or not at all satisfied. CONCLUSIONS: The objective and subjective curative rates of colpocleisis in treatment of severe POP are high with lower morbidity and recurrence. Colpocleisis is a safe and effective management in selected elderly patients with severe POP, who no longer desire to maintain vaginal coital function.