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Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
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Vaginal Obliterative Procedures for Pelvic Organ Prolapse: A Systematic Review
Gunhilde M Buchsbaum1, Toy Gee Lee2
1Professor.
Obstetrical & Gynecological Survey
|March 18, 2017
Summary
Vaginal obliterative procedures like colpocleisis are effective for severe pelvic organ prolapse, offering high patient satisfaction with low complication rates. These procedures are suitable for women not desiring future coital function.
Area of Science:
- Gynecology
- Urogynecology
- Surgical Procedures
Background:
- Pelvic organ prolapse (POP) is increasingly prevalent due to population aging.
- Patient-centered care is shifting outcome assessment parameters.
- Vaginal obliterative procedures are a surgical option for advanced POP.
Purpose of the Study:
- To review the history of vaginal obliterative procedures for advanced POP.
- To discuss indications, outcomes, and complications of colpocleisis.
- To review concomitant procedures like hysterectomy and anti-incontinence surgery.
Main Methods:
- Literature review of English language publications.
- Focus on obliterative vaginal surgery for advanced POP.
- Historical review from the late 1800s to present.
Main Results:
- LeFort and total colpocleisis are effective for advanced POP with low complication rates and high patient satisfaction.
- Hysterectomy is often unnecessary for procidentia.
- Anti-incontinence procedures can be combined with colpocleisis; evidence on occult stress incontinence is conflicting.
Conclusions:
- Colpocleisis is valuable for severe POP in women not seeking coital function.
- Results are durable, even for recurrent prolapse after failed reconstructive surgery.
- Patient goals and presurgical counseling are key to satisfaction.
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