A qualitative study of women's values and decision-making surrounding LeFort colpocleisis

LeFort colpocleisis for uterovaginal prolapse can be appealing to elderly non-sexually active patients given the durability and low risk, particularly when the alternative procedure is more invasive and includes a hysterectomy. We used qualitative methods to explore women's decision-making and feelings after this procedure.

We interviewed ten women after a LeFort colpocleisis (with or without mid-urethral sling) for uterovaginal prolapse. We conducted semi-structured interviews that were recorded and transcribed and then analyzed using grounded theory. The main themes were: the process of decision-making about whether to have an obliterative procedure, adequacy of preoperative counseling, and comparison against an alternative, more invasive surgical procedure with a hysterectomy. We also used the Decision Regret Scale and the Satisfaction with Decision Scale for Pelvic Floor Disorders.

Women made the decision to pursue LeFort colpocleisis mainly by themselves. They felt positive about the ability to control their body and their life through their own decision. None of the women regretted the procedure on the basis of the inability to have penetrative intercourse and did not feel it affected their sexual function in a negative way. Women felt adequately counseled regarding other options and the surgical procedure. Many patients wished they had pursued surgery earlier because they were very satisfied with the results.

Women who underwent LeFort colpocleisis were very happy with their decision. They primarily made the decision to have surgery autonomously. None of them regretted having an obliterative procedure for pelvic organ prolapse for reasons of sexual function.