Colpocleisis with a skin flap

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery

Background:

• Pelvic organ prolapse (POP) affects up to 50% of women over 50.
• Reconstructive surgeries for POP have high long-term recurrence rates (up to 50%).
• Managing patients with repeated surgical failures presents significant challenges.

Purpose of the Study:

• To present a surgical technique for treating recurrent enterocele in patients with previous surgical failures.
• To evaluate the efficacy of a Le Fort colpocleisis combined with a perineal skin flap and Labhard perineoplasty for recurrent POP.

Main Methods:

• The study describes a surgical approach for recurrent enterocele using a perineal skin flap during a Le Fort colpocleisis.
• Labhard perineoplasty was added to the procedure.
• This technique is suitable for patients with a POP-Q stage 2 or larger genital prolapse who are not sexually active.

Main Results:

• The described surgical technique successfully treated recurrent enterocele in a patient with a frail posterior vaginal wall after prior unsuccessful surgeries.
• The patient experienced an uneventful postoperative course.
• Excellent healing was observed at the 2-month follow-up examination.

Conclusions:

• Obliterative surgery, such as Le Fort colpocleisis with a perineal skin flap and Labhard perineoplasty, is a potential option for managing recurrent POP in older, non-sexually active women.
• This technique addresses recurrent enterocele, particularly when the posterior vaginal wall quality is compromised.
• It offers a solution for patients with a history of failed previous prolapse surgeries.