Colpocleisis as an obliterative surgery for pelvic organ prolapse: A single-center experience

Pelvic organ prolapse (POP) is a common condition, and its incidence is anticipated to increase with the aging population. When surgical intervention is required for a POP, the surgeon must select between reconstructive and obliterative techniques. Colpocleisis is a proficient surgical procedure for geriatric patients with POP and various comorbidities, particularly for those who do not desire to maintain vaginal functionality for intercourse. This study seeks to assess the experience of a single center with the colpocleisis procedure.

This study retrospectively analyzed 58 cases of colpocleisis performed at the Ondokuz Mayis University Faculty of Medicine from July 21, 2015, to January 17, 2025. This encompassed the patients' preoperative and postoperative medical histories as well as perioperative outcomes. The Patient Global Impression-Improvement questionnaire was utilized to assess perceived efficacy. We assessed self-reported quality of life utilizing the Pelvic Floor Distress Inventory - questionnaire 20. We evaluated regret by posing an additional inquiry: "Do you regret opting for vaginal closure surgery for prolapse (Yes/No)?"

The mean age of the patients was 75.55 ± 8.21. POP stage 3 was diagnosed in 93.1% of patients. The mean postoperative follow-up period was 2.88 ± 1.89 years, and 94.8% of patients achieved anatomical success, as measured by pelvic organ prolapse quantification stage 2. The patients achieved a subjective success rate of 77.5%. The general regret rate was determined to be 6.8%. There were no reported regrets regarding sexual performance. The most prevalent postoperative complication was urinary tract infection. The study demonstrated substantial enhancements in pelvic symptom measurements between preoperative and postoperative assessments. The median Pelvic Floor Distress Inventory - questionnaire 20 decreased from 78.1 to 16.6 (P < .001), Pelvic Organ Prolapse Distress Inventory decreased from 45.35 to 8.3 (P < .001), Colorectal-Anal Distress Inventory decreased from 7.4 to 4.65 (P = .019), and Urinary Distress Inventory decreased from 25.2 to 6.2 (P < .001). All of these variables exhibited statistically significant differences.

Colpocleisis is the most effective surgical option for older women with POP, providing high patient satisfaction, minimal regret, and significant improvements in pelvic symptoms at long-term follow-up.