Patients' Decisions to Undergo Colpocleisis: A Qualitative Study

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery
• Patient-centered care

Background:

• Shared decision-making is crucial in urogynecologic surgery, particularly for colpocleisis.
• Loss of vaginal patency with colpocleisis carries a risk of patient regret.

Purpose of the Study:

• To understand the perspectives of patients who chose to undergo colpocleisis.
• To explore patient experiences and factors influencing the decision for vaginal closure.

Main Methods:

• Qualitative, inductive thematic analysis of semi-structured interviews.
• 17 purposively sampled patients who underwent colpocleisis between 2022-2024.
• Exploration of prolapse experience, surgeon counseling, patient goals, and regret.

Main Results:

• Four emergent themes: patient autonomy, patient expectations, surgeon counseling influence, and satisfaction without regret.
• Participants were older, active, and analytically approached pelvic floor disorders.
• None recalled sexual activity at the time of surgical decision.

Conclusions:

• Colpocleisis decisions are individualized but share common themes.
• Surgeon counseling significantly influences patient evaluation of options and outcomes.
• Thorough counseling and appropriate patient selection appear to minimize regret.