Effectiveness of Obliterative Surgery in Managing Advanced Apical Prolapse in Elderly Women: A 20-Years of Single Surgeon’s Experience

<b>Objectives:</b> The aim of this study was to evaluate the surgical outcomes, therapeutic efficacy, and psychological satisfaction of the Le Fort partial colpocleisis (LFC) procedure, an obliterative surgical treatment option, in elderly women with advanced apical prolapse, based on the 20-year surgical experience of a single surgeon. <b>Methods:</b> A retrospective cohort study was conducted on 81 women aged 60 and older who underwent LFC for advanced apical prolapse at a single institution from 2006 to 2025. Baseline characteristics, comorbidities, perioperative outcomes, complications, and patients' satisfaction were analyzed. <b>Results:</b> Among the patients, 86.4% were aged 70 or older, and also 85.2% of the women had comorbidities that could influence surgical outcomes. The surgical success rate was 96.3%, with recurrences observed in three cases. The median operative time was 89 min, but it decreased to median 77 min as the accumulated surgeon's experience. Similarly, hospitalization duration and patient-reported postoperative pain score also showed significant reductions. Transient postoperative complications were minimal, predominantly transient urinary symptoms (voiding difficulty in 4.9%, urinary frequency in 6.2%, and urinary incontinence in 3.7% of the patients). Satisfaction with the surgical treatment was high, with 98.4% reporting overall satisfaction. <b>Conclusion:</b> LFC is a safe and effective option for elderly women with advanced apical prolapse, offering high satisfaction rates and low morbidity. Surgeon's experience significantly enhances outcomes after about 20 cases. Careful patient selection and throughout counseling are essential to optimize outcomes and address patients' satisfaction by enhancing physical and psychological quality of life.