Colpocleisis—Still a Valuable Option: A Point of Technique

<b>Background/Objectives</b>: Pelvic organ prolapse (POP) is a common condition that increases with age and affects up to 40% of women. Colpocleisis is a possible native-tissue repair used in elderly persons not interested in vaginally penetrative sex to correct advanced POP. This study aims to evaluate the recurrence and reoperation rate of a technique using purse-string sutures in a standardised way. <b>Methods</b>: This retrospective quality control study evaluated all women who underwent obliterative procedures for POP at the Department of Obstetrics and Gynaecology at the University Hospital of Bern from 2014 to 2023. Total Colpocleisis (TC) and Le-Fort Colpocleisis (LFC) were performed by a standardised technical procedure using purse-string sutures. The primary outcome was the recurrence rate measured by the POP-Q stage (stage 2 or higher). Reoperation rate, perioperative complications, bladder outlet disorders and incontinence symptoms were assessed as secondary outcomes. <b>Results</b>: We analysed eighty-eight patients who underwent obliterative surgery with TC or LFC in this study. The recurrence rate for all patients was 16%, and the reoperation rate was 9.2%. In patients without previous surgeries (52%), the recurrence rate was 7%. Thirteen patients (14.8%) had perioperative complications, mainly urinary tract infections (seven patients, 8%). Objective POP improved significantly (<i>p</i> < 0.001), as did the bladder voiding dysfunction in the rate of high postvoid residual volume (<i>p</i> < 0.05), stress urinary incontinence, overactive bladder and mixed urinary incontinence (<i>p</i> < 0.001). In three patients, de novo stress urinary incontinence developed postoperatively. <b>Conclusions</b>: Colpocleisis by the purse-string technique is an effective surgical treatment for advanced POP surgery. Recurrence and reoperation rates are similar to the previously mentioned techniques and are easy to learn due to the standardised procedure.

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Publication Details

Journal
Journal of Clinical Medicine
Published
2025-10-21
DOI
https://doi.org/10.3390/jcm14207433
Primary Topic
Congenital gastrointestinal and neural anomalies
Type
article
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0.00
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article

Colpocleisis—Still a Valuable Option: A Point of Technique

Giovanni Ruggeri, Diana Hoehn, Anna-Sophie Villiger, Michael D. Mueller et al.
Journal of Clinical Medicine
Congenital gastrointestinal and neural anomalies
article

Colpocleisis—Still a Valuable Option: A Point of Technique

Giovanni Ruggeri, Diana Hoehn, Anna-Sophie Villiger, Michael D. Mueller, Gloria Ryu, Annette Kühn, Hannes Egli, Martin Chase Marak
article en

Abstract

<b>Background/Objectives</b>: Pelvic organ prolapse (POP) is a common condition that increases with age and affects up to 40% of women. Colpocleisis is a possible native-tissue repair used in elderly persons not interested in vaginally penetrative sex to correct advanced POP. This study aims to evaluate the recurrence and reoperation rate of a technique using purse-string sutures in a standardised way. <b>Methods</b>: This retrospective quality control study evaluated all women who underwent obliterative procedures for POP at the Department of Obstetrics and Gynaecology at the University Hospital of Bern from 2014 to 2023. Total Colpocleisis (TC) and Le-Fort Colpocleisis (LFC) were performed by a standardised technical procedure using purse-string sutures. The primary outcome was the recurrence rate measured by the POP-Q stage (stage 2 or higher). Reoperation rate, perioperative complications, bladder outlet disorders and incontinence symptoms were assessed as secondary outcomes. <b>Results</b>: We analysed eighty-eight patients who underwent obliterative surgery with TC or LFC in this study. The recurrence rate for all patients was 16%, and the reoperation rate was 9.2%. In patients without previous surgeries (52%), the recurrence rate was 7%. Thirteen patients (14.8%) had perioperative complications, mainly urinary tract infections (seven patients, 8%). Objective POP improved significantly (<i>p</i> < 0.001), as did the bladder voiding dysfunction in the rate of high postvoid residual volume (<i>p</i> < 0.05), stress urinary incontinence, overactive bladder and mixed urinary incontinence (<i>p</i> < 0.001). In three patients, de novo stress urinary incontinence developed postoperatively. <b>Conclusions</b>: Colpocleisis by the purse-string technique is an effective surgical treatment for advanced POP surgery. Recurrence and reoperation rates are similar to the previously mentioned techniques and are easy to learn due to the standardised procedure.

Journal of Clinical MedicineVol. 14(20)
University of Bern (CH), University Hospital of Bern (CH), Texas A&M University (US)
Openalex Percentile: Top 53%
Congenital gastrointestinal and neural anomalies
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