Colpocleisis deemed safe for advanced pelvic organ prolapse

(HealthDay)—Colpocleisis is a safe and effective treatment for advanced pelvic organ prolapse; however, urinary frequency and urgency often persist after the procedure, according to research published in the September issue of Urology.

Michelle E. Koski, M.D., of the Medical University of South Carolina in Charleston, and colleagues retrospectively characterized outcomes for 53 patients with Pelvic Organ Prolapse Questionnaire stage 3 or greater or Baden Walker grade 3 or greater who had undergone a colpocleisis procedure from 2001 to 2010.

The researchers found that 73.6 percent of the participants underwent total colpocleisis, 26.4 percent had a Le Fort procedure, and 60.4 percent underwent a concomitant sling procedure. After a mean follow-up of 9.3-months, four complications were reported: blood transfusion, pulmonary embolism, clot evacuation, and intraoperative cystotomy repair. None of the patients experienced new urgency, prolapse recurrence, or chronic urinary retention. Stress urinary incontinence persisted in four patients and started in one patient of the group who did not undergo a sling procedure. Twenty-two patients completed questionnaires; 90.9 percent reported their condition as much better. However, urinary frequency and urgency were a frequent postoperative complaint (33.3 percent on the Urinary Distress Invetory-6).

"In a selected patient population, colpocleisis is safe and efficacious. Persistent lower urinary tract symptoms comprise the highest frequency of complaints after colpocleisis, and this must be included in patient counseling," the authors write. "In an aging patient population with expected increase in demand for pelvic floor reconstruction, colpocleisis is a useful approach for the urologist."

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