Improved Total Colpocleisis For Recrudescent Severe Pelvic Organ Prolapse

Objective:To describe the complications and efficacy of improved total colpocleisis for recrudescent severe pelvic organ prolapse.Methods:In this descriptive study, we analyzed the complications and efficacy of improved total colpocleisis in 7 women with pelvic organ prolapse at the Women's Hospital of Zhejiang University between October 2005 and August 2008. We use the plication of urethra or tension-free obturator tape (TVT-O) for treatment of SUI. The patients were reassessed at 8-12 weeks after the surgery. Objective criteria of cure and subjective criteria were studied with assessment of the repercussions of treatment on quality of life by physical examination, and appropriate questions. The urodynamics study was did if necessary. The assessment were repeated every three months. 12 months after surgery the patients were assessed every 6 months.Results:All of the women referred to our Urogynaecological Units complaining of reprolapse symptoms after total vaginal hysterectomy because of prolapse of uterus. And now had vaginal cuff prolapse POP-Q stage III -IV with subjective feeling of prolapse. The mean age was 68.7 years(range, 55-82). Mean surgical time was 124.3 minutes(range,90-180). The patients were discharged 5-8 days after the surgery. The mean follow-up period was 20.4 months (range, 6-40). There was no recurrence of prolapse and a very low complication rate. The 2 patients with preoperative stress urinary incontinence were cured after surgery.Conclusion:Improved total colpocleisis is an effective and safe treatment for recrudescent severe pelvic organ prolapse in elderly women.