Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse

Walter S. Von Pechmann, Martina Mutone, Joanne Daggy, Douglass S. Hale

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

OBJECTIVES: Our purpose was (1) to report long-term objective and subjective outcome data after total colpocleisis with high levator plication and (2) to compare operative morbidity of total colpocleisis in patients with prior versus concurrent hysterectomy. STUDY DESIGN: The medical records of patients who underwent total colpocleisis with high levator plication between August 1, 1988, and December 31, 2000, were retrospectively reviewed. Patient characteristics, operative data, and objective outcome measures including pelvic organ prolapse staging measurements were obtained from subject records. Subjective outcome measures were obtained by a standardized telephone survey. A t test was used to compare continuous variables between patients who underwent prior versus concurrent hysterectomy. The Fisher exact test was used to test for association between patient group and each categorical variable. RESULTS: During the 12-year study period, 92 subjects underwent total colpocleisis with high levator plication. Of the 92 subjects, 90 (97.8%) underwent concurrent operations and 37 (40.2%) underwent simultaneous hysterectomy. With objective cure defined as absence of prolapse to the hymen, 90 subjects (97.8%) were objectively cured after a median follow-up of 12 months (range, 0-64 months). Of 62 subjects available for telephone follow-up, 56 (90.3%) reported being satisfied or very satisfied with how the surgery cured their prolapse after a median follow-up of 24 months (range, 13-161 months). Concurrent hysterectomy was associated with statistically significant increases in absolute change in hematocrit (9.5% without vs 11.9% with hysterectomy) and transfusion requirement (12.7% without vs 35.1% with hysterectomy). There was no significant difference in surgical complications between groups. CONCLUSION: Total colpocleisis is an effective operation for the treatment of advanced pelvic organ prolapse. Concurrent hysterectomy is associated with higher blood loss and transfusion requirements.

Original languageEnglish
Pages (from-to)121-126
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume189
Issue number1
DOIs
StatePublished - Jul 1 2003

Fingerprint

Pelvic Organ Prolapse
Hysterectomy
Prolapse
Telephone
Therapeutics
Hymen
Outcome Assessment (Health Care)
Hematocrit
Blood Transfusion
Medical Records
Morbidity

Keywords

  • Colpectomy
  • Colpocleisis
  • Pelvic organ prolapse
  • Vaginal hysterectomy
  • Vaginectomy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. / Von Pechmann, Walter S.; Mutone, Martina; Daggy, Joanne; Hale, Douglass S.

In: American Journal of Obstetrics and Gynecology, Vol. 189, No. 1, 01.07.2003, p. 121-126.

Research output: Contribution to journalArticle

Von Pechmann, Walter S. ; Mutone, Martina ; Daggy, Joanne ; Hale, Douglass S. / Total colpocleisis with high levator plication for the treatment of advanced pelvic organ prolapse. In: American Journal of Obstetrics and Gynecology. 2003 ; Vol. 189, No. 1. pp. 121-126.
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abstract = "OBJECTIVES: Our purpose was (1) to report long-term objective and subjective outcome data after total colpocleisis with high levator plication and (2) to compare operative morbidity of total colpocleisis in patients with prior versus concurrent hysterectomy. STUDY DESIGN: The medical records of patients who underwent total colpocleisis with high levator plication between August 1, 1988, and December 31, 2000, were retrospectively reviewed. Patient characteristics, operative data, and objective outcome measures including pelvic organ prolapse staging measurements were obtained from subject records. Subjective outcome measures were obtained by a standardized telephone survey. A t test was used to compare continuous variables between patients who underwent prior versus concurrent hysterectomy. The Fisher exact test was used to test for association between patient group and each categorical variable. RESULTS: During the 12-year study period, 92 subjects underwent total colpocleisis with high levator plication. Of the 92 subjects, 90 (97.8{\%}) underwent concurrent operations and 37 (40.2{\%}) underwent simultaneous hysterectomy. With objective cure defined as absence of prolapse to the hymen, 90 subjects (97.8{\%}) were objectively cured after a median follow-up of 12 months (range, 0-64 months). Of 62 subjects available for telephone follow-up, 56 (90.3{\%}) reported being satisfied or very satisfied with how the surgery cured their prolapse after a median follow-up of 24 months (range, 13-161 months). Concurrent hysterectomy was associated with statistically significant increases in absolute change in hematocrit (9.5{\%} without vs 11.9{\%} with hysterectomy) and transfusion requirement (12.7{\%} without vs 35.1{\%} with hysterectomy). There was no significant difference in surgical complications between groups. CONCLUSION: Total colpocleisis is an effective operation for the treatment of advanced pelvic organ prolapse. Concurrent hysterectomy is associated with higher blood loss and transfusion requirements.",
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