X Deffieux1, T Thubert2, L Donon3, J-F Hermieu4, L Le Normand5, C Trichot6. 1. Service de gynécologie obstétrique et médecine de la reproduction, AP-HP, hôpital Antoine-Béclère, F-92140 Clamart, France. Electronic address: xavier.deffieux@aphp.fr. 2. Service d'urologie, CHU Bordeaux, Bordeaux, France. 3. Polyclinique Côte-Basque-Sud, 7, rue Léonce-Goyetche, 64500 Saint-Jean-de-Luz, France. 4. Service d'urologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France. 5. Service d'urologie, CHU Nantes, place Alexis-Ricordeau, 44093 Nantes Cedex 1, France. 6. Service de gynécologie obstétrique et médecine de la reproduction, AP-HP, hôpital Antoine-Béclère, F-92140 Clamart, France.
Abstract
OBJECTIVE: To provide clinical practice guidelines (CPGs) based on the best evidence available (level of evidence (LE)), concerning colpocleisis as a surgical treatment of pelvic organ prolapse. METHODS: This article concern a systematically review of the literature concerning colpocleisis (obliterative surgery). RESULTS: At short term follow-up, colpocleisis is associated with an anatomical success rate of 98 % (LE3) and a subjective success rate of 93% (LE3). A decrease in genital, urinary and anorectal symptoms and an enhancement of quality of life are observed in most women following colpocleisis (LE4). At mid-term (1 to 3 years) follow-up, patients' satisfaction ("satisfied" or "very satisfied" ranges from 85 to 100% (LE3)). At long-term follow-up, regret rate (women who regret having had the surgery) is 5% (LE4). In women over 80 years old, colpocleisis is associated with a decrease in per-and post-operative complication rates when compare to other surgical techniques used for pelvic organ prolapse surgery (LE2). CONCLUSION: Colpocleisis is a valid surgical option for elderly patients with pelvic organ prolapse surgery, and who are definitely permanently sexually inactive (Grade C).
OBJECTIVE: To provide clinical practice guidelines (CPGs) based on the best evidence available (level of evidence (LE)), concerning colpocleisis as a surgical treatment of pelvic organ prolapse. METHODS: This article concern a systematically review of the literature concerning colpocleisis (obliterative surgery). RESULTS: At short term follow-up, colpocleisis is associated with an anatomical success rate of 98 % (LE3) and a subjective success rate of 93% (LE3). A decrease in genital, urinary and anorectal symptoms and an enhancement of quality of life are observed in most women following colpocleisis (LE4). At mid-term (1 to 3 years) follow-up, patients' satisfaction ("satisfied" or "very satisfied" ranges from 85 to 100% (LE3)). At long-term follow-up, regret rate (women who regret having had the surgery) is 5% (LE4). In women over 80 years old, colpocleisis is associated with a decrease in per-and post-operative complication rates when compare to other surgical techniques used for pelvic organ prolapse surgery (LE2). CONCLUSION: Colpocleisis is a valid surgical option for elderly patients with pelvic organ prolapse surgery, and who are definitely permanently sexually inactive (Grade C).