Anne Villot1, Anne-Cécile Pizzoferrato2, Annie Longie3, Bernard-Jean Paniel4, Arnaud Fauconnier5. 1. Department of Gynaecology and Obstetrics, University Hospital of Caen, Caen, France; Caen Normandie University, Caen, France. 2. Department of Gynaecology and Obstetrics, University Hospital of Caen, Caen, France; Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Versailles St-Quentin University, Montigny-le-Bretonneux, France. Electronic address: pizzoferrato-ac@chu-caen.fr. 3. Department of Gynaecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France. 4. Paris-Est University, Creteil, France. 5. Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, Versailles St-Quentin University, Montigny-le-Bretonneux, France; Paris-Est University, Creteil, France.
Abstract
OBJECTIVES: At the time of controversies on surgical treatment of pelvic organ prolapse, our aim was to describe an effective technique of hysterocolpectomy with colpocleisis for elderly patients not wishing to maintain vaginal sexual activity and present mid-term results including pelvic floor symptoms and quality of life, patient satisfaction and surgical complications using validated scores. STUDY DESIGN: We conducted a retrospective study of all patients having undergone this surgery between June 2006 and June 2016. Women were examined using POP-Q classification and completed validated questionnaires concerning symptoms and quality of life before and after the surgery. Patient satisfaction was assessed using the PGI-I. Complications were described according to the Clavien-Dindo classification. RESULTS: During the 10-year period, 37 women underwent the surgery with a mean age at surgery of 81.2 years (range: 61-93 years). One per-operative complication occurred (a rectal wound that was sutured) and five Clavien-Dindo grade 3b postoperative complications. Three repeat operations were necessary within 15 days; one suburethral sling had to be lowered because of urinary retention; one tension-free vaginal tape had to be unilaterally sectioned for acute urinary retention; and one woman presented a pararectal abscess requiring surgical drainage. The mean duration of hospitalization was 5.5 (+/-4.2) days. The mean follow-up time was 44.1 (±30.1) months. All symptoms and quality of life scores decreased significantly after the surgery and patient satisfaction was good (PGI-I score = 1.55 +/-0.8). CONCLUSIONS: Hysterocolpectomy with colpocleisis appears to be an effective treatment with a high level of patient satisfaction among the elderly.
OBJECTIVES: At the time of controversies on surgical treatment of pelvic organ prolapse, our aim was to describe an effective technique of hysterocolpectomy with colpocleisis for elderly patients not wishing to maintain vaginal sexual activity and present mid-term results including pelvic floor symptoms and quality of life, patient satisfaction and surgical complications using validated scores. STUDY DESIGN: We conducted a retrospective study of all patients having undergone this surgery between June 2006 and June 2016. Women were examined using POP-Q classification and completed validated questionnaires concerning symptoms and quality of life before and after the surgery. Patient satisfaction was assessed using the PGI-I. Complications were described according to the Clavien-Dindo classification. RESULTS: During the 10-year period, 37 women underwent the surgery with a mean age at surgery of 81.2 years (range: 61-93 years). One per-operative complication occurred (a rectal wound that was sutured) and five Clavien-Dindo grade 3b postoperative complications. Three repeat operations were necessary within 15 days; one suburethral sling had to be lowered because of urinary retention; one tension-free vaginal tape had to be unilaterally sectioned for acute urinary retention; and one woman presented a pararectal abscess requiring surgical drainage. The mean duration of hospitalization was 5.5 (+/-4.2) days. The mean follow-up time was 44.1 (±30.1) months. All symptoms and quality of life scores decreased significantly after the surgery and patient satisfaction was good (PGI-I score = 1.55 +/-0.8). CONCLUSIONS: Hysterocolpectomy with colpocleisis appears to be an effective treatment with a high level of patient satisfaction among the elderly.