title: Colpocleisis for advanced pelvic organ prolapse.
abstract: OBJECTIVE
  To characterize our experience with colpocleisis in a urologic setting because it has not been documented broadly in the urologic literature.
  
  
  METHODS
  Retrospective review of demographics, urodynamics, presenting symptoms, complications, and outcomes for patients undergoing colpocleisis from 2001-2010 was performed. A questionnaire including the short forms of the Urinary Distress Inventory and Pelvic Organ Prolapse Distress Inventory (POPDI-6), and the Patient Global Impression of Improvement was sent to consenting patients.
  
  
  RESULTS
  Fifty-three patients were identified. Examinations were all POP-Q stage 3 or greater or Baden Walker grade 3 or higher; 73.6% underwent total colpocleisis and 26.4% Le Fort; 60.4% underwent concomitant sling. Complications included 1 patient requiring transfusion, 1 with pulmonary embolus, 1 needing clot evacuation, and 1 requiring intraoperative cystotomy repair. There was no postoperative de novo urgency, no recurrence of prolapse, and no chronic urinary retention. In patients not undergoing urethral sling, stress urinary incontinence persisted in 4 patients and occurred de novo in 1. Mean follow-up was 9.3 months. Twenty-two surveys were returned: 90.9% described their condition as much or very much better on Patient Global Impression of Improvement. The average POPDI-6 score was 9.1. Frequency and urgency were the most common complaints leading to bother on the UDI-6 (33.3%). Most of these responders had a preoperative urge component.
  
  
  CONCLUSIONS
  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. In an aging patient population with expected increase in demand for pelvic floor reconstruction, colpocleisis is a useful approach for the urologist.
authors.affiliation: Department of Urology, Medical University of South Carolina, Charleston, SC 29425, USA. mkoski82@hotmail.com
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Koski
authors.forename: Denise
authors.initials: D
authors.lastname: Chow
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bedestani
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Togami
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Chesson
authors.forename: J Christian
authors.initials: JC
authors.lastname: Winters
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods; D014621:Vagina / Q000601:surgery*