title: Labhardt's colpoperineocleisis: subjective results of an alternative treatment for genital prolapse in patients who are not sexually active--2-year follow-up.
abstract: OBJECTIVE
  Genital prolapse affects up to 50 % of multiparous women and has an impact on quality of life (QoL) for many. Vaginal obliterative techniques are relevant in older patients who are not sexually active. We performed Labhardt's colpoperineocleisis in such patients. The objective was the evaluation of subjective outcomes of this technique using PGI-I.
  
  
  METHODS
  Retrospective cohort analysis of patients. We performed a bivariate, multivariate analysis, and survival curves for subjective improvement.
  
  
  RESULTS
  Seventy-four cases were analyzed. Average age of the patients was 72 years, median parity 4, 95.9 % POP-Q stage III or IV, anterior leading edge defect in 61.1 %. Operating time: 54 min, estimated blood loss 70 ml, no intraoperative complications, 12 patients had protocol deviations with changes in the recommended type of suture. Median hospital stay was 2 days and average follow-up 24.9 months. There was 13.5 % anatomical recurrence, 3 of which (30 %) were in patients with protocol deviations. 1.9 % developed clinically significant de novo stress urinary incontinence (SUI).
  64 (86 %) reported subjective improvement and 10 did not. In the subjective improvement group, 98.4 % reported being very much or much better. In the non-subjective improvement group 80 % reported that they were the same as before surgery and 20 % were worse. In bivariate analysis anatomical recurrence showed significance and persisted after multivariate analysis with an OR of 8322 for subjective failure.
  
  
  CONCLUSIONS
  Labhardt's colpoperineocleisis is a safe technique with good subjective results. It has few complications, an acceptable recurrence rate, and a low rate of de novo SUI. It may be important to use the #0 or #1 polydioxanone sutures, as these are associated with better outcomes in this series. Comparative studies with other obliterative techniques are needed.
authors.affiliation: Urogynecology Unit, Complejo Asistencial Dr. Sotero del Rio, Santiago, Chile, jpizarro@med.puc.cl.
authors.forename: Javier
authors.initials: J
authors.lastname: Pizarro-Berdichevsky
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Galleguillos
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cuevas
authors.forename: Bernardita
authors.initials: B
authors.lastname: Blümel
authors.forename: Alejandro
authors.initials: A
authors.lastname: Pattillo
authors.forename: Silvana
authors.initials: S
authors.lastname: González
authors.forename: Alejandro
authors.initials: A
authors.lastname: Majerson
authors.forename: Oslando
authors.initials: O
authors.lastname: Padilla
authors.forename: Mauricio
authors.initials: M
authors.lastname: Cuello
authors.forename: Juan Andrés
authors.initials: JA
authors.lastname: Ortiz
authors.forename: Howard B
authors.initials: HB
authors.lastname: Goldman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D061646:Operative Time; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014550:Urinary Incontinence, Stress / Q000209:etiology; D014621:Vagina / Q000601:surgery*
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