title: Risk factors for recurrence after Le Fort colpocleisis for severe pelvic organ prolapse in elderly women.
abstract: BACKGROUND
  We investigated parameters associated with recurrence after partial (Le Fort) colpocleisis surgery for severe pelvic organ prolapse (POP) in elderly women.
  
  
  METHODS
  A retrospective cohort study included all women who underwent partial colpocleisis in a single tertiary center from February 2007 through July 2013 for stage 3 or 4 triple compartment prolapse. Inclusion criteria were age over 60, sexually inactive, medical comorbidities, increased risk for comprehensive reconstructive pelvic surgery, and refusal or failure to use a pessary as a conservative non-surgical treatment. Exclusion criteria were post-menopausal bleeding, pelvic malignancy, and the desire to preserve coital function.
  
  
  RESULTS
  The study group included 47 women of mean age 77.3 ± 8.2 (range 61-91 years). All had medical comorbidities. Fourteen patients (29.8%) had undergone previous hysterectomy. All patients underwent partial colpocleisis and perineorrhaphy. Seven women (14.9%) underwent mid-urethral sling for urinary incontinence. Mean follow-up was 14.8 ± 10.3 months (range, 2-37 months) and mean hospitalization, 3.5 ± 1.5 days (range, 2-9 days). There were no intraoperative complications. Postoperative complications comprised lower urinary tract infection (n = 2). Objective cure (according to vaginal examination) was 80.9% (38/47), and subjective (according to symptoms), 91.5% (43/47). No patient regretted the loss of sexual function. The main reasons for prolapse recurrence were statistically significant longer post-operative vaginal length and wider genital hiatus.
  
  
  CONCLUSIONS
  Objective and subjective cure rates of Le Fort colpocleisis for the treatment of severe POP were high with low morbidity. Parameters associated with prolapse recurrence were longer postoperative vaginal length and wider genital hiatus.
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: haimkr@clalit.org.il.
authors.forename: H
authors.initials: H
authors.lastname: Krissi
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Amirav1@clalit.org.il.
authors.forename: A
authors.initials: A
authors.lastname: Aviram
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: EitanR@clalit.org.il.
authors.forename: R
authors.initials: R
authors.lastname: Eitan
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: Anat.m.from@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: From
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ArnonW@clalit.org.il.
authors.forename: A
authors.initials: A
authors.lastname: Wiznitzer
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Petach Tikva, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: dr.peled@gmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Peled
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020884:Colpotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery; D014621:Vagina / Q000473:pathology / Q000601:surgery
keywords: Colpocleisis; Pelvic organ prolapse