title: Outcomes of vaginal hysterectomy and constricting colporrhaphy with concurrent levator myorrhaphy and high perineorrhaphy in women older than 75 years of age.
abstract: OBJECTIVE
  We performed constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy, and investigated the intraoperative complications, and short-term outcomes of these constricting procedures in patients aged 75 years or older.
  
  
  METHODS
  We searched our hospital database for cases, between January 2011 and January 2014, of women aged over 75 years who underwent surgery for pelvic organ prolapse of stage 2 or higher, via vaginal hysterectomy, constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy, with or without treatment of urinary incontinence. All volunteers were evaluated via pelvic examination using the pelvic organ prolapse quantification system, the modified Decision Regret Scale-Pelvic Floor Disorders form, the Satisfaction Decision Scale-Pelvic Floor Disorders form, and the Pelvic Floor Distress Inventory form.
  
  
  RESULTS
  Fifty-four patients were included in the study. The mean follow-up time was 24.4 months after constricting surgery (range: 8-44 months). There were four cases (7%) of de novo urge incontinence (the symptoms resolved upon prescription of anticholinergic medication). Two patients developed de novo stress urinary incontinence after the procedure and were treated via transobturator sling surgery using Safyre T(®) polypropylene monofilament slings. No anatomical or subjective recurrence of prolapse was noted during the follow-up period. No patient required additional surgery for recurrence of prolapse.
  
  
  CONCLUSIONS
  Constricting anterior and posterior colporrhaphy, levator myorrhaphy, and high perineorrhaphy with concurrent hysterectomy is a feasible, safe, and effective surgical option in elderly patients at low anesthesiological risk. The decision to perform an incontinence procedure should be individualized based on preoperative findings after prolapse reduction.
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Töz
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: Aykut
authors.initials: A
authors.lastname: Özcan
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: Nesin
authors.initials: N
authors.lastname: Apaydın
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Uyar
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: Betül
authors.initials: B
authors.lastname: Kocakaya
authors.affiliation: Department of Gynecology and Obstetrics, Tepecik Education and Research Hospital, İzmir, Turkey.
authors.forename: Gülin
authors.initials: G
authors.lastname: Okay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods*; D007431:Intraoperative Complications; D056887:Pelvic Organ Prolapse / Q000601:surgery*
keywords: constrictive surgical procedures; older women; pelvic organ prolapse; urinary incontinence