Colpohysterectomy. A contribution to gynecologic geriatric surgery

Abstract

From 1983 to 1992 we performed 70 interventions because of a total genital prolapse: 51 vaginal hysterectomies and four removals of the cervical stump, both combined with vaginectomy and fifteen vaginectomies of the prolapsed vaginal vault. Two patients underwent another procedure during the same anesthesia: mastectomy and treatment of an inguinal hernia respectively. The youngest patient was 59 years old and the oldest 89. Fifty-four patients were aged between 71 and 82. Thirteen women had worn a pessary before the operation. Fifty-one interventions took less than 75 minutes. Serious postoperative complications included myocardial infarction on postoperative day eight in one patient and bronchopneumonia and cardiovascular decompensation in a second patient. No case of relapsing prolapse has come to our knowledge so far. We hold hysterectomy combined with vaginectomy to be the treatment method of choice in women with total genital prolapse and no further desire of cohabitation. When performed by an experienced surgeon it is the method with the lowest potential of recurrence and therefore to be preferred to other procedures.