Le Fort colpocleisis: An evaluation of results and quality of life at intermediate-term follow-up

Abstract

ObjectivesTo assess postoperative complications, intermediate-term anatomic and subjective success rates, and quality of life following obliterative Le Fort colpocleisis (LFC) for advanced pelvic organ prolapse (POP). Study DesignWe conducted a retrospective cohort study with 53 subjects who underwent LFC surgery between January 2012 and April 2019. Demographic and treatment data were retrieved from a hospital database. Data on postoperative anatomic results were gathered from individual examinations of study subjects. The Clavien-Dindo classification was used to evaluate the complications. The Prolapse-Quality of Life (P-QoL) questionnaire was administered in person or over the telephone before and after the operation. Low scores on the P-QoL reflect a high quality of life. ResultsThe mean age at operation was 73 ± 7.1 years. The mean time between LFC and the postoperative questionnaire and interview was 30.8 ± 15.7 months (range: 12–82). Ninety-two percent of subjects had at least one comorbidity. When subjects were classified using the Pelvic Organ Prolapse (POP) Quantification System, seven (13.2 %) had Stage 3 POP and 46 (86.8 %) had Stage 4 POP. The overall rate of minor peri-operative complications rate was 11.3 % (six subjects). The objective success rate of LFC at intermediate-term follow-up was 98.1 %, and the subjective success rate was 96.2 %. The mean time between LFC and the postoperative questionnaire and interview was 30.8 ± 15.7 months (range: 12–82). There was a statistically significant decrease in the postoperative P-QoL score (p < 0.001). ConclusionsBased on positive intermediate-term anatomic and subjective outcomes, including a significant decrease in P-QoL questionnaire scores and a lack of regret, obliterative LFC should be considered a first-choice procedure for elderly and sexually inactive women with advanced POP.