PD50-08 PREDICTORS OF REGRET AFTER COLPOCLEISIS FOR PELVIC ORGAN PROLAPSE: A SYSTEMATIC REVIEW

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Pelvic Prolapse1 Apr 2015PD50-08 PREDICTORS OF REGRET AFTER COLPOCLEISIS FOR PELVIC ORGAN PROLAPSE: A SYSTEMATIC REVIEW Juzar Jamnagerwalla, Karyn Eilber, Samantha Jagannathan, Niv Hakami-Majd, Eugene Shkolyar, and Jennifer Anger Juzar JamnagerwallaJuzar Jamnagerwalla More articles by this author , Karyn EilberKaryn Eilber More articles by this author , Samantha JagannathanSamantha Jagannathan More articles by this author , Niv Hakami-MajdNiv Hakami-Majd More articles by this author , Eugene ShkolyarEugene Shkolyar More articles by this author , and Jennifer AngerJennifer Anger More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Colpocleisis is a safe and effective procedure to alleviate the symptoms of pelvic organ prolapse (POP) in women who are not sexually active (Fitzgerald et al). With the goal of determining factors associated with regret after colpocleisis, we synthesized the available literature examining satisfaction and reasons for regret among women undergoing colpocleisis. METHODS The review was conducted according to the recommendations of the MOOSE (Meta-Analysis of Observational Studies in Epidemiology) group. We performed a systematic review of PubMed and Medline to identify articles published between 1948 and 2013 using search terms “colpocleisis, obliterative and vaginal”. RESULTS Our literature search identified 182 titles, of which 42 were ultimately included in the review. Twenty-nine studies reported objective POP outcomes data with a pooled patient population of 1,714 patients. Objective POP success ranged from 89% to 100%. Seventeen studies included satisfaction in their analysis, with a pooled patient population of 1,077 patients. The individual satisfaction reported in these studies ranged from 86.4% to 96%. Twenty-four studies included data on urinary outcomes after colpocleisis. The rate of de novo stress urinary incontinence (SUI) in women who did not undergo concomitant sling ranged from 0-13%. In women who had preoperative SUI with concurrent placement of midurethral sling, SUI was persistent in between 6-17% of women. Ten studies included regret in their analysis, with a pooled patient population of 415 patients. Thirty-one out of 415 women (7.5%) at least partially regretted their decision. Frequent causes of regret included loss of sexual function (41%) and worsening pre-operative urinary incontinence (31%). CONCLUSIONS Though colpocleisis is associated with a high success and satisfaction rate overall, few studies exist that examine sources of regret. The data available suggests that regret is often due to worsening urinary incontinence or remorse about loss of sexual function. Careful patient selection for colpocleisis may help predict who may be more likely to become sexually active again. In addition, patient age alone should not deter providers from placing a concomitant prophylactic sling at the time of colpocleisis. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1048 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Juzar Jamnagerwalla More articles by this author Karyn Eilber More articles by this author Samantha Jagannathan More articles by this author Niv Hakami-Majd More articles by this author Eugene Shkolyar More articles by this author Jennifer Anger More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...