LeFort Colpocleisis Research Articles

Management of pelvic abscess after Le Fort colpocleisis

We report the case of a 75-year-old woman who developed pelvic abscess following Le Fort colpocleisis. After drainage and completion of treatment with intravenous antibiotherapy, the patient returned with persistent signs of infection, which responded to outpatient gentamicin irrigation through Le Fort vaginal tunnels.

Le Fort Colpocleisis

In Brief Objectives To evaluate the efficacy of Le Fort colpocleisis on bladder, bowel function, and quality of life (QOL) in elderly women with advanced genital prolapse. Methods Women with severe genital prolapse who were unable to satisfactorily wear a vaginal pessary underwent a Le Fort colpocleisis with concomitant anti-incontinence procedure, if required. During 2-week, 6-week, and 6-month postoperative visits, patients were examined and questioned about irritative voiding symptoms (voids > 10/day, nocturia > 2/night, urgency), incontinence, constipation, and overall well-being. Quality-of-life impact was evaluated with an instrument for pelvic prolapse, which was sent to all patients at least 12 weeks after operation. Follow-up by telephone was attempted to encourage completion of the questionnaire. Results Forty-five women underwent a Le Fort colpocleisis and high perineoplasty. Thirty-one (69%) also had a tension-free vaginal tape procedure. Mean age was 83 ± 5.2 years. Ninety-three percent (42/45) of the women had failed previous pessary use. One patient (2%) had recurrence of her prolapse. There were no significant differences in preoperative and postoperative incidence of irritative voiding and constipation symptoms. Eighty-two percent (37/45) of the QOL questionnaires were returned for analysis. The possible range of total score on the questionnaire is 15 to 75. Mean QOL score for the population was 24.8 ± 8.6. Patients with postoperative irritative voiding symptoms, constipation, or SUI symptoms had a mean score of 25.8 ± 9.1, and patients without these symptoms had a mean score of 21.4 ± 6.0 (P = 0.19). Conclusions Le Fort colpocleisis is a feasible treatment option for severe vaginal prolapse in the elderly patient. Low QOL impact scores after operation, despite irritative bladder symptoms and constipation, demonstrate the beneficial outcome of colpocleisis in elderly women who have advanced genital prolapse and are not sexually active. The evaluation of the efficacy of Le Fort colpocleisis on the bladder, bowel function and quality of life in elderly women with advanced genital prolapse.

Transvaginal needle suspension with lefort colpocleisis for stress incontinence and advanced uterovaginal prolapse in a high-risk patient

Surgical therapy in high-risk patients with advanced symptomatic pelvic floor defects sometimes mandates a compromise in the extent of proposed and desired repairs in favor of procedures that can be performed more rapidly. An 80-year-old woman with disabling genuine stress urinary incontinence and stage IV uterovaginal prolapse who was unable to retain a pessary was at high surgical risk due to ischemic heart disease. Uterovaginal prolapse was treated by LeFort partial colpocleisis, and stress urinary incontinence by transvaginal needle suspension with symptomatic cure and without significant perioperative morbidity. Operating time was 29 minutes and estimated blood loss was 50 ml. The patient was discharged on the second postoperative day with adequate spontaneous voiding and without urinary retention. A combination of partial colpocleisis with transvaginal needle suspension worked well in this case and may represent an effective and rapid surgical option for similar women.

The le fort colpocleisis: An analysis of 43 operations

1.1. The principles underlying the surgical treatment of uterovaginal prolapse are briefly enumerated.2.2. The indications for the LeFort colpocleisis, as one of the forms of surgical treatment, are stated, and the history of the operation reviewed.3.3. The results attained in 43 patients subjected to the LeFort operation are analyzed, noting an anatomic failure in one patient and a functional failure in another.4.4. The authors' technique of colpocleisis, including a circular amputation of the cervix as part of the operation when indicated, is described.5.5. A singular disadvantage of the operation is the later inaccessibility of the uterus in the event of subsequent metrorrhagia, as evidenced by the histories of three patients in the group of 43 reported. The importance of avoiding estrogen administration for fear of inducing diagnostically disturbing, uterine bleeding in women who have had a LeFort operation is emphasized.

The le fort colpocleisis: An analysis of thirty-one cases with a description of the technic used by the authors

The le fort colpocleisis: An analysis of thirty-one cases with a description of the technic used by the authors