Severe Genital Prolapse Research Articles

Stasis ulcer and hydronephrosis after severe genital prolapse: a case report\xa0

Introduction and importanceThe most common complication of pelvic organ prolapse is stress urinary incontinence, whereas hydronephrosis or stasis ulcers are quite rare and typical of severe stages. The best treatment for this unusual presentation is still controversial. Here we present our approach.Case presentationHere we present the case of a 70-year-old White/Caucasian woman who presented to our hospital with genital procidentia lasting for 10 years that was associated with both hydronephrosis and stasis ulcers.Clinical findings and investigationsThe Pelvic Organ Prolapse Quantitation system was used to assess the severity of the prolapse, being evaluated as stage IV with the apical compartment leading. A thorough search of the literature was conducted to find any similar cases and evaluate the best evidence treatment.Interventions and outcomesA no-mesh procedure comprising vaginal hysterectomy, axial apex suspension, and anterior and posterior repair with ulcerated skin removal resulted in complete resolution of both mechanical and functional symptoms. At 3- and 6-month follow-up visits, a satisfying vaginal profile without hydronephrosis was seen. The Pelvic Organ Prolapse Quantitation at 6 months follow-up was as follows: Aa -3, Ba -3, C -7; gh 2, pb 3, tvt 9; Ap -3, Bp -3.Relevance and impactPelvic organ prolapse involves many organs and causes further complications, leading seldom to renal insufficiency and stasis ulcers. A temporary solution to the obstruction can be achieved by utilizing a pessary, but this device cannot be applied when a stasis ulcer has been previously established. The use of mesh for pelvic floor repair is controversial, but a previous vaginal ulcer may represent a contraindication. A complete evaluation and a challenging surgery may allow the recovery of complicated and severe pelvic organ prolapse. Native tissue pelvic repair gives no erosion postsurgical risk, which is the typical complication of the prosthesis.

Influence of preoperative preparation on the vaginal architectonics of postmenopausal women with severe genital prolapse

Patients with severe postmenopausal genital prolapse (GP) are the most clinically difficult group of women, in which surgical treatment with mesh implants presents significant difficulties due to the duration of lesions amid pronounced structural changes in the tissues of the urogenital tract under conditions of hormone deficiency. That is why it is of particular importance to study the histological characteristics of the vaginal mucosa in women with GP, who must conduct surgical treatment of vaginal access.
 Aim. To study the histological features of the vaginal mucosa in postmenopausal women with severe GP in preparation for surgical treatment with vaginal access.
 Materials and methods. The study involved 70 postmenopausal women suffering from GP of stage III, IV in combination with genitourinary menopausal syndrome. Patients were randomized blindly into two groups. The therapy was carried out using vaginal forms of estrogen and progesterone preparations in combination with lactobacilli. In the comparison group, preoperative preparation was not performed. All patients underwent clinical and laboratory examination: general examination and gynecological examination, morphological examination of biopsy samples of the mucous membrane of the anterior vaginal wall, which were obtained during subsequent surgical treatment of GP. Methods of parametric statistics were used.
 Results. It was established that focal dystrophy, acanthotic severity, keratinization of the vaginal epithelium, moderate inflammation are characteristic morphological changes in the vaginal mucosa in women with postmenopausal GP. Application at the stage of preparation for surgical treatment using vaginal forms, as a result of which estrogen and progesterone enhance the inflammatory process in the ulcerative vagina, reduce dystrophic changes and their severity in relation to complex changes and differentiation of the vaginal epithelium and activation of regeneration processes in tissues.
 Conclusion. Reducing inflammation and the severity of dystrophic processes in vaginal enemas at the stage of preoperative preparation of women with postmenopausal GP favorably affects the regeneration processes, which in the first place can improve the outcome of surgical treatment.

Alternative combined surgical treatment of severe pelvic organ prolapsed

Objective: This study aimed to evaluate the rate of satisfactory outcomes of surgery on women with severe genital prolapse using fast-track surgery including an improved method of combined surgical treatment. Materials and methods: The study included 60 women with severe forms of pelvic organ prolapse. The average age of patients with POP-Q II was 56.4 (20 women from 52 to 63), those with POP-Q III-59.4 (40 patients from 54 to 68). Results: A new method of combination surgery for severe forms of pelvic organ prolapse using abdominal mesh and native tissues was developed. The following parameters were evaluated as objective criteria for effectiveness of treatment: duration of surgery, amount of blood loss, postoperative complications, time until and forms of pelvic organ prolapse recurrence: their number, variety, relapse stage, time of relapse. The average duration of surgery was 120 min. The average blood loss was 200 ml. There were 6 cases of early postoperative complications. The rate of relapses was 2%. An analysis of outcomes indicates high effectiveness of treatment and recovery of pelvic organ function. Thus, this method can be recommended for surgical treatment of combined forms of severe genital prolapse.

Features of surgical treatment in young patients with severe genital prolapse

Features of surgical treatment in young patients with severe genital prolapse

Genital prolapse in women of advanced age, complicated decubital ulcer view at the preoperative treatment

Genital prolapse is a syndrome of pelvic floor prolapse and pelvic organs prolapse, leading to a breach of their functions. Severe prolapse is accompanied by restriction of movement of patients, severe sexual dysfunction, urinary disorders, development of severe psychological problems up to depression, and complicated by decubital ulcers (erosions) of the cervix and vagina in 18–32% of cases. This article presents the results of preoperative treatment of decubital ulcers in 59 elderly women with genital prolapse. The study group consisted of 30 women with genital prolapse and verified cervical disease who underwent complex therapy including depantol (1 suppository 2 times/day every day intravaginal at night for 10 days) and lavomax (0.125 g first two days, and then 0.125 g in 48 hours, with 10 tablets per course). A control group included 29 patients with severe descent and prolapse of internal genital organs, complicated decubital ulcer of cervix who underwent conventional therapy duration of 10 days. The control group consisted of 20 healthy women aged 53–65 years. Analysis of the treatment effectiveness showed that this scheme of complex therapy of decubital ulcers in patients with postmenopausal genital prolapse, which included depantol and lavomax on the conventional scheme has demonstrated its clinical efficacy in 96.4% of cases (total clinical remission to improve) at very good tolerability in 97.2% of cases. Adverse effects and side effects were not observed in any case. The proposed therapy of decubital ulcers in postmenopausal women with severe genital prolapse in preoperative period allows in short time to achieve epithelialization of defect without rough scarring due to reparative effects on the tissue, to improve the quality of patients life and is an effective method of preoperative treatment for this category of patients.

Cirugía reconstructiva de la pelvis en el prolapso genital severo con uso de prótesis anterior y fijación al ligamento sacroespinoso

Una alternativa con algunas ventajas e iguales resultados en el manejo quirúrgico del prolapso genital total para la fijación de la cúpula al sacro por vía abdominal es la fijación de la cúpula al ligamento sacroespinoso. Objetivo: Evaluar los resultados del empleo de malla anterior y fijación al ligamento sacroespinoso en el prolapso genital total. Diseño: Estudio retrospectivo y descriptivo. Institución: Servicio de Ginecología Especializada, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú. Participantes: Mujeres con diagnóstico de prolapso genital total. Método: Revisión retrospectiva de 12 pacientes con diagnóstico de prolapso genital total y que tuvieron cirugía reconstructiva pélvica con empleo de malla anterior y fijación al ligamento sacroespinoso. Principales medidas de resultados: Resultados de las técnicas. Resultados: La edad promedio fue 64 años. La comorbilidad principal fue la obesidad. La histerectomía abdominal fue el antecedente quirúrgico más frecuente. Se realizó histerectomía vaginal más colocación de malla anterior con fijación al ligamento sacroespinoso a tres pacientes, solo malla anterior con fijación sacroespinosa a cuatro pacientes, malla anterior con fijación sacroespinosa y malla transobturatiz (TOT) a tres pacientes, histerectomía vaginal con malla anterior, fijación sacroespinosa y TOT a dos pacientes. Como complicaciones hubo extrusión de malla en un paciente; dos pacientes a las que no se colocó TOT presentaron incontinencia de orina al esfuerzo, una urgencia miccional nueva, una dispareunia; dos pacientes presentaron granuloma de sutura y una refirió dolor pélvico inespecífico, síntomas que evolucionaron favorablemente. La evaluación del prolapso genital después de la cirugía no fue mayor de grado I. Conclusiones: Al fijar el compartimento apical al sacroespinoso mediante el uso de TOT y de la malla anterior garantizó que no se presentara incontinencia urinaria de esfuerzo, recidiva o aparición de defectos del compartimiento anterior.

Should Prophylactic Anti-Incontinence Procedures Be Performed at the Time of Prolapse Repair? Systematic Review

Urodynamic studies performed prior to prolapse repair in women with high-grade pelvic organ prolapse (POP) have revealed asymptomatic stress urinary incontinence (SUI) in 36% to 80% of these women. The probable explanation for maintenance of continence prior to surgery in these patients may be urethral kinking or compression of the urethra by the genital prolapse. Once the genital prolapse has been repaired, these women are at high risk of postoperative SUI. Although occult SUI and prolapse repair can be corrected during a single surgery, combining both procedures is highly controversial. Some surgeons question the effectiveness of a single surgery to make both repairs and recommend a second surgical procedure after prolapse repair to correct occult incontinence. However, there are risks associated with a new hospitalization and a second surgery. This systematic literature review was conducted to determine whether performing prophylactic anti-incontinence procedures during surgical POP correction in women with severe genital prolapse and no symptoms of incontinence could prevent postoperative SUI. PubMed, EMBASE, Cochrane Library, and Lilacs databases were searched to identify articles published up to January 12, 2014. The search was limited to randomized trials. All participants had severe POP and no symptoms of SUI prior to prolapse surgery. The primary study outcome was the incidence of SUI or the need of treatment for this condition after the surgical procedure. The initial search identified 5618 studies; 66% of these were selected for full text analysis. Only 7 of these trials met the study inclusion and exclusion criteria. Following the systematic review, a meta-analysis was performed with common variables of studies and the same scale of quantification. Performance of any prophylactic anti-incontinence procedure during prolapse repair reduced the incidence of SUI postoperatively; the relative risk was 0.51, with a 95% confidence interval of 0.38 to 0.68. However, the results were different when the types of anti-incontinence procedure used were analyzed separately. The only anti-incontinence procedure that led to a significant reduction in the incidence of UI was retropubic midurethral sling surgery (relative risk, 0.09; 95% confidence interval, 0.02–0.36). These data show that use of the retropubic midurethral sling concomitantly with prolapse repair in women with severe POP is the only prophylactic anti-incontinence procedure that reduces risk of SUI.

Importancia de la reducción del prolapso vaginal anterior severo durante el examen clínico y estudio urodinamicoámico, en el diagnóstico de incontinencia urinaria oculta

Objetivos: Demostrar la importancia de reducir el prolapso de grado alto (POPQ >+3) en la evaluación clínica y urodinamia, buscando la presencia de incontinencia urinaria oculta; y planear el tratamiento de ambas patologías (prolapso e incontinencia urinaria de esfuerzo - IUE) en el mismo acto quirúrgico para evitar la IUE después de la corrección solo del prolapso. Diseño: Estudio retrospectivo y descriptivo. Institución: Urología, Clínica San Pablo, Sede Surco, Lima Perú. Participantes: Mujeres con prolapso genital. Intervenciones: Entre julio de 2009 y junio 2012, a 40 pacientes entre 43 y 78 años (edad media de 62,9 años), con prolapso genital grado III y IV, se les redujo el prolapso con gasas, tanto en la evaluación clínica como en el estudio urodinámico (clasificación IUE, según la Sociedad Internacional de Continencia - SIC). Principales medidas de resultados: Incontinencia oculta. Resultados: Se encontró 19 pacientes (47,5%) con incontinencia oculta diagnosticada en la evaluación clínica. El grado del prolapso evaluado, de acuerdo al POP-Q, fue +III en 14 (73,7%), +IV en 5 (26,3%); el tipo de IUE según la SIC fue I en 11 (57,9%), II en 7 (36,9%) y III en 1 (5,2%); no hubo IUE tipo IV. Conclusiones: La reducción del prolapso de alto grado POPQ>+III debe ser hecha rutinariamente en la evaluación por el ginecólogo y uroginecólogo, y en la urodinamia, de manera de detectar la incontinencia oculta para la planificación de ambas patologías en un solo acto quirúrgico. De esta manera se evitará una segunda intervención para corrección de la IUE, así como los consecuentes problemas médicos-legales. No todos los pacientes con prolapso genital tienen incontinencia oculta.

The use of the pessary test in preoperative assessment of women with severe genital prolapse

Objective To investigate whether a preoperative pessary test could be used to identify patients with occult stress incontinence and if simultaneous anti-incontinence surgery with a midurethral sling could prevent postoperative incontinence. Study design Eighty-two patients with a positive pessary test and severe genital prolapse participated in the study: 43 patients underwent prolapse surgery and transobturator tension-free vaginal tape (TVT-O) insertion and 39 patients underwent prolapse surgery only. Results The objective cure rate for TVT-O and prolapse surgery was 90.7% at three months follow up and 88.4% at two years follow up. The objective cure rate for prolapse surgery only was 74.4% at three months and 58.9% at two years follow up. Conclusion The pessary test can be used preoperatively in patients with significant genitourinary prolapse to identify those with occult stress urinary incontinence. The TVT-O procedure in this context could be a useful optional procedure as it appears to be very effective and safe in patients with occult stress incontinence.

A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS

The effectiveness, tolerability and complications of two surgical procedures using prosthetic materials with different physical and structural properties were assessed with a full Urogynecology work-up, through a retrospective study of 158 patients with severe genital prolapse (POP-Q staging III-IV) selected from November 2006 to April 2009. Eighty-six patients underwent fascial replacement surgery with ProliftTM System with a dual transobturator access in the anterior district and a transperineal posterior access with a synthetic polypropylene type I mesh (Group A). Seventy-two patients who underwent pelvic organ prolapse surgery with Avaulta/Avaulta PlusTM System with a dual transobturator access in the anterior district and a dual transperineal posterior access with a biosynthetic polypropylene type I mesh coated with a film of hydrophilic porcine collagen were placed in Group B. There were no intra and postoperative complications. Results of mean 20.8 month follow-up showed an effective anatomical cure rate of 89.5% in group A and 86.1% in group B and a low percentage of erosive complications, 8.1% and 5.6% respectively. Validated questionnaires for prolapse, the UDI 6 s.f., the IIQ7 s.f. and the PISQ-12 all showed a statistically significant improvement of quality of life in patients undergoing the two procedures (Wilcoxon test: P<0.001).

Clinical outcome of transvaginal sacrospinous fixation with the Veronikis ligature carrier in genital prolapse

Objective To evaluate the clinical outcome of sacrospinous fixation (SSF) using the Veronikis ligature carrier (VLC) for genital prolapse. Study design A retrospective longitudinal study was performed. From December 2003 through June 2008, SSF was performed in 76 patients using the VLC as part of their site-specific reconstructive pelvic surgery. All patients were followed up postoperatively at 6 weeks, 3 months, 6 months, 12 months, and annually thereafter. Results The median operative time of SSF was 34 min. It took less than 5 min to introduce two sutures through the ligament using the VLC. Four patients (5.3%) had recurrent vaginal vault descent at 3–8 months, and received SSF again. Three patients had recurrent stage 1 cystocele at 6–12 months, but did not require further surgery. Conclusion The VLC allowed effective introduction of the suspending suture through the sacrospinous ligament and might be considered an important surgical component in the treatment of severe genital prolapse.

Occult Urinary Stress Incontinence in Women with Severe Genital Prolapse Evidenced by Minimally Invasive Test

Study Objective: To review the effectiveness of preoperative test in the diagnosis of urinary occult incontinence, in order to plan a correction with a prophylactic sub-mid urethral mesh in the prolapse surgery.

Myiasis in the uterine cavity of an elderly woman with a complete uterine prolapse

Myiasis is the infestation of the tissues of vertebrate animals by the larvae of flies (maggots). As the condition generally occurs in exposed areas of the body, genital myiasis is a rare condition, and myiasis of the uterine cavity is even rarer, only one case having been previously described in the literature. The case reported here describes myiasis of the uterine cavity and ulcerated vaginal mucosa of an 89-year-old woman with a severe (third-degree) genital prolapse. This case describes an extremely rare situation, and emphasizes the need for good hygiene and surgical correction in patients with a genital prolapse.

Incontinencia urinaria oculta evidenciada por estudio urodinámico preoperatorio en pacientes con prolapso genital severo

AbstractOccult stress incontinence identify by preoperative urodynamic study in women with severe pelvic organ prolapse ObjectiveTo review the effectiveness of preoperative urodynamic study made with correction of the severe genital prolapse by Bresky valve in the diagnosis of urinary occult incontinence, in order to plan a correction with a prophylactic sub-mid urethral mesh in the prolapse surgery Patients and methodPatients of the Urogynecology and Vaginal Surgery Unit of Las Condes Clinic, between January 2006 and December 2007, with grade III or IV cystocele. A condition was patients without previous prolapse and/or incontinence surgeries. A non multichannel urodynamics test was made with prolapse correction by a Bresky valve. The urethra retro resistance measurement and cystometry was made. In the women in whom the occult urinary incontinence was discards the prolapse surgery was made with Prolift mesh. In the women with occult incontinence a prophylactic sub-mid urethral tape was applied in the prolapse surgery, to avoid the appearance of incontinence after surgery ResultsThirty eight women fulfilled the criterion to enter in this study, 14 (36,8%) of them did not register occult urinary incontinence in the urodynamic test. In the 24 (63.2%) with occult incontinence: Type I in 1; type II in 2; type III in 1 and type II+III in 10. During the cystometry 3 of them registered an asymptomatic hyperactive detrusor. In 1 (4.2%) of the 24 patients with prophylactic incontinence surgery, in the immediate postoperative time a failure was observed. The rest 23 women did not present incontinence during the observation period between 4 to 24 months. In the 14 women only with prolapse surgery incontinence was not registered ConclusionsThe preoperative urodynamic test with correction of severe genital prolapse by Bresky valve is an efficient method to detect the occult urinary incontinence. This allows planning a prophylactic incontinence surgery. According to our experience this method is safe and effective to avoid that the occult incontinence appears after a severe cystocele surgery repair and allows to given an integral solution to the pelvic floor problems that frequently sees associate, because they risk factors are the same to these conditions and both cause a high degree of deterioration of quality of life

Prevalence of occult stress incontinence in continent women with severe genital prolapse

SummaryWe studied 32 clinically continent women with severe prolapse. We found evidence of occult stress incontinence in 10 of these women after reduction of the prolapse with a ring pessary. Our results, confirming the work of others, suggest that a high proportion of women with severe genito-urinary prolapse are at an increased risk of occult stress incontinence that could result in incontinence after surgery for prolapse. Urodynamic studies after restoring anatomy with a ring pessary may identify these women needing anti-incontinence procedures at the time of surgical repair of the prolapse.

A randomized comparison of tension-free vaginal tape and endopelvic fascia plication in women with genital prolapse and occult stress urinary incontinence

Objective The purpose of this study was to compare 2 anti-incontinence procedures in women who had severe genital prolapse and potential stress incontinence. Study design In addition to vaginal reconstructive surgery, 50 patients with stage II or higher anterior defect and a positive stress test result with prolapse reduction received either tension-free vaginal tape or plication of the endopelvic fascia. Preoperative evaluation included history, physical examination, stress test, and urodynamic assessment. Data were analyzed with the Student t test, the Fisher's exact test, and the Wilcoxon signed-rank test. Results The median follow-up time was similar for both groups, 26 and 24 months. Subjective (96% vs 64%; P = .01) and objective (92% vs 56%; P<.01) continence rates were higher after the tension-free vaginal tape procedure. Time for the resumption of spontaneous voiding, rates of urinary retention, or de novo urge incontinence were similar in the 2 groups. Conclusion Tension-free vaginal tape can be recommended for patients with prolapse and occult stress incontinence.

PROLAPSO GENITAL SEVERO: CONSIDERACIONES CLÍNICAS, FISIOPATOLÓGICAS Y DE TÉCNICA QUIRÚRGICA AL MOMENTO DE SU CORRECCIÓN

SUMMARY Current surgical treatment of severe genital prolapse is consequence of a better knowledge and understanding of the pelvic floor. An extensive review of the anatomic and physiopathological foundations that determine the apparition of prolapse is presented.

Colposacrosuspension for severe genital prolapse

Objective: A descriptive study of 140 patients with severe genital prolapse managed by colposacrosuspension with mesh interposition and a modified Burch colposuspension. Methods: A laparotomy was performed with mobilization of the rectum and exploration of the rectovaginal septum. Vaginally, a longitudinal incision was made in the posterior vaginal wall which was completely separated from the rectum. A perineal repair was done, whereafter a strip of Vypro ® (Johnson & Johnson, Brussels, Belgium) mesh was inserted from the perineum to the sacrum at S1. It was fixated to the perineum and vagina while the rectum was elevated and attached to the mesh. Where a perineal repair was deemed not necessary, the mesh extended from the mid-vagina to the sacrum. A second mesh strip was placed anteriorly of the vagina, covering the upper third of the vagina and extending to the sacrum. After closure of the pelvic peritoneum, covering the mesh, a modified Burch colposuspension was performed. Follow-up was done at 6 weeks, 6 months and yearly thereafter. Results: The median age was 61 years with a median parity of 3. All patients presented with grade 2 (extending to the vaginal introitus) or 3 (outside the vaginal introitus) prolapse. Approximately one-third had urinary incontinence and a similar proportion complained of difficulty in defecation. All the patients underwent colposacrosuspension with the mesh extending to the perineum in 67% of the patients. A Burch colposuspension was performed in 79% of the women. Postoperatively, 97% of the patients were followed for 1–29 months with a median of 8.5 months (mean 10.2 months). Recurrent prolapse, grade 2 or 3, developed in 11 patients (8%) and 17 patients (12%) developed urinary incontinence, needing a transvaginal tape procedure. Removal of the mesh was necessary in one patient (0.7%). Conclusion: Colposacrosuspension for severe genital prolapse delivered satisfactory short-term results. It is, however, a major surgical procedure and elderly or compromised patients may require less invasive procedures.

Vaginectomy with pelvic herniorrhaphy for prolapse

OBJECTIVE: The study was undertaken to report our experience with vaginectomy and pelvic herniorrhaphy for vaginal prolapse. STUDY DESIGN: This was an observational study of patients undergoing vaginectomy (n = 41) or hysterovaginectomy (n = 13) for stage III/IV vaginal prolapse. Morbidity was compared with cohorts who had undergone transvaginal repair of prolapse, by using the Mann-Whitney U test. RESULTS: Morbidity did not differ significantly (estimated blood loss) between the vaginectomy and hysterovaginectomy groups. There were no recurrent hernias (6-56 months). Operative time, estimated blood loss, and day of discharge were significantly greater for the posthysterectomy prolapse group compared with the vaginectomy group. Operative time was significantly greater for the uterovaginal prolapse group versus the hysterovaginectomy group. CONCLUSIONS: Vaginectomy with or without hysterectomy with pelvic herniorrhaphy is associated with a low rate of morbidity in a high-risk patient population. Hysterovaginectomy is not associated with a clinically significant difference in morbidity over vaginectomy alone. Vaginectomy with or without hysterectomy should be offered as a surgical option to selected patients with severe genital prolapse.

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.