Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis

Katsara, Alkisti; Wight, E; Heinzelmann‐Schwarz, Viola; Kavvadias, Tilemachos

doi:10.1007/s00404-016-4158-y

Cited by 24 publications

(23 citation statements)

References 13 publications

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“…Women who had previously undergone transvaginal reconstructive surgery reported good POP-specific QOL [110]. Women who had previously undergone obliterative surgery reported deficits in sexual function [111] and body image [111,112]. However, most reported low regret, improvement in POP-specific QOL, and were satisfied [111][112][113].…”

Section: Follow-upmentioning

confidence: 99%

See 1 more Smart Citation

A Scoping Study of Psychosocial Factors in Women Diagnosed With and/or Treated for Pelvic Organ Prolapse

Touza

Rand

Carpenter³

et al. 2018

Female Pelvic Med Reconstr Surg

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Section: Follow-upmentioning

confidence: 99%

“…Women who had previously undergone obliterative surgery reported deficits in sexual function [111] and body image [111,112]. However, most reported low regret, improvement in POP-specific QOL, and were satisfied [111][112][113]. Women who reported better POP-specific QOL after surgery were more likely to be satisfied [114].…”

Section: Follow-upmentioning

confidence: 99%

A Scoping Study of Psychosocial Factors in Women Diagnosed With and/or Treated for Pelvic Organ Prolapse

Touza

Rand

Carpenter³

et al. 2018

Female Pelvic Med Reconstr Surg

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“…Therefore, despite its low invasiveness, surgeons are reluctant to offer obliterative procedures because of concern about patient regret. However, many papers have shown significant improvement of body image, QOL, bladder and bowel symptoms and a low level of regret and high satisfaction following colpoclesis [ 7 , 11 – 13 ]. In our study, we included only elderly patients who had not had coital intercourse for at least several years and did not wish to have it in the future.…”

Section: Discussionmentioning

confidence: 99%

Razor-type dermatomes enable quick and thin vaginal dissection with less bleeding in colpocleisis

Kato

Hayashi²,

Adachi³

et al. 2019

Int Urogynecol J

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Introduction and hypothesis Although colpocleisis is a low-invasive surgical option to treat pelvic organ prolapse, it sometimes involves a long operative time with substantial bleeding. To streamline the vaginal dissection process in colpoclesis, we introduced the usage of dermatomes. Methods All patients were sexually inactive women with post-hysterectomy prolapse. Data of the dermatome group were retrospectively compared with those of the historical control group based on operative features, perioperative complications and pathology of dissected tissue. In the dermatome group, 34 women underwent total colpocleisis with vaginal dissection using dermatomes; 4 were done mainly with electric dermatomes, and 30 were done with razor-type dermatomes. In the control group, 20 women underwent total colpocleisis with vaginal dissection using Metzenbaum scissors. Results Using dermatomes in vaginal dissection was helpful to shorten total operative time (including perineoplasty) by one third from 76 to 51 min, to shorten the time of colpocleisis by half, from 62 to 32 min, and to reduce intraoperative bleeding by 76%, from 62 to 15 ml. In addition, none in the dermatome group and 2/20 patients in the control group had unintended peritoneal opening. Dissection with scissors removed not only the epithelium and submucosal layer but also the muscle layer. This was minimized with razor-type dermatomes and never occurred with electric dermatomes. Whereas electric dermatomes are difficult to get accustomed to and are expensive, razor-type dermatomes enable thinner dissection compared with scissors, are easy to handle and are inexpensive. Conclusions Razor-type dermatomes enable quick and thin vaginal dissection with less bleeding. Therefore, they can be recommended as a practical tool for colpocleisis, a prolapse operation mainly for frail elderly patients.

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“…However, access to POP surgery in low income countries is very limited because it is expensive and the skilled personnel to perform the surgery are few [ 25 ]. Surgery for symptomatic POP has been shown to improve the QOL in high income countries [ 5 , 13 , 26 – 28 ]. However, in low income countries including Uganda, the impact of surgery on QOL is rarely reported yet this evidence is important for advocacy in scaling up treatment for POP in these resource limited settings where women with POP face various challenges in accessing care [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of surgery on quality of life of Ugandan women with symptomatic pelvic organ prolapse: a prospective cohort study

et al. 2021

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Background Pelvic organ prolapse (POP) is a significant public health issue that negatively affects the Quality of Life (QOL) of women in both low and high-income countries. About 20% of women will undergo surgery for POP over their lifetime. However, there is a paucity of information on the effect of surgery on QOL especially in resource-limited settings. We therefore assessed the QOL among women with symptomatic POP living in rural southwestern Uganda and the impact of surgery on their quality of life. Methods We conducted a prospective cohort study among 120 women with symptomatic POP scheduled for surgery at the urogynecology unit of Mbarara Regional Referral Hospital. The QOL at baseline and at 1 year after surgery in the domains of physical performance, social interaction, emotional state, sexual life, sleep quality, personal hygiene and urinary bladder function was determined using a King’s Quality of Life questionnaire. A paired t-test was used to compare the difference in mean scores at baseline and at 1-year post-surgery. Results Of the 120 participants that were enrolled at baseline, 117(98%) completed the follow-up period of 1 year. The baseline QOL was poor. The domains with the poorest QOL were physical, social, sexual, emotional and sleep quality. The mean QOL scores in all the domains and the overall QOL significantly improved 1 year after surgery (p < 0.001). The overall QOL improved by 38.9% after surgery (p < 0.001). Conclusions The QOL was poor among women with symptomatic POP and surgery improved the QOL in all the domains of life. We recommend that surgery as an option for treatment of symptomatic POP should be scaled up to improve on the QOL of these women.

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Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis

Abstract: Colpocleisis seems to be an effective treatment for pelvic organ prolapse. In the long term, impact on quality of life is positive, whilst urinary tract symptoms seem to be the most bothersome factor.

Cited by 24 publications

References 13 publications

A Scoping Study of Psychosocial Factors in Women Diagnosed With and/or Treated for Pelvic Organ Prolapse

A Scoping Study of Psychosocial Factors in Women Diagnosed With and/or Treated for Pelvic Organ Prolapse

Razor-type dermatomes enable quick and thin vaginal dissection with less bleeding in colpocleisis

Impact of surgery on quality of life of Ugandan women with symptomatic pelvic organ prolapse: a prospective cohort study

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