Abstract

Colpocleisis is an obliterative surgical option for women with pelvic organ prolapse (POP) which is often performed in a frail population. However, due to the fact that outcomes remain largely unknown we aimed to assess the durability and perioperative safety of colpocleisis in a large population-based cohort.All women undergoing colpocleisis and other POP repairs in California (2005-2011) were identified using the Office of Statewide Health Planning and Development datasets. Durability was defined as the absence of future POP repair after index repair for the duration of the datasets. Thirty-day morbidity was assessed by identifying readmissions, repeat surgeries, and complications. A metric to assess frailty in large administrative databases was applied to assess the impact of frailty on outcomes. Colpocleisis outcomes were compared to other types of POP repairs by developing propensity score matched groups.Of the 2,707 women undergoing colpocleisis, reoperation for prolapse occurred in 47 (1.8%). At least one complication occurred in 11.1% of the cohort, with serious complications occurring in 2%. Frail patients were more likely to experience any complication (23.3% vs. 10.3%, p<0.01) and a serious complication (5.0% vs. 1.8%, p=0.02) and was the best predictor of morbidity. Colpocleisis was associated with a more durable repair (overall failure 1.8% versus 3.5%, p<0.01) with no difference in complication rates as compared to the matched cohort.Colpocleisis provides a more durable outcome than reconstructive POP repairs, without increased perioperative morbidity. Frailty is a better predictor than age for perioperative complications after colpocleisis.

View details for DOI 10.1097/JU.0000000000001239

View details for PubMedID 32648798