Department of Urology, Medical University of South Carolina, Charleston, SC 29425, USA.
Urology. 2012 Sep;80(3):542-6. doi: 10.1016/j.urology.2012.06.009.
To characterize our experience with colpocleisis in a urologic setting because it has not been documented broadly in the urologic literature.
Retrospective review of demographics, urodynamics, presenting symptoms, complications, and outcomes for patients undergoing colpocleisis from 2001-2010 was performed. A questionnaire including the short forms of the Urinary Distress Inventory and Pelvic Organ Prolapse Distress Inventory (POPDI-6), and the Patient Global Impression of Improvement was sent to consenting patients.
Fifty-three patients were identified. Examinations were all POP-Q stage 3 or greater or Baden Walker grade 3 or higher; 73.6% underwent total colpocleisis and 26.4% Le Fort; 60.4% underwent concomitant sling. Complications included 1 patient requiring transfusion, 1 with pulmonary embolus, 1 needing clot evacuation, and 1 requiring intraoperative cystotomy repair. There was no postoperative de novo urgency, no recurrence of prolapse, and no chronic urinary retention. In patients not undergoing urethral sling, stress urinary incontinence persisted in 4 patients and occurred de novo in 1. Mean follow-up was 9.3 months. Twenty-two surveys were returned: 90.9% described their condition as much or very much better on Patient Global Impression of Improvement. The average POPDI-6 score was 9.1. Frequency and urgency were the most common complaints leading to bother on the UDI-6 (33.3%). Most of these responders had a preoperative urge component.
In a selected patient population, colpocleisis is safe and efficacious. Persistent lower urinary tract symptoms comprise the highest frequency of complaints after colpocleisis, and this must be included in patient counseling. In an aging patient population with expected increase in demand for pelvic floor reconstruction, colpocleisis is a useful approach for the urologist.
描述我们在泌尿科环境中进行阴道封闭术的经验，因为它在泌尿科文献中没有广泛记录。
对 2001 年至 2010 年间接受阴道封闭术的患者的人口统计学、尿动力学、主要症状、并发症和结局进行回顾性分析。向同意参加的患者发送了包括尿失禁困扰量表和盆腔器官脱垂困扰问卷（POPDI-6）简短形式以及患者整体改善印象的问卷。
共确定了 53 例患者。检查均为 POP-Q 分期 3 期或更高级别或 Baden Walker 分级 3 级或更高；73.6%行全阴道封闭术，26.4%行 Le Fort 术；60.4%行同期吊带术。并发症包括 1 例需要输血，1 例发生肺栓塞，1 例需要清除血块，1 例需要术中膀胱切开修复。术后无新发急迫性尿失禁，无脱垂复发，无慢性尿潴留。未行尿道吊带术的患者中，4 例持续性压力性尿失禁，1 例新发压力性尿失禁。平均随访时间为 9.3 个月。共收到 22 份调查回复：90.9%的患者在患者整体改善印象中描述他们的病情“明显”或“非常好”。POPDI-6 平均评分为 9.1。频率和急迫性是导致 UDI-6 困扰的最常见抱怨（33.3%）。这些应答者中的大多数在术前就有急迫性症状。
在选择的患者人群中，阴道封闭术是安全有效的。在阴道封闭术后，持续性下尿路症状构成了最高频率的抱怨，这必须包含在患者咨询中。在预期对盆底重建需求增加的老年患者人群中，阴道封闭术是泌尿科医生的一种有用方法。
