Department of Gynecology, Fujian Provincial Key Laboratory of Women and Children's Critical Diseases Research, Fujian Province Key Clinical Specialty for Gynecology, Fujian Maternity and Child Health Hospital, Fuzhou, China.
Int J Gynaecol Obstet. 2024 Mar;164(3):1132-1140. doi: 10.1002/ijgo.15161. Epub 2023 Sep 30.
To evaluate the effectiveness of modified total colpocleisis for advanced pelvic organ prolapse (POP) in elderly women and to assess the improvement in lower urinary tract symptoms (LUTS) of the patients.
An observational cohort study was conducted, including 105 POP patients who underwent modified total colpocleisis between April 2020 and December 2022. The study analyzed the patients' demographic characteristics, perioperative outcomes, and follow-up outcomes, including complications, remission of LUTS, satisfaction rates, and regret rates. Confirming the safety, durability, and patient satisfaction of modified total colpocleisis.
Most patients (95/105, 90.5%) had more than one comorbidity. Eighty-six (81.9%) had a concomitant hysterectomy, the average operative time was 112.78 ± 34.92 min, with a median estimated bleeding of 50 mL (10-300 mL). Perioperative changes in hemoglobin and hematocrit were 11.64 ± 10.03 g/L and 3.87% ± 3.05%, respectively. Urinary retention was the most common complication (10/105, 9.5%). With a median follow up of 16 months (3-35 months), 101 patients (96.2%) reported satisfaction with the results of the procedure, with none reporting regret. Both subjective and anatomical recurrence rates were quite low (2.9% and 5.7%, respectively). Twenty-three (21.9%) had de novo urinary incontinence, and the remaining LUTS such as frequent, urgent, hesitation, and difficulty emptying were significantly improved (P < 0.05).
Modified total colpocleisis is an effective treatment option for elderly women with severe POP. This procedure can significantly improve several LUTS, and most de novo incontinence is mild and has a limited impact on patients' quality of life.
评估改良全阴道封闭术治疗老年女性晚期盆腔器官脱垂（POP）的有效性，并评估患者下尿路症状（LUTS）的改善情况。
进行了一项观察性队列研究，纳入了 2020 年 4 月至 2022 年 12 月期间接受改良全阴道封闭术的 105 例 POP 患者。该研究分析了患者的人口统计学特征、围手术期结局和随访结局，包括并发症、LUTS 缓解情况、满意度和后悔率。以证实改良全阴道封闭术的安全性、耐久性和患者满意度。
大多数患者（95/105，90.5%）有多种合并症。86 例（81.9%）同时行子宫切除术，平均手术时间为 112.78±34.92 分钟，中位估计出血量为 50 毫升（10-300 毫升）。围手术期血红蛋白和血细胞比容的变化分别为 11.64±10.03g/L 和 3.87%±3.05%。尿潴留是最常见的并发症（10/105，9.5%）。中位随访 16 个月（3-35 个月）后，101 例（96.2%）患者对手术结果表示满意，无患者表示后悔。主观和解剖学复发率均较低（分别为 2.9%和 5.7%）。23 例（21.9%）新发尿失禁，其余 LUTS，如频繁、急迫、犹豫和排空困难均明显改善（P<0.05）。
改良全阴道封闭术是治疗老年女性严重 POP 的有效治疗选择。该术式可显著改善多种 LUTS，且大多数新发尿失禁为轻度，对患者生活质量的影响有限。
