Single surgeon's experience with Le Fort partial colpocleisis in advanced apical prolapse.

Objectives: The aim of this study was to evaluate the outcomes of women with advanced apical prolapse who were treated with the obliterative LeFort partial colpocleisis (LFC) procedure by single surgeon.

Methods: We reviewed the medical records of patients who underwent LFC for advanced apical prolapse. Operative data were collected from detailed operative records and included in the analysis. The analysis evaluated total operating times (incision to closure), kinds of intraoperative events, and the level of hemoglobin (Hb) drop. The Hb drop value was calculated by subtracting the Hb level within three days of surgery from the preoperative Hb level. The analysis also included the length of hospitalization (days), length of indwelling Foley catheter, and types of acute postoperative complications.

Results: From 2006 to 2023, seventy-one patients underwent LFC. The median age of patients at operation was 76.8 years. The median follow-up time was 29.4 ± 27.0 [0-108] months. Immediate postoperative complications, which were virtually all urinary symptoms, were present in 15.7% of patients, and 86.3% of the patients were in spontaneous remission. There was one case of perineal wound infection which was cured by incision and drainage. Two patients had recurrences of vaginal tearing, and both had a common history of complaining of constipation after the operation. One of the cases was successfully treated by repeated LFC. Another two patients experienced persistent feeling of a bearing-down sensation. The subjective success rate of the LFC procedure for all patients was 94.4% (/71).

Conclusions: Our study has demonstrated that LFC can result in a high subjective success rate and a high level of subjective satisfaction. The results also show that obliterative LFC can be considered a good surgical treatment option for managing POP in selected elderly women with multiple co-morbidities and who do not need to conserve vaginal intercourse. An obliterative procedure for POP remains the least invasive and the most durable surgical repair available.