# Colpocleisis—Still a Valuable Option: A Point of Technique

## TL;DR

Colpocleisis using purse-string sutures is an effective and standardized surgical option for advanced pelvic organ prolapse in elderly women.

## Contribution

The study evaluates recurrence and reoperation rates using a standardized purse-string suture technique for colpocleisis.

## Key findings

- The overall recurrence rate was 16%, with a reoperation rate of 9.2%.
- Patients without prior surgeries had a lower recurrence rate of 7%.
- Bladder voiding dysfunction and incontinence symptoms improved significantly post-surgery.

## Abstract

Background/Objectives: Pelvic organ prolapse (POP) is a common condition that increases with age and affects up to 40% of women. Colpocleisis is a possible native-tissue repair used in elderly persons not interested in vaginally penetrative sex to correct advanced POP. This study aims to evaluate the recurrence and reoperation rate of a technique using purse-string sutures in a standardised way. Methods: This retrospective quality control study evaluated all women who underwent obliterative procedures for POP at the Department of Obstetrics and Gynaecology at the University Hospital of Bern from 2014 to 2023. Total Colpocleisis (TC) and Le-Fort Colpocleisis (LFC) were performed by a standardised technical procedure using purse-string sutures. The primary outcome was the recurrence rate measured by the POP-Q stage (stage 2 or higher). Reoperation rate, perioperative complications, bladder outlet disorders and incontinence symptoms were assessed as secondary outcomes. Results: We analysed eighty-eight patients who underwent obliterative surgery with TC or LFC in this study. The recurrence rate for all patients was 16%, and the reoperation rate was 9.2%. In patients without previous surgeries (52%), the recurrence rate was 7%. Thirteen patients (14.8%) had perioperative complications, mainly urinary tract infections (seven patients, 8%). Objective POP improved significantly (p < 0.001), as did the bladder voiding dysfunction in the rate of high postvoid residual volume (p < 0.05), stress urinary incontinence, overactive bladder and mixed urinary incontinence (p < 0.001). In three patients, de novo stress urinary incontinence developed postoperatively. Conclusions: Colpocleisis by the purse-string technique is an effective surgical treatment for advanced POP surgery. Recurrence and reoperation rates are similar to the previously mentioned techniques and are easy to learn due to the standardised procedure.