The Efficacy and Safety of Colpocleisis for Urinary Retention in Elderly Women With Pelvic Organ Prolapse

TL;DR

Colpocleisis is a safe and effective surgery for elderly women with pelvic organ prolapse and urinary retention, helping them void naturally or manage catheterization more easily.

Contribution

Demonstrates colpocleisis as a viable treatment for urinary retention in elderly women with advanced pelvic organ prolapse.

Findings

89% of patients achieved spontaneous voiding after colpocleisis.

No perioperative complications or prolapse recurrence were observed.

Postoperative voiding metrics improved significantly in most patients.

Abstract

Objective

This study aimed to evaluate the clinical efficacy and safety of colpocleisis for urinary retention in elderly women with advanced pelvic organ prolapse (POP), with a particular focus on symptom resolution, postoperative voiding function, and perioperative safety.

Methods

This retrospective study included nine elderly women (median age: 79 years) with POP-associated urinary retention who underwent colpocleisis at our institution between January 2019 and December 2024. Colpocleisis was performed only in patients who were not sexually active and did not desire future sexual activity. Urinary retention was defined as the inability to void spontaneously, requiring either intermittent catheterization or placement of an indwelling urethral catheter. All patients underwent a preoperative urodynamic evaluation. Surgical outcomes and the postoperative voiding function were assessed, including the voided volume, maximum urinary flow rate (Qmax), and post-void residual volume (PVR).

Results

Eight of the nine patients (89%) achieved spontaneous voiding postoperatively and were successfully weaned from catheterization. One patient with spinal cord injury continued to require catheterization but experienced easier management and an overall improvement in quality of life. No perioperative complications were observed, and no POP recurrence was noted during a median follow-up of three (range: 1-18) months. The median postoperative voided volume, Qmax, and PVR were 175 mL, 15.9 mL/s, and 20 mL, respectively.

Conclusions

Colpocleisis may represent a safe and effective surgical option in elderly women with POP-related urinary retention. It facilitates spontaneous voiding or simplifies catheter management, contributing to an improved quality of life. Given its minimally invasive, mesh-free nature and short operative time, colpocleisis could be a valuable treatment option for elderly patients with voiding dysfunction who do not wish to preserve sexual function.

Figures