Colpocleisis and urinary incontinence

OBJECTIVE: The study was undertaken to review results of colpocleisis performed for advanced pelvic organ prolapse (POP) in elderly women, with attention to perioperative stress incontinence. STUDY DESIGN: We performed a retrospective chart review of all colpocleisis procedures performed July 2000 through March 2002. RESULTS: Sixty-four women with median age 78 years (68-90 years) with symptoms and signs of advanced POP underwent partial vaginectomy and colpocleisis. Concomitantly, 21 (33%) women underwent suburethral sling and 12 (19%) underwent suburethral plication procedures for treatment of stress urinary incontinence (SUI). Three patients with dementia were unable to offer subjective symptoms. One patient died in hospital from multisystem organ failure unrelated to colpocleisis. When last seen, 2 (3%) of the remaining 60 patients had some persistence of symptoms of POP. Of 30 women without preoperative symptoms of SUI, 8 had new-onset SUI symptoms after surgery. CONCLUSION: Colpocleisis is an effective method for treatment of advanced POP. Lower urinary tract evaluation and treatment remain challenging in this setting.