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Long-term Pelvic Floor Symptoms, Recurrence, Satisfaction, and Regret Following Colpocleisis

Winkelman, William D., MD*†‡; Haviland, Miriam J., MSPH†‡; Elkadry, Eman A., MD*†‡

Female Pelvic Medicine & Reconstructive Surgery: July 27, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000602
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There are insufficient studies on long-term outcomes following colpocleisis, which limits physicians' ability to effectively counsel patients. The purpose of this study was to assess pelvic floor symptoms, recurrence, satisfaction, and regret among patients who underwent colpocleisis procedures.

Methods This is an ambidirectional cohort study involving patients who underwent a colpocleisis at a single institution from 2002 to 2012. Medical records were reviewed, and patients were contacted by telephone in order to complete questionnaires.

Results A total of 73 patients met inclusion criteria for our study. At the time of colpocleisis, patients were an average of 78.1 years old (range, 62–85 years). Patients were followed up in clinic for a median of 44.4 months, and the majority reported overactive bladder postoperatively. We were able to contact 33 patients by telephone. Median time between surgery and telephone follow-up was 6 years (range, 5–15 years). Among these patients, 78% were satisfied with the procedure; however, 13% reported strong feelings of regret. Regret was associated with postoperative bowel and bladder symptoms. The majority reported urinary frequency (63%) and urgency urinary incontinence (56%). Fewer than half (44%) of patients reported bowel symptoms. Only 19% reported prolapse symptoms. No patients reported regret due to loss of sexual function.

Conclusions Colpocleisis remains an excellent surgical option for elderly patients. However, regret and dissatisfaction may increase over time as bowel and bladder symptoms may be perceived to be the result of surgery. Our findings highlight the continued need for detailed consent and expectation setting for women considering colpocleisis.

From the *Mount Auburn Hospital, Cambridge; and

Beth Israel Deaconess Medical Center; and

Harvard Medical School, Boston, MA.

Correspondence: William D. Winkelman, MD, Boston Urogynecology Associates, 725 Concord Ave, Suite 1200 Cambridge, MA 02138. E-mail: william.d.winkelman@gmail.com.

The authors have declared they have no conflicts of interest.

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