Eur J Obstet Gynecol Reprod Biol. 2026 Apr 10;322:115116. doi: 10.1016/j.ejogrb.2026.115116. Online ahead of print.
ABSTRACT
BACKGROUND: Colpocleisis remains an effective yet often underutilised surgical option for advanced pelvic organ prolapse (POP), particularly in elderly women who no longer desire vaginal intercourse. Despite its long history, concerns persist regarding postoperative complications, urinary symptoms, and patient regret. This study aimed to evaluate the perioperative, long-term, and patient-reported outcomes of colpocleisis, and to identify predictors of persistent urinary incontinence.
METHODS: A retrospective single-centre cohort study was conducted including 66 women aged ≥60 years who underwent colpocleisis between January 2015 and January 2025. Perioperative data were obtained from a prospectively maintained database. Long-term follow-up was available for 40 patients, with a mean follow-up duration of 41.36 months. Outcomes included complications, prolapse recurrence, urinary symptoms, and patient satisfaction assessed using Patient Global Impression (PGI) questionnaires. Comparisons between partial and total colpocleisis were performed using risk ratios (RR), and univariate logistic regression was used to identify predictors of persistent urinary incontinence.
RESULTS: The mean age was 78 years. Overall perioperative complication rate was 9.1% (95% CI 4.2-18.5%). At long-term follow-up, anatomical success was achieved in 92.5% (95% CI 80.1-97.4%), with no patients requiring repeat prolapse surgery (0%, 95% CI 0-4.5%). Persistent urinary incontinence occurred in 30% (95% CI 18.1-45.4%), while no cases of de novo incontinence were observed. High patient satisfaction was reported by 81.4% (95% CI 63.0-92.1%), with a low regret rate of 3.7% (95% CI 0.7-18.3%). There were no statistically significant differences in outcomes between partial and total colpocleisis. On univariate analysis, urodynamic stress incontinence (OR 7.5, 95% CI 1.57-35.7, p = 0.01) and BMI ≥ 30 (OR 5.0, 95% CI 1.13-22.2, p = 0.03) were significant predictors of persistent urinary incontinence.
CONCLUSIONS: Colpocleisis is a safe and highly effective procedure for selected patients with advanced POP especially during the current emphasis on native tissues repairs for POP, offering durable anatomical outcomes, high satisfaction, and low regret rates. Preoperative urodynamic findings and obesity are important predictors of persistent urinary symptoms and should be considered during patient counselling and surgical planning.
PMID:41967161 | DOI:10.1016/j.ejogrb.2026.115116
