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International Urogynecology Journal

, Volume 25, Issue 3, pp 417–424 | Cite as

Labhardt’s colpoperineocleisis: subjective results of an alternative treatment for genital prolapse in patients who are not sexually active—2-year follow-up

  • Javier Pizarro-BerdichevskyEmail author
  • Gonzalo Galleguillos
  • Rodrigo Cuevas
  • Bernardita Blümel
  • Alejandro Pattillo
  • Silvana González
  • Alejandro Majerson
  • Oslando Padilla
  • Mauricio Cuello
  • Juan Andrés Ortiz
  • Howard B. Goldman
IUJ Video

Abstract

Introduction and hypothesis

Genital prolapse affects up to 50 % of multiparous women and has an impact on quality of life (QoL) for many. Vaginal obliterative techniques are relevant in older patients who are not sexually active. We performed Labhardt’s colpoperineocleisis in such patients. The objective was the evaluation of subjective outcomes of this technique using PGI-I.

Methods

Retrospective cohort analysis of patients. We performed a bivariate, multivariate analysis, and survival curves for subjective improvement.

Results

Seventy-four cases were analyzed. Average age of the patients was 72 years, median parity 4, 95.9 % POP-Q stage III or IV, anterior leading edge defect in 61.1 %. Operating time: 54 min, estimated blood loss 70 ml, no intraoperative complications, 12 patients had protocol deviations with changes in the recommended type of suture. Median hospital stay was 2 days and average follow-up 24.9 months. There was 13.5 % anatomical recurrence, 3 of which (30 %) were in patients with protocol deviations. 1.9 % developed clinically significant de novo stress urinary incontinence (SUI). PGI-I: 64 (86 %) reported subjective improvement and 10 did not. In the subjective improvement group, 98.4 % reported being very much or much better. In the non-subjective improvement group 80 % reported that they were the same as before surgery and 20 % were worse. In bivariate analysis anatomical recurrence showed significance and persisted after multivariate analysis with an OR of 8322 for subjective failure.

Conclusion

Labhardt’s colpoperineocleisis is a safe technique with good subjective results. It has few complications, an acceptable recurrence rate, and a low rate of de novo SUI. It may be important to use the #0 or #1 polydioxanone sutures, as these are associated with better outcomes in this series. Comparative studies with other obliterative techniques are needed.

Keywords

Pelvic organ prolapse Gynecological surgical procedures Frail elderly Quality of life Vaginal prolapse 

Abbreviations

POP

Pelvic organ prolapse

PGI-I

Patient global impression of improvement

SUI

Stress urinary incontinence

OR

Odds ratio

BMI

Body mass index

POP-Q

Pelvic organ prolapse quantification

ISI

Incontinence severity index

Notes

Consent

Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

Acknowledgements

We are deeply grateful to Dr. Manuel Fernandez who has devoted his professional life to gynecological–oncological surgery and as a great vaginal surgeon, selflessly taught us this technique. We would also like to thank Dr. Marco Aramayo, Dr. Marco Arellano, and Jacobo Alvo for their critical review of this manuscript.

Conflict of interest

None.

Supplementary material

ESM 1

(MP4 95755 kb)

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Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Javier Pizarro-Berdichevsky
    • 1
    • 2
    • 3
    • 7
    Email author
  • Gonzalo Galleguillos
    • 1
    • 2
    • 4
  • Rodrigo Cuevas
    • 1
    • 2
  • Bernardita Blümel
    • 1
  • Alejandro Pattillo
    • 1
    • 2
  • Silvana González
    • 1
  • Alejandro Majerson
    • 6
  • Oslando Padilla
    • 5
  • Mauricio Cuello
    • 2
  • Juan Andrés Ortiz
    • 1
    • 2
    • 4
  • Howard B. Goldman
    • 3
  1. 1.Urogynecology UnitComplejo Asistencial Dr. Sotero del RioSantiagoChile
  2. 2.Division Obstetricia y Ginecologia, Facultad de MedicinaPontificia Universidad Catolica de ChileSantiagoChile
  3. 3.Cleveland ClinicClevelandUSA
  4. 4.Clinica Santa MariaSantiagoChile
  5. 5.Departamento de Salud Pública, Facultad de MedicinaPontificia Universidad Catolica de ChileSantiagoChile
  6. 6.Urology, Facultad de MedicinaPontificia Universidad Catolica de ChileSantiagoChile
  7. 7.Av Concha y Toro 3459, Puente Alto, 8207257SantiagoChile

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