International Urogynecology Journal

, Volume 30, Issue 3, pp 495–497 | Cite as

Rouhier’s colpocleisis with concomitant vaginal hysterectomy: an instructive video for female pelvic surgeons

  • Florin ConstantinEmail author
  • Nikolaus Veit-Rubin
  • Lauriane Ramyead
  • Jean Dubuisson
IUJ Video


Introduction and hypothesis

The treatment of pelvic organ prolapse (POP) in elderly women can be challenging. The vaginal operation known as colpocleisis, the total occlusion of the urogenital hiatus, with concomitant hysterectomy was described by Rouhier and represents a safe, time-saving, and reproducible procedure in the case of POP associated with uterine pathological conditions. It is suitable for elderly women who do not require preservation of coital function. The objective of this video is to provide anatomical illustrations and a precise description of the surgical steps.


We present the case of a 62-year-old woman who was referred for hysterectomy in the context of metastatic endometrial cancer. She complained about vaginal bulge and was diagnosed with a POP-Q stage 4 genital prolapse on physical examination. Due to important comorbidities such as arterial hypertension, obesity, and three-site metastatic disease, we suggested a colpocleisis with concomitant vaginal hysterectomy. This approach was intended to treat the prolapse and perform a palliative surgery to alleviate abnormal uterine bleeding.


This video illustrates the different surgical steps of a colpohysterectomy according to Rouhier. No intraoperative complications occurred and the postoperative follow-up was uneventful. The patient was fully satisfied and POP has not recurred after a 17-month follow-up.


Colpocleisis should remain an exceptional approach, but could be offered to sexually inactive women of advanced age after thorough discussion and patient consent. If a hysterectomy is necessary, Rouhier’s operation offers a time-saving, reproducible, and efficient option for women with symptomatic POP who do not desire future vaginal intercourse.


Colpocleisis Vaginal hysterectomy Pelvic organ prolapse Rouhier 


Compliance with ethical standards

Conflicts of interest



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

Supplementary material

192_2018_3765_MOESM1_ESM.mp4 (100.5 mb)
ESM 1 (MP4 102869 kb)


  1. 1.
    Ortman JM, Velkoff VA, Hogan H. An aging nation: the older population in the United States. US Department of Commerce Economics and Statistics Administration. 2014.
  2. 2.
    Wu JM, Matthews CA, Conover MM, Pate V, Jonsson FM. Lifetime risk of stress incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123:1201–6.CrossRefGoogle Scholar
  3. 3.
    FDA Safety Communication. Urogynecologic surgical mesh: update on the safety and effectiveness of transvaginal placement for pelvic organ prolapse. Available at: Retrieved 1 February 2017.
  4. 4.
    Dieter AA, Wilkins MF, Wu JM. Epidemiological trends and future care needs for pelvic floor disorders. Curr Opin Obstet Gynecol. 2015;27:380.CrossRefGoogle Scholar
  5. 5.
    Wu JM, Kawasaki A, Hundley AF, Dieter AA, Myers ER, Sung VW. Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 2011;205:230.e1–5.CrossRefGoogle Scholar
  6. 6.
    FitzGerald MP, Richter HE, Siddique S, Thompson P, Zyczynski H. Colpocleisis: a review. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(3):261–71.CrossRefGoogle Scholar
  7. 7.
    Zimmerman CW. Colpocleisis. In: Kovac S, et al., editors. Advances in reconstructive vaginal surgery. Philadelphia: Lippincott; 2007. p. 636–55.Google Scholar
  8. 8.
    Clavé H. Mini-invasive vaginal hysterectomy with thermo-fusion hemostasis. J Visc Surg. 2011;148:e189–96.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity Hospitals GenevaGenevaSwitzerland
  2. 2.Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria

Personalised recommendations