Modified colpocleisis for repair of pelvic organ prolapse post-radical cystectomy
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Introduction and hypothesis
Since the era of neoadjuvant chemotherapy, complications of pelvic organ prolapse (POP) post-radical cystectomy have become more common; however, the exact incidence is not documented in the literature. The objective was to repair post-radical cystectomy POP, despite the lack of endopelvic fascia normally needed for this type of repair.
Three patients aged 60 to 80 had symptomatic POP (of all three compartments: apical, anterior, and posterior) following radical cystectomy and ileal conduit urinary diversion, and no interest in maintaining their coital abilities. Two of the three women were status post-hysterectomy. Colpocleisis, which is known to have a success rate of almost 100%, was performed on the first two patients, with a recurrence of the prolapse shortly after this correction (2–4 months), probably due to the lack of endopelvic fascia. Following the failure of the procedure, a side-to-side closure of the vagina was performed. The latter was the procedure of choice performed on the third patient. We present a video clip of the vaginal closure to demonstrate the procedure performed.
Repair was successful in all three cases, with no relapse to date (4 months post-surgery).
Closure of the vaginal canal successfully treated POP in our case series. There were no intra- or postoperative complications in any of the cases. Patients were discharged the following day and did not show any signs of recurrence at follow-up (3, 5, and 6 months post-surgery).
KeywordsRadical cystectomy Prolapse repair POP repair POP recurrence
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.
We certify that all authors have seen and approves this final version of the manuscript being submitted. The article is our original work, has not had prior publication, and is not under consideration for publication elsewhere. None of the authors has any financial ties to disclose.
Institutional review board approval
The local institutional review board was consulted and according to their assessment, this manuscript does not require approval or exemption.