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Modified colpocleisis for repair of pelvic organ prolapse post-radical cystectomy

  • Adi Halberthal-Cohen
  • Yechiel Z. BurkeEmail author
  • Emad Matanes
  • Gilad Amiel
  • Lior Lowenstein
IUJ Video
  • 5 Downloads

Abstract

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.

Methods

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.

Results

Repair was successful in all three cases, with no relapse to date (4 months post-surgery).

Conclusions

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).

Keywords

Radical cystectomy Prolapse repair POP repair POP recurrence 

Notes

Compliance with ethical standards

Conflicts of interest

None.

Consent

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

Author agreement/declaration

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.

Supplementary material

192_2019_3996_MOESM1_ESM.mp4 (149 mb)
ESM 1 (MP4 152614 kb)

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyRambam Health Care CampusHaifaIsrael
  2. 2.Ruth and Bruce Rappaport Faculty of MedicineTechnionHaifaIsrael

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