A qualitative study of women’s values and decision-making surrounding LeFort colpocleisis

  • Kristin Wadsworth
  • Danny LovatsisEmail author
Original Article


Introduction and hypothesis

LeFort colpocleisis for uterovaginal prolapse can be appealing to elderly non-sexually active patients given the durability and low risk, particularly when the alternative procedure is more invasive and includes a hysterectomy. We used qualitative methods to explore women’s decision-making and feelings after this procedure.


We interviewed ten women after a LeFort colpocleisis (with or without mid-urethral sling) for uterovaginal prolapse. We conducted semi-structured interviews that were recorded and transcribed and then analyzed using grounded theory. The main themes were: the process of decision-making about whether to have an obliterative procedure, adequacy of preoperative counseling, and comparison against an alternative, more invasive surgical procedure with a hysterectomy. We also used the Decision Regret Scale and the Satisfaction with Decision Scale for Pelvic Floor Disorders.


Women made the decision to pursue LeFort colpocleisis mainly by themselves. They felt positive about the ability to control their body and their life through their own decision. None of the women regretted the procedure on the basis of the inability to have penetrative intercourse and did not feel it affected their sexual function in a negative way. Women felt adequately counseled regarding other options and the surgical procedure. Many patients wished they had pursued surgery earlier because they were very satisfied with the results.


Women who underwent LeFort colpocleisis were very happy with their decision. They primarily made the decision to have surgery autonomously. None of them regretted having an obliterative procedure for pelvic organ prolapse for reasons of sexual function.


Decision-making LeFort colpocleisis Pelvic organ prolapse Qualitative research 



The authors thank Josie Chundamala, Scientific Grant Editor funded by the Department of Obstetrics and Gynecology at Mount Sinai Hospital, for complimentary assistance editing and preparing this manuscript for submission.

Compliance with ethical standards

Conflicts of interest



  1. 1.
    Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89:501–6.CrossRefGoogle Scholar
  2. 2.
    FitzGerald MP, Richter HE, Siddique S, Thompson P, Zyczynski H, Weber A. Colpocleisis: a review. Int Urogynecol J. 2006;17:261–71.CrossRefGoogle Scholar
  3. 3.
    Zebede S, Smith A, Plowright L, Hegde A, Aguilar V, Davila W. Obliterative LeFort colpocleisis in a large group of elderly women. Obstet Gynecol. 2013;121:279–84.CrossRefGoogle Scholar
  4. 4.
    Katsara A, Eduard Wight E, Heinzelmann-Schwarz V, Kavvadias T. Long-term quality of life, satisfaction, pelvic floor symptoms and regret after colpocleisis. Arch Gynecol Obstet. 2016;294:999–1003.CrossRefGoogle Scholar
  5. 5.
    Crisp CC, Book NM, Smith AL, Cunkelman JA, Mishan V, Treszezamsky AD, et al. Body image, regret, and satisfaction following colpocleisis. Am J Obstet Gynecol. 2013;209:473.e1–7.CrossRefGoogle Scholar
  6. 6.
    Bernard HR. Research methods in anthropology, second edition. London: Sage Publications; 1995.Google Scholar
  7. 7.
    Denzin NK, Lincoln YS, editors. The SAGE handbook of qualitative research, fourth edition. London: Sage Publications; 2011.Google Scholar
  8. 8.
    O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89:1245–51.CrossRefGoogle Scholar
  9. 9.
    Sung VW, Kauffman N, Raker CA, Myers DL, Clark MA. Validation of decision- making outcomes for female pelvic floor disorders. Am J Obstet Gynecol. 2008;198:575.e1–6.CrossRefGoogle Scholar
  10. 10.
    Barber MD, Amundsen CL, Paraiso MF, Weider AC, Romero A, Walter MD. Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2008;18:799–806.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologySinai Health SystemTorontoCanada

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