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).
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Halberthal-Cohen, A., Burke, Y.Z., Matanes, E. et al. Modified colpocleisis for repair of pelvic organ prolapse post-radical cystectomy. Int Urogynecol J 31, 409–410 (2020). https://doi.org/10.1007/s00192-019-03996-9
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DOI: https://doi.org/10.1007/s00192-019-03996-9