Safety and Efficacy of Vaginal Reconstruction in Elderly Women with Medical CoMorbidities - Abstract
Objective: To compare colpocleisis and vaginal reconstruction in elderly women with medical co-morbidities.
Methods: This is a retrospective cohort study of patients who underwent pelvic organ prolapse surgery between November 2015 and December 2018. Demographic
information, operative data, and short-term outcomes were evaluated.
Results: One hundred three patients qualified for the study (23 colpocleisis, 80 vaginal reconstruction). Patients who chose colpocleisis were older (75.4 ± 6.3 years vs. 71.3 ± 4.8 years, P = .01) and were more likely to have a prior hysterectomy (39% vs. 16%, P = .02). Patients who had colpocleisis had similar severity of prolapse compared to those who chose vaginal reconstruction (Stage 3.6 ± 0.7 vs. 3.3 ± 0.7, P = .08). Patients who chose vaginal reconstruction had greater blood loss (200 ± 132 ml vs. 106 ± 105 ml, P = .01) but did not require more transfusions. While procedure time was greater for those who had vaginal reconstruction (247 ± 54 min vs. 168 ± 34 min, P = .01), hospital length of stay were similar (1.1 ± 0.3 days vs. 1.7 ± 2.5 days, P=.06). There were no differences in major or minor complications. The rate of subjective recurrent prolapse with at least one year of follow-up was also similar (0% vs. 6%, P = .58).
Conclusion: Vaginal reconstruction is safe and feasible with good short-term success in elderly patients with medical co-morbidities.
Brief summary: Retrospective study comparing total vaginal reconstruction and colpocliesis in elderly women with medical co-morbidities. Vaginal reconstruction is safe and feasible with good short-term success.