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Enlightening the mechanisms of POP recurrence after LeFort colpocleisis. Case report and review.

ΤίτλοςEnlightening the mechanisms of POP recurrence after LeFort colpocleisis. Case report and review.
Publication TypeJournal Article
Year of Publication2017
AuthorsMikos, T., Chatzipanteli M., Grimbizis G. F., & Tarlatzis B. C.
JournalInt Urogynecol J
Volume28
Issue7
Pagination971-978
Date Published2017 Jul
ISSN1433-3023
Λέξεις κλειδιάAged, Female, Gynecologic Surgical Procedures, Humans, Pelvic Organ Prolapse, Recurrence
Abstract

INTRODUCTION AND HYPOTHESIS: Obliterative procedures for the treatment of pelvic organ prolapse have been reported to have a recurrence rate up to 10%. We present (1) a case report of a patient with prolapse after LeFort colpocleisis and how it was managed in our department, and (2) a review of the literature regarding the types of recurrence after LeFort colpocleisis, their rate and their treatment.METHODS: A 77-year-old woman was treated in our department for recurrence of prolapse through the right lateral channel 6 months after LeFort colpocleisis. A systematic review of the literature up to 2016 was performed through MEDLINE, Web of Science and the Cochrane Library.RESULTS: The patient underwent a modified repeat colpocleisis and 6 months later was doing well with no signs of recurrence. We found 28 eligible studies including 1,810 patients, and the rate of recurrence after LeFort colpocleisis was 4.2% (76/1,810) leaving the majority of patients very satisfied. Information about the management of recurrence of prolapse after LeFort colpocleisis was provided in 17 studies including 33 patients with a 60-month follow-up. It appears that there are three major categories of recurrent prolapse after LeFort partial colpocleisis: (1) patients with a total breakdown of colpocleisis (57.6%), (2) patients with "channel prolapse" (15.2%), and (3) patients with prolapse at sites not involved in the primary partial colpocleisis (27.3%). The most frequent treatments were total colpocleisis/colpectomy (27.3%), perineorrhaphy and posterior repair (9.1%) and hysterectomy (9.1%). Almost 50% of these patients opted not to have surgical treatment.CONCLUSIONS: The rate of prolapse recurrence after LeFort colpocleisis is estimated to be 4.2%. The management of recurrences after LeFort colpocleisis depends on the time and type of recurrence. The repeat modified LeFort colpocleisis is a viable option in patients with channel prolapse; if no uterus exists, colpectomy appears to be the best option.

DOI10.1007/s00192-016-3236-9
Alternate JournalInt Urogynecol J
PubMed ID28025678

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