Colpocleisis for pelvic organ prolapse: patient goals, quality of life, and satisfaction

Abstract

Objective: To assess patient-centered colpocleisis outcomes in women.

Methods: This is a prospective cohort study. Between March 2000 and December 2005, 94 patients underwent colpocleisis. Patients completed follow-up questionnaires about their personal postoperative goal attainment satisfaction with care, regrets about surgery, as well as the Incontinence Impact Questionnaire and Urogenital Distress Inventory.

Results: Forty patients (42.6% of all patients) returned questionnaires with complete data on study outcomes. Mean age was 75.4 years (+/-6.8 years), and mean weight was 70.9 kg (+/-10.8 kg). Mean follow up was 2.75 years (+/-1.90 years). Most women agreed or strongly agreed that their goals were met for vaginal pressure (100%), urinary incontinence (84.9%), bladder emptying (76.4%), urinary frequency/urgency (91.2%), physical activity (88.6%), restoration of normal anatomy (95 %), colorectal symptoms (65.0%), and self-image (96.9%). Mean goal attainment (1.4+/-0.6) was associated with the postsurgery Urogenital Distress Inventory (r=-0.45, P=.003.) although not the Incontinence Impact Questionnaire. Mean scores improved presurgery to postsurgery for both the Urogenital Distress Inventory (39.9+/-24.9 versus 21.0+/-20.3, P<.01) and the Incontinence Impact Questionnaire (35.4+/-29.3 versus 17.3+/-24.6, P<.01). Ninety-five percent of respondents were either "very satisfied" or "satisfied" with their surgical outcome, while 5% reported postoperative regret. Of the entire series, 19.1% experienced postoperative complications.

Conclusion: Colpocleisis results in improved quality of life and substantial goal attainment, with a low proportion of regret.

Level of evidence: II.