Colpocleisis for Advanced Pelvic Organ Prolapse

Purpose of Review The purpose of this review is to consolidate and present the most recent literature on colpocleisis in the treatment of pelvic organ prolapse. Recent Findings Since its origin in the 1800s, the techniques for colpocleisis have remain largely unchanged. We will review the peri-operative considerations for a patient undergoing an obliterative procedure, specifically focusing on the potential concern for uterine pathology. There are no universally accepted guidelines for endometrial evaluation in the asymptomatic post-menopausal patient, yet the majority of providers prefer to perform some type of pre-operative endometrial evaluation. Colpocleisis can be performed with hysterectomy as a part of the procedure, as a uterine-sparing procedure, or in a patient who has already had a hysterectomy. Performing a hysterectomy at the time of colpocleisis is associated with longer operating times and higher estimated blood loss, but removal of the uterus negates the concern for future uterine pathology. Anti-incontinence procedures are commonly performed concomitantly. Complications following colpocleisis are not common. As the life expectancy in the USA and medical comorbidities increase, future studies are needed to evaluate long-term outcomes. Colpocleisis is a minimally invasive and safe procedure which demonstrates consistently high rates of patient satisfaction. Female pelvic reconstructive surgeons should be comfortable with offering obliterative procedures as an option for patients desiring definitive treatment.