Colpocleisis: guidelines for clinical practice

Objective: To provide clinical practice guidelines (CPGs) based on the best evidence available (level of evidence (LE)), concerning colpocleisis as a surgical treatment of pelvic organ prolapse. Methods: This article concern a systematically review of the literature concerning colpocleisis (obliterative surgery). Results: At short term follow-up, colpocleisis is associated with an anatomical success rate of 98 % (LE3) and a subjective success rate of 93% (LE3). A decrease in genital, urinary and anorectal symptoms and an enhancement of quality of life are observed in most women following colpocleisis (LE4). At mid-term (1 to 3 years) follow-up, patients' satisfaction ("satisfied" or "very satisfied" ranges from 85 to 100% (LE3)). At long-term follow-up, regret rate (women who regret having had the surgery) is 5% (LE4). In women over 80 years old, colpocleisis is associated with a decrease in per- and post-operative complication rates when compare to other surgical techniques used for pelvic organ prolapse surgery (LE2). Conclusion: Colpocleisis is a valid surgical option for elderly patients with pelvic organ prolapse surgery, and who are definitely permanently sexually inactive (Grade C). (C) 2016 Published by Elsevier Masson SAS.