LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret
Introduction and Hypothesis The aims of this study were to define long-term anatomic outcome, satisfaction rate, and reasons for disappointment and regret in a group of patients with advanced pelvic organ prolapse who underwent LeFort colpocleisis (LFC). Materials and Methods This was a retrospectiv...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Journal of Mid-Life Health |
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| Online Access: | https://journals.lww.com/10.4103/jmh.jmh_38_24 |
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| author | Themistoklis Mikos Sofia Tsiapakidou Matteo Lioupis Christos Anthoulakis Iakovos Theodoulidis Grigoris F. Grimbizis |
| author_facet | Themistoklis Mikos Sofia Tsiapakidou Matteo Lioupis Christos Anthoulakis Iakovos Theodoulidis Grigoris F. Grimbizis |
| author_sort | Themistoklis Mikos |
| collection | DOAJ |
| description | Introduction and Hypothesis
The aims of this study were to define long-term anatomic outcome, satisfaction rate, and reasons for disappointment and regret in a group of patients with advanced pelvic organ prolapse who underwent LeFort colpocleisis (LFC).
Materials and Methods
This was a retrospective, single-center, cohort study including consecutive patients who underwent LFC from 2007 to 2021. All patients had surgery involving vaginal hysterectomy and anti-incontinence procedure where clinically indicated. All patients were examined 3 months after surgery. A cross-sectional telephone survey was performed in 2022 using the Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), and Patient Global Impression of Change (PGI-C) questionnaires, as well as the Decision Regret Scale. Student’s t-test, Fisher’s Chi-square test, and univariable logistic regression analysis were carried out.
Results
One hundred and forty-one patients (mean age 74.95 ± 6.25 years) were included. The mean preoperative POP Quantification C/D point was +6 (±2.7). In 86 (60.99%) patients, a hysterectomy and in 56 (39.71%), a mid-urethral synthetic sling was performed. At 3-month follow-up, there was one prolapse recurrence (0.71%) and no case of regret of sexual function loss. In the long term, 28 patients died, and 69 patients were interviewed through telephone (follow-up 61.65 months). The mean PGI-S, PGI-I, and PGI-C scores were 1.42 (±0.81), 1.93 (±1.45), and 5.91 (±1.69) respectively, and no patient declared regret about vaginal intercourse loss. Preoperative and postoperative persistent or de novo mixed UI appeared to be related to decreased satisfaction and regret post-LFC (P = 0.0021).
Conclusion
LFC is a valuable, easy-to-perform technique with long-lasting results and decreased postoperative anti-incontinence rates. However, de novo or persistent urinary incontinence appears to be related to decreased satisfaction rates. |
| format | Article |
| id | doaj-art-e9af58c571b148f1836e0a0b61b1405d |
| institution | OA Journals |
| issn | 0976-7800 0976-7819 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Mid-Life Health |
| spelling | doaj-art-e9af58c571b148f1836e0a0b61b1405d2025-08-20T02:12:25ZengWolters Kluwer Medknow PublicationsJournal of Mid-Life Health0976-78000976-78192024-10-0115315316010.4103/jmh.jmh_38_24LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and RegretThemistoklis MikosSofia TsiapakidouMatteo LioupisChristos AnthoulakisIakovos TheodoulidisGrigoris F. GrimbizisIntroduction and Hypothesis The aims of this study were to define long-term anatomic outcome, satisfaction rate, and reasons for disappointment and regret in a group of patients with advanced pelvic organ prolapse who underwent LeFort colpocleisis (LFC). Materials and Methods This was a retrospective, single-center, cohort study including consecutive patients who underwent LFC from 2007 to 2021. All patients had surgery involving vaginal hysterectomy and anti-incontinence procedure where clinically indicated. All patients were examined 3 months after surgery. A cross-sectional telephone survey was performed in 2022 using the Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), and Patient Global Impression of Change (PGI-C) questionnaires, as well as the Decision Regret Scale. Student’s t-test, Fisher’s Chi-square test, and univariable logistic regression analysis were carried out. Results One hundred and forty-one patients (mean age 74.95 ± 6.25 years) were included. The mean preoperative POP Quantification C/D point was +6 (±2.7). In 86 (60.99%) patients, a hysterectomy and in 56 (39.71%), a mid-urethral synthetic sling was performed. At 3-month follow-up, there was one prolapse recurrence (0.71%) and no case of regret of sexual function loss. In the long term, 28 patients died, and 69 patients were interviewed through telephone (follow-up 61.65 months). The mean PGI-S, PGI-I, and PGI-C scores were 1.42 (±0.81), 1.93 (±1.45), and 5.91 (±1.69) respectively, and no patient declared regret about vaginal intercourse loss. Preoperative and postoperative persistent or de novo mixed UI appeared to be related to decreased satisfaction and regret post-LFC (P = 0.0021). Conclusion LFC is a valuable, easy-to-perform technique with long-lasting results and decreased postoperative anti-incontinence rates. However, de novo or persistent urinary incontinence appears to be related to decreased satisfaction rates.https://journals.lww.com/10.4103/jmh.jmh_38_24lefort colpocleisispatients global impression patients’global impression questionnairepostoperative dissatisfactionpostoperative regreturinary incontinencevaginal function loss |
| spellingShingle | Themistoklis Mikos Sofia Tsiapakidou Matteo Lioupis Christos Anthoulakis Iakovos Theodoulidis Grigoris F. Grimbizis LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret Journal of Mid-Life Health lefort colpocleisis patients global impression patients’ global impression questionnaire postoperative dissatisfaction postoperative regret urinary incontinence vaginal function loss |
| title | LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret |
| title_full | LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret |
| title_fullStr | LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret |
| title_full_unstemmed | LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret |
| title_short | LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret |
| title_sort | lefort colpocleisis unmet expectations about correction of urinary symptoms are related to disappointment and regret |
| topic | lefort colpocleisis patients global impression patients’ global impression questionnaire postoperative dissatisfaction postoperative regret urinary incontinence vaginal function loss |
| url | https://journals.lww.com/10.4103/jmh.jmh_38_24 |
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