Overview and aims:

Surgery for Pelvic Organ Prolapse (POP) is increasing with the aging of population. When maintenance of vaginal length and coital function is not a surgical goal, obliterative surgery is effective for POP treatment, especially in women with comorbidities. Our primary study goal was to evaluate the objective and subjective cure rates of different obliterative surgeries. We also aimed to characterize this population of women and the complications of this type of surgery.

Study design:

We conducted an observational retrospective cohort study

Population: 82 patients who underwent obliterative surgery as a treatment for primary or recurrent POP.

Methods:

Retrospective review of clinical charts, with descriptive and bivariate analysis.

Results:

All women were sexually inactive and their mean age was 77.3 years-old. Overall, they had excessive weight and 97.6% of them had a POP-Q stage of III or more. The majority of these women had two or more comorbidities at time of surgery, and cardiovascular disease was the most severe in 40% of them. Twenty eight percent of them had already underwent a surgery for POP. There were only two cases of minor complications after surgery, specifically lower urinary tract infection. Overall, objective cure rate was 89.7% and subjective cure rate was 98.5%, for a mean time of follow-up of 18.5 months. We found no differences between different obliterative procedures. De novo urge urinary incontinence developed in 22% of patients.

Conclusions:

Obliterative surgery is a good treatment option for severe POP, especially in women with anesthetic risk and no desire for future vaginal coitus. In our cohort we found excellent objective and subjective POP cure rates after obliterative surgeries, combined with low risks..

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