Extended Colpoperineorrhaphy for Severe Prolapse in Elderly or At Risk Acoital Women
Young, Stephen B. Moore Simas, Tiffany A McKinnon, Monica M. Aronson, Michael P. Morse, Abraham N. Howard, Allison E.
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Abstract
Objective: To observe the efficacy of the Extended Colpoperineorrhaphy (ECP), a minimally invasive procedure for symptomatic cure of severe prolapse in acoital women who are not candidates for definitive surgery or pessary.
Methods: At UMass Memorial Medical Center, a prospective observational study was undertaken between December 1993 and December 1999. Twenty-four elderly or medically at risk, acoital patients with severe pelvic organ prolapse, who could not be successfully treated with a pessary underwent an ECP. Preoperative and postoperative prolapse grades utilizing the Baden-Walker system were compared and pessary use reported.
Results: Preoperatively, 19 of 24 Grades 3 and 4 prolapse patients were pessary failures while 5 refused pessary treatment. At a mean of 17 months follow-up, 50% were asymptomatic and at les than or equal to Grade 2, 42% were treatable and asymptomatic with a pessary and 8% failed surgery and pessary.
Conclusion: ECP alone was 92% successful with or without pessary in treating elderly or medically at risk acoital women with grades 3 and 4 prolapse.
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Young SB, Moore Simas TA, McKinnon MM, Aronson MP, Morse AN, Howard AE. Extended colpoperineorrhaphy for severe prolapse in elderly or at risk acoital women. Journal of Pelvic Medicine and Surgery 2004;10(1):9-13.