Comparison of perioperative conditions between total and partial colpocleisis for elderly patients suffered from severe pelvic organ prolapse / 中华妇产科杂志

Objective To study perioperative period conditions of total and partial colpocleisis with severe pelvic organ prolapse(POP)in elderly patients. Methods From Jan. 2014 to Oct. 2017286 severe POP elderly patients underwent total or partial colpocleisis. The mean age was(76.0±5.1)years(60-90 years). Of which,220 patients(76.9％, 220/286)presented more than one kind of medical disease. The operative time, intraoperative blood loss, hospital stay after surgery, postoperative complications, preoperative urinary dysuria symptoms of total and partial colpocleisis in treatment of 286 patients were analyzed. Results In 286 patients, 172 patients(60.1％)underwent total colpocleisis and 114 patients(39.9％) underwent partial colpocleisis. Totally 48 patients(16.8％)in 286 patients underwent anti-urinary incontinence procedure. The mean operating time of 286 patients was(67 ± 22)minutes, the mean blood loss was(52 ±57)ml, the mean hospital stay after surgery was(5.9 ± 1.9)days(2-16 days). The rate of postoperative complications was 8.7％(25/286). Those complications including 1 case of bladder injury during operation, 3 cases of postoperative pelvic hematoma, 1 case of intestinal obstruction, 5 cases of atrial fibrillation, 10 cases of postoperative morbidity, 3 cases of pulmonary embolism, 1 case of lower limb thrombosis, 1 case of urinary retention underwent electrical stimulation treatment because of ineffective application of urinary retention catheter. The mean operating time was(67±22)minutes in total colpocleisis and(68±20) minutes in partial colpocleisis(P>0.05), the mean blood loss was(58±62)ml in total colpocleisis and(41± 45)ml in partial colpocleisis(P>0.05), the mean hospital stay after surgery was(5.9 ± 1.9)days in total colpocleisis and(6.0 ± 1.8)days in partial colpocleisis(P>0.05), the rate of post operative complications was 8.1％(14/172) in total colpocleisis and 9.6％(11/114)in partial colpocleisis(P>0.05), respectively;those four of comparisons showed no significant difference. There were 129 patients(45.1％, 129/286)with voiding difficulty before surgery;the mean postvoid residual volumes of the above two operation types of people after operation were(35 ± 43)and(34 ± 41)ml, which showed no significant difference(P>0.05). Conclusions Colpocleisis is a safe and effective management in selected elderly patients with severe POP, who no longer desire to maintain vaginal coital function. There is no significant difference in the perioperative period conditions between total and partial colpocleisis. The choice of surgical procedure is based on factors such as the presence or absence of malignancy in the uterus, age and willingness of the patient, and general condition.

Colpocleisis sitio-específica: 3 años de experiencia / Site-specific colpocleisis: 3 years of experience

RESUMEN El prolapso de órganos pélvicos es definido como el descenso de la pared anterior y /o posterior de la vagina y/ o la cúpula o útero a través de la vagina. Esta patología se ha visto asociada a disfunción urinaria, alteración de la defecación y disfunción sexual. El prolapso sintomático de órganos pélvicos es una condición que afecta negativamente la calidad de vida de las mujeres, encontrando una prevalencia de 3-6%. La cirugía obliterativa de vagina, tiene un menor tiempo quirúrgico, las tasas de morbilidad y pérdida de sangre son más bajas, la recuperación es más rápida, y el éxito anatómico mayor. Las pacientes que son ideales candidatas a la colpocleisis suelen presentar múltiples comorbilidades médicas que las descartan para llevar a una cirugía reconstructiva con una eficiencia de 90% en la literatura, refiriendo que mejora de la calidad de vida y la imagen corporal para la mayoría de pacientes. OBJETIVO: Realizar una revisión sobre el procedimiento de colpocleisis referente a los resultados anatómicos, resolución de los síntomas, satisfacción con los resultados quirúrgicos y la morbimortalidad asociada de pacientes que consultaron a una institución prestadora de salud privada de tercer nivel, ubicada en Medellín, (Colombia). METODOLOGÍA: Se realizó un estudio de cohorte retrospectivo en el cual se incluyen todas las pacientes con prolapso grado 3-4 a quienes se les haya realizado colpocleisis en el periodo de tiempo comprendido entre 2013 al 2016, en una institución prestadora de salud privada de III nivel en Medellín, Antioquia, que atiende régimen contributivo del sistema seguridad social en Colombia y pacientes particulares. Se usó la escala de cuantificación del Prolapso del Órgano Pélvico (POP-Q) para determinar los niveles de prolapso y que tipo de prolapso se identificaba antes y después de la cirugía. Se les solicitó a todas evaluación urodinámica multicanal preoperatoria con reducción del prolapso para evaluar incontinencia oculta o dificultades de micción. Y se realizó una evaluación subjetiva de la respuesta a la cirugía con la escala de Impresión Global de Mejora del paciente (PGI-I). RESULTADOS: Se realizó una recolección de datos entre enero de 2013 a diciembre de 2016. Fueron sometidas a colpocleisis 143 pacientes, 27 de ellas (18.8 %) tenían más de 80 años. 52 pacientes (36.3%) entre 60-70 años, 62 pacientes (43.3%) entre 70-80 años y 1 pacientes <60 años. La edad media del grupo de edad fue de 75 años, rango 58-94 años; el índice de masa corporal promedio fue de 27, la duración del seguimiento promedio fue 9 meses, y el número de partos vaginales 4. El 97.9% de las pacientes presentaban comorbilidades médicas. Hubo una tasa de curación de 97.9%. CONCLUSIÓN: El estudio de cohorte describe nuestra experiencia y agrega a los datos existentes que apoyan la viabilidad y seguridad de la colpocleisis. Encontramos alta eficacia de las cleisis en cuanto a la satisfacción de las pacientes, en mejoría de calidad de vida, independiente de la edad, con una baja tasa de complicaciones y fallas quirúrgicas. La colpocleisis es una buena opción de tratamiento para prolapso de órganos pélvicos estadio 3-4, en quienes no deseen conservar la función sexual, sin embargo este concepto debe ser individualizado para cada paciente.

ABSTRACT Pelvic organ prolapse is defined as the descent of the anterior and / or posterior wall of the vagina and / or the dome or uterus through the vagina. This pathology has been associated with urinary dysfunction, altered defecation and sexual dysfunction. Symptomatic prolapse of pelvic organs is a condition that negatively affects the quality of life of women, finding a prevalence of lifetime prevalence is 3-6%. Obliterative vaginal surgery, has a shorter surgical time, morbidity and blood loss rates are lower, recovery is faster, and anatomic success greater. Patients who are ideal candidates for colpocleisis usually present multiple medical comorbidities that discard them to lead to reconstructive surgery. With an efficiency of 90% in the literature, indicating that improvement of the quality of life and body image for the majority of patients. OBJECTIVE: To perform a review of the colpocleisis procedure regarding anatomical results, resolution of symptoms, satisfaction with surgical results and associated morbidity and mortality of patients who consulted a third-level private health care institution located in Medellín, (Colombia). METHODOLOGY: A retrospective cohort study was carried out in which all patients with grade III-IV prolapse who underwent colpocleisis were included in the period from 2013 to 2016, in a private health institution of III level in Medellín, Antioquia, that attends contributory regime of the social security system in Colombia and private patients. The Pelvic Organ Prolapse (POP-Q) scale was used to determine prolapse levels and what type of prolapse was identified before and after surgery. All preoperative multichannel urodynamic evaluations with prolapse reduction were requested to evaluate occult incontinence or micturition difficulties. And a subjective evaluation of the response to surgery was performed with the Global Impression of Patient Improvement (PGI-I) scale. RESULTS: Data were collected between January 2013 and December 2016. Thirty-three patients were submitted to colpocleisis, 27 of which 18.8 (%) were older than 80 years. 52 (36.3%) patients between 60-70 years, 62 (43.3%) between 70-80 years and <60 years 1 patient. The mean age of the age group was 75 years, range 58-94 years; the mean body mass index was 27, the average follow-up duration was 9 months, and the number of vaginal deliveries was 4. (97.9%) of the patients had medical comorbidities. With a cure rate of 97.9%. CONCLUSION: The cohort study describes our experience and adds to existing data that support the viability and safety of colpocleisis. We found high efficacy of cleisis in terms of patient satisfaction, improvement in quality of life, independent of age, with a low rate of complications and surgical failures. Colpocleisis is a good treatment option for prolapse of pelvic organs stage III-IV, in those who do not wish to preserve sexual functionality, however this concept must be individualized for each patient.

Colpocleisis para el tratamiento del prolapso de cúpula vaginal grave / Colpocleisis for the treatment ofadvanced vaginal vault prolapse

INTRODUCCIÓN: El prolapso de los órganos pélvicos (POP) es una condición cuya prevalencia aumenta con la edad. Es necesario que los cirujanos comprendan las indicaciones, riesgos, limitaciones y resultados de las varias técnicas quirúrgicas disponibles. En este artículo se aborda el tratamiento quirúrgico obliterativo del POP (colpocleisis y colpectomia) en base a la revisión de estudios. TÉCNICA: En la literatura son descritas muchas variaciones de las técnicas obliterativas. Con el objetivo de reglamentar la técnica para futuros estudios, describimos la técnica de LeFort modificada, realizada por los autores. Los métodos obliterativos tienen un tiempo operatório, morbilidad perioperatoria reducida y una tasa baja de recurrencia del prolapso. El índice de calidad de vida y satisfacción de la paciente son altos. CONCLUSIÓN: La literatura existente respecto a la colpocleisis es limitada por la calidad metodológica. Por tanto, no hay nivel de evidencia I o II, en lo que se refiere a la colpocleisis. Sin embargo, esta técnica debe hacer parte del arsenal terapéutico del cirujano en el abordaje de los prolapsos severos en mujeres mayores.

INTRODUCTION. The pelvic organ prolapse (POP) is a condition whose prevalence increases with age. Surgeons need to understand the indications, risks, constraints and results of various surgical techniques. This article is about obliterative surgical treatment of POP (colpocleisis and colpectomia) and it is based on the review of studies is discussed. TECHNICAL. In the literature are many variations of the techniques obliterative. In order to regulate the art for future study, we describe the technique of LeFort modified by the authors. The obliterative methods have operatory time, reduced perioperative morbidity and a low rate of recurrence of prolapse. The index ofquality oflife and patient satisfaction are high. CONCLUSION. The literature regarding the colpocleisis is limited by methodological quality. Therefore no evidence level I or II, in what concerns the colpocleisis. However, this technique should be part of the armamentarium of the surgeon in addressing severe prolapse in elderly women.

Satisfacción de las pacientes y síntomas pélvicos posterior a colpocleisis / Patient's satisfaction and pelvic symptoms after colpocleisis technique

La colpocleisis como técnica obliterante se va realizando desde el año 1823 y se ofrece como alternativa para tratamiento quirúrgico de prolapso tipo III y IV a pacientes sin deseo de vida sexual y con riesgos de morbilidad transquirúrgica. No existe mucha evidencia del grado de satisfacción post-quirúrgica de las pacientes Objetivo: determinar el grado de satisfacción de las pacientes sometidas a colpocleisis y los síntomas pélvicos más frecuentemente encontrados a lo largo del primer año post- quirúrgico. Método: studio transversal no experimental. Se aplicó cuestionario validado de satisfacción post-quirúrgica en pacientes sometidas a colpocleisis durante periodos 2013 a 2014, vía telefónica, dentro de su primer año post-quirúrgico. Se tabularon los datos obtenidos. Resultados: El total de pacientes encuestadas se encontraban entre satisfechas y muy satisfechas e indicaban que volverían a someterse a la cirugía. La edad promedio de las pacientes fue de 76 años. El 50% de las pacientes presentaron incontinencia urinaria de urgencia, 15% incontinencia anal, el restante 35% no presentó ninguna sintomatología. Los síntomas pélvicos se presentaron con más frecuencia en las pacientes con prolapsos tipo IV. Conclusiones: el nivel de satisfacción delas pacientes sometidas a colpocleisis es alto, se puede seguir ofreciendo como alternativa quirúrgica en mujeres sin actividad sexual, la sintomatología pélvica más frecuente fue incontinencia urinaria de urgencia e incontinencia anal, en las pacientes con mayor grado de prolapso.

The colpocleisis as obliterans technique is conducted since 1823 and is offered as an alternative to surgical treatment of prolapse type III and IV patients with no sexual desire for life and morbidity risks transsurgical. There is much evidence of the degree of post-surgical patient satisfaction Objective: to determine the degree of satisfaction of patients undergoing colpocleisis and urinary symptoms most frequently encountered throughout the first year post-surgery Methods:cross-sectional study is not experimental. validated questionnaire post-surgical satisfaction in patients undergoing colpocleisis during periods 2013-2014, by telephone, in his first post-surgical year was applied. The data obtained are tabulated Results: total patients were surveyed between satisfied and very satisfied and indicated they would undergo surgery. The average age of patients was 76 years. 50% of patients had urinary urge incontinence, anal incontinence 15%, 35% showed no symptoms. Patients who had type IV prolapses, presented some pelvic symptoms. Conclusion: The level of satisfaction delas patients undergoing colpocleisis is high, you can continue to offer as surgical alternative for women without sexual activity, the most common pelvic symptoms were urinary urge incontinence and anal incontinence in patients with higher degree of prolapse.

Técnicas obliterativas en el tratamiento quirúrgico del prolapso genital femenino: experiencia en el Servicio de Salud Metropolitano Oriente, Santiago-Chile / Obliterative techniques in the surgical treatment of female genital prolapse: experience in the Metropolitan Health Service Oriente, Santiago-Chile

INTRODUCCIÓN Y OBJETIVOS: El prolapso genital afecta hasta al 50% de las mujeres a nivel mundial, su calidad de vida, percepción corporal y vida sexual. A las pacientes de edad avanzada frecuentemente les ofrecemos técnicas quirúrgicas obliterativas para su manejo. El objetivo fue evaluar los resultados de las técnicas obliterativas basados en nuestra experiencia local. MÉTODOS: análisis retrospectivo de pacientes tratadas con técnicas obliterativas en nuestro hospital entre los años 2008 y 2016. RESULTADOS: se incluyeron 78 pacientes, la edad promedio fue de 74.5 años, 11.5% de las pacientes presentaba comorbilidad de mayor riesgo quirúrgico, 24% eran pacientes histerectomizadas por prolapso y 30.8% presentaba incontinencia de orina al momento de la cirugía. El tiempo quirúrgico promedio fue 52 minutos, 73.1% de las cirugías fueron con técnica de LeFort y 5.1% presentó complicaciones postquirúrgicas precoces. Se contactaron telefónicamente 59 pacientes, 90% refirió mejor calidad de vida, 92% satisfacción con la cirugía, 3.4% recidiva del prolapso y 44% incontinencia urinaria, en su mayoría moderada o severa. La recidiva reportada estuvo acorde a lo reportado en la literatura, pero la incontinencia de orina reportada fue muy alta respecto a lo reportado y de predominio de urgencias. CONCLUSIÓN: las técnicas obliterativas son efectivas en el tratamiento quirúrgico del prolapso y el principal problema postquirúrgico a largo plazo asociado fue la incontinencia de orina de urgencias.

INTRODUCTION AND OBJECTIVES: Genital prolapse affects up to 50% of women worldwide, their quality of life, body perception and sex life. For older patients, we often offer obliterative surgical techniques to manage it. The objective was to evaluate the results of the obliterative techniques based on our local experience. METHODS: retrospective analysis of patients treated with obliterative techniques in our hospital between 2008 y 2016. RESULTS: 78 patients were included, with an average age of 74.5 years, 11.5% of the patients had comorbidities of high surgical risk, 24% were previously hysterectomized because of genital prolapse and 30.8% had urinary incontinence at the time of the surgery. Average surgical time was 52 minutes, 73.1% of the surgeries were performed with the LeFort technique and 5.1% presented early postoperative complications. 59 patients were contacted by telephone, 90% reported better quality of life, 92% were satisfied with the surgery, 3.4% had recurrence of the prolapse and 44% reported urinary incontinence, mostly moderate or severe. The reported relapse was in line with what was reported in the literature, but the reported urinary incontinence was very high compared to what was reported, and was predominantly urge incontinence. CONCLUSION: obliterative techniques are effective in the surgical treatment of genital prolapse and the main long term problem after surgery was urge incontinence.

Colpocleisis como opción para corregir los prolapsos de la cúpula vaginal / Colpocleisis as option to correct vaginal vault prolapse

Introducción: el prolapso de cúpula vaginal permanece como un problema bien definido y difícil en el terreno de cirugía reconstructiva de la pelvis y se consideran cada vez más las opciones mínimamente invasivas y seguras para su solución. Objetivo: caracterizar a un grupo de pacientes con prolapso de cúpula vaginal tratadas por cirugía. Métodos: se realizó un estudio de tipo descriptivo retrospectivo con los registros de las historias clínicas de 70 pacientes operadas con ese diagnóstico en el Servicio de Ginecología del Hospital Ramón González Coro desde junio de 2003 hasta diciembre de 2012. Se obtuvo datos en relación con variables de orden clínico, detalles quirúrgicos y eventos evolutivos. La información procedió de modelos de encuestas, historias clínicas y libro de registros de cirugías. Resultados: son alentadores con pocas recidivas y constituye una propuesta alternativa exitosa y de poco riesgo, aplicable en nuestro medio siempre que se respeten los criterios individualizados. Conclusiones: la corrección quirúrgica del prolapso de cúpula vaginal resulta un proceder efectivo y es avalada por el elevado grado de satisfacción de pacientes curadas o mejoradas, por lo que recomendamos la incorporación de estas técnicas. Su uso es cada vez más extendido y el necesario adiestramiento del personal para su ejecución(AU)

Introduction: vaginal vault prolapse continues to be a difficult though well defined problem in reconstructive pelvic surgery. Minimally invasive and safe options are increasingly considered for its solution. Objective: characterize a group of patients with vaginal vault prolapse treated by surgery. Methods: a retrospective descriptive study was conducted of the medical records of 70 patients diagnosed with this condition at the Gynecology Service of Ramón González Coro Hospital from June 2003 to December 2012. Data about clinical, surgical and evolution variables were obtained from surveys, the patients' medical records and the hospital's surgery registry. Results: results are encouraging due to the small number of recurrences. The procedure is a successful, safe alternative applicable in our environment as long as individualized criteria are abided by. Conclusions: surgical correction of vaginal vault prolapse is an effective procedure endorsed by the high level of satisfaction among healed or alleviated patients. We therefore recommend the inclusion of such techniques, whose increasingly common use requires the training of the personnel who will perform them(AU)

Colpocleisis in elderly patients with severe pelvic organ prolapse / 中华妇产科杂志

Objective To study the objective and subjective therapeutic effect of total and partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapsed ( POP) in selected elderly patients.Methods From Oct 2005 to Feb.2010,63 severe POP patients[59-87 years,median age (75 ±6) years]with stage Ⅲ and Ⅳ by POP-Q system underwent total and partial colpocleisis.The mean age was (75 ±6)years (59-87 years).Fifty-eight patients(58/63,92% )present more than one kind of medical disease.There were 53 cases with uterus prolapse,1 case with cervix prolapse and 9 cases with vaginal vault prolapse.Seven patients were recurrent POP from previous surgery.Twenty-three patients(36% ) presentedvoiding difficulty.Seven patients (17%) presented obstructive bowel symptom.Three patients (5%) presented fecal incontinence,and 28 patients(44% )presented either had urinary incontinence or history of that Among 63 patients,48 patients (76% ) underwent total colpoclesis,and 15 (24% ) patients partial colpoclesis.Meanwhile,58 (92% ) patients underwent levator myorrhaphy plus perineorrhaphy and 20 (32% ) patients underwent anti-urinary incontinence procedure ( TVT-0 ),respectively.Patients were followed up to evaluate therapeutic effect at 2 months and 1 year after surgery.Objective evaluation included the POP-Q and the length of vagina,genital hiatus,perineal body.A nonvalidated Body Image and Satisfaction Questionnaire was completed for subjective evaluation.Results The mean operating time of 63 patients was (105 ±48) minutes,which was (128 ±58) in total and (82 ±26) minutes partial procedures,which exhibited significant difference(P<0.05).The mean blood loss was (187 ± 128) ml (50-600 ml),total and partial procedures caused (232 ± 159) and (101 ±54) ml,respectively,which also showed significant difference ( P < 0.05 ).No intraoperative injury or death occurred.The rate of postoperative complications was 5% (3/63).Mean follow-up time of 63 patients was 22.5 months (1-51 months).All patients had POP-Q staging score ≤Ⅰ.No recurrent patient was observed.At 1 year after operation,the mean preoperative total vaginal length (TVL) and genital hiatus (GH) of (7.7 ± 1.1) and (5.5 ± 1.5)cm were decreased to (3.4 ± 1'.l)and (2.3 ±0.5) cm (P<0.01) ;and perineal body (PB) measurements was increased from (2.6±0.9) to (3.4 ±0.9)cm(P <0.01).Three (5%,3/63) patients had mild urinary incontinence after the operation.Twenty-three patients with voiding difficulty presenting the mean postvoid residual volumes (110 ± 38) ml(50-235 ml) were decreased to 12 ml after the operation.Obstructive bowel symptom was improved in 6(54%,6/11) patients,and fecal incontinence improved in 2(2/3).One year after the operation,52 ( 82% ) patients completed the nonvalidated Body Image and Satisfaction Questionnaire.49 (94% ) patients said either 'very satisfied' or 'satisfied' with the outcome of their surgery,while 3 ( 6% ) reported unsatisfied or not at all satisfied.Conclusions The objective and subjective curative rates of colpocleisis in treatment of severe POP are high with lower morbidity and recurrence.Colpocleisis is a safe and effective management in selected elderly patients with severe POP,who no longer desire to maintain vaginal coital function.

A Case of Latzko Partial Colpocleisis for Treating Huge Vesicovaginal Fistula

Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula. VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary leakage of urine into the vaginal canal. In addition to the medical sequelae from these fistulas, they often have a profound effect on the patient's emotional well-being. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are most commonly seen. In 1914, Latzko published his partial colpocleisis technique for repair of posthysterectomy VVF, in which he employed the resection of scarred vaginal mucosa and a layered horizontal closure. Latzko's procedure has been cited, with his 95-100% success rates noted. Recently we experienced a case of huge vesicovaginal fistula. The patient is a 67-year-old woman with a history of constant urine leakage. The problem began after she had undergone total abdominal hysterectomy 30 years ago for uterine ruture. We repaired it by Latzko partial colpocleisis.

Comparison study of Le Fort colpocleisis and total vaginal hysterectomy for prolapses uteri / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to evaluate and compare the Le Fort colpocleisis and conventional total vaginal hysterectomy in the uterine prolapse patients in the medically compromised or elderly patients. METHODS: This study was to analyze the data from 16 patients with uterine prolapse undergone Le Fort colpocleisis at the department of obstetrics and gynecology, Chung-ang university hospital from January 1991 to December 2000, and 36 patients with uterine prolapse undergone total vaginal hysterectomy from January 1999 to December 2000. We compared the age of patients, operation time, type of anesthesia, estimated blood loss, changes in hemoglobin, duration of hospitalization, occurrence of febrile morbidity, and medical complications based on the medical records. RESULTS: The mean operation time of 16 patients undergone Le Fort colpocleisis with uterine prolapse was 51+/-18 minutes, the estimated blood loss was 175+/-134 cc, hemoglobin change was 1.72+/-1.14 mg/dl, the mean days of hospitalization was 7.2+/-2.8 days, and the febrile illness occurred in 2 patients. In this group, general anesthesia was used in 10 patients (75%), local anesthesia in 4 patients (25%), and spinal and epidural anesthesia in 1 case respectively. The mean operation time of 11 patients undergone total vaginal hysterectomy with uterine prolapse was 86+/-29 minutes, the estimated blood loss was 366+/-154 cc, hemoglobin change was 2.36+/-1.22 mg/dl, the mean days of hospitalization was 7.8+/-1.6 days, and the febrile illness occurred in 3 patients. General anesthesia was done in total vaginal hysterectomy group and vulva hematoma was developed in 1 case postoperatively. There are significant difference (p<0.01) between the Le Fort colpocleisis and total vaginal hysterectomy in operational time, estimated blood loss, and type of anesthesia, but no significant difference in days of hospitalization, febrile morbidity. CONCLUSION: The assessment of Le Fort colpoclesis in uterine prolapse offers signinficant benefits in elderly or compromised patients and the method is safe for operation.

Latzko partial colpocleisis of vesicovaginal fistula / 대한산부인과학회잡지

Vesicovaginal fistula is a uncommon status in the developed countries. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are seen. Fistula is a discomfort to the patient because of urine leakage, odor, and its inconvenience. We have experienced one case of fistula after abdominal hysterectomy and have repaired it by Latzko partial colpocleisis. So we report a case with some references.