Video Session

Poster, Podium & Video Sessions

V2-10: SURGICAL TECHNIQUE: TOTAL COLPOCLEISIS

Friday, May 12
9:30 AM - 9:30 AM
Location: BCEC: Room 254

Presentation Authors: Rena Malik*, Carlos Finsterbusch, Catherine Harris, Maude Carmel, Dallas, TX

Introduction: Total colpocleisis is an excellent treatment option utilizing native tissue for complete vault eversion in older women not interested in coital function. This video illustrates our surgical technique for total colpocleisis.

Methods: An 88 year-old female presented with pelvic organ prolapse (POP) after failing conservative management. She complained of concomitant storage and voiding lower urinary tract symptoms (LUTS), particularly stress urinary incontinence (SUI) with a pessary in place. Examination revealed complete procidentia and SUI with POP reduction. She elected to undergo total colpocleisis, and transobturator midurethral sling placement.

Results: The procedure began by marking of four quadrants, from the apex to bladder neck, posterior and lateral vaginal walls. Lidocaine with epinephrine was used for hydrodissection and hemostasis. The vaginal epithelium was dissected and excised in each quadrant. Purse string sutures were placed sequentially at 2-3 cm from each other until the entire prolapse was reduced. Cystoscopy was performed to ensure patency of the ureters. The anti-incontinence procedure (not shown) was performed. The anterior vaginal wall was closed, followed by posterior vaginal wall closure including a tight perineorrhaphy.

Conclusions: On examination at 6 months, no recurrence of her prolapse was noted. Further, the patient reported that her SUI and LUTS had resolved. Colpocleisis remains an effective and minimally invasive option for women with severe POP who are not interested in maintaining sexual function.

Source Of Funding: none

Rena D. Malik, MD

UT Southwestern Medical Center

Rena D Malik, M.D. is a Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellow at the UT Southwestern Medical Center. She completed her urology residency training at the University of Chicago Medicine and prior to that completed her medical school education at New York University School of Medicine . She specializes in pelvic organ prolapse, urinary incontinence, voiding dysfunction and neurogenic bladder. She has an interest in health literacy research and promoting women in urology. She is a member of the American Urological Association, Society of Women in Urology, and the Society of Urodynamics, Female Pelvic Mediicne and Urogenital Reconstruction where she is on the social media committee.

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