Advertisement

Body image, regret, and satisfaction following colpocleisis

      Objective

      Colpocleisis is a definitive surgical treatment for prolapse resulting in vaginal obliteration. We sought to evaluate body image, regret, satisfaction, and pelvic floor symptoms following this procedure.

      Study Design

      This was a prospective multicenter study through the Fellows' Pelvic Research Network. All women electing colpocleisis for management of pelvic organ prolapse were screened for enrollment. The Pelvic Floor Impact Questionnaire, Pelvic Floor Distress Inventory, and the modified Body Image Scale (BIS) were completed preoperatively and 6 weeks following surgery. Additionally, the Decision Regret Scale and the Satisfaction with Decision Scale were administered at the 6-week postoperative visit. A sample size of 88 subjects was calculated to evaluate change in the BIS score.

      Results

      In all, 87 patients were analyzed. Mean age was 79 years (SD 5.8) with a mean body mass index of 27 (SD 5.3). The majority (89.3%) was Caucasian. Six weeks after surgery, significant improvements were noted in all parameters. Mean BIS scores decreased from 4.8 to 1.2 (P < .001), signifying improved body image. Indeed, the overall number of subjects with BIS scores in the normal range doubled after surgery. Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire scores decreased significantly (P < .001 and P < .001), suggesting a positive impact on bladder, bowel, and prolapse symptoms. Finally, low levels of regret (mean score 1.35) and concurrent high satisfaction (mean score 4.73) were documented.

      Conclusion

      Colpocleisis improves body image and pelvic floor symptoms while giving patients a definitive surgical option that results in low regret and high satisfaction.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. US Census Bureau. Projections of the population by selected age groups and sex for the United States: 2015-2060. Available at: https://www.census.gov/population/projections/data/national/2012/summarytables.html. Accessed Jan. 1, 2013.

        • Luber K.M.
        • Boero S.
        • Choe J.Y.
        The demographics of pelvic floor disorders: current observations and future projections.
        Am J Obstet Gynecol. 2001; 184: 1496-1503
        • Fitzgerald M.P.
        • Richter H.E.
        • Siddique S.
        • Thompson P.
        • Zyczynski H.M.
        • Weber A.M.
        • for the Pelvic Floor Disorders Network
        Colpocleisis: a review.
        Int J Pelvic Floor Dysfunct. 2006; 17: 261-271
        • Berlin F.
        Three cases of complete prolapsus uteri operated upon according to the method of Leon LeFort.
        Am J Obstet Gynecol. 1881; 14: 866
        • Hanson G.E.
        • Kettel W.C.
        The Neugebauer-LeFort operation: a review of 288 colpocleisis.
        Obstet Gynecol. 1969; 34: 352-357
        • DeLancey J.O.
        • Morley G.W.
        Total colpocleisis for vaginal eversion.
        Am J Obstet Gynecol. 1997; 176: 1228-1232
        • Fitzgerald M.P.
        • Richter H.E.
        • Bradley C.S.
        • et al.
        Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis.
        Int Urogynecol J. 2008; 19: 1603-1609
        • Hullfish K.L.
        • Boubjerg V.E.
        • Steers W.D.
        Colpocleisis for pelvic organ prolapse: patient goals, quality of life and satisfaction.
        Obstet Gynecol. 2007; 110: 341-345
        • Zielinski R.
        • Miller J.
        • Low L.K.
        • Sampselle C.
        • Delancey J.O.
        The relationship between pelvic organ prolapse, genital body image, and sexual health.
        Neurourol Urodyn. 2012; 31: 1145-1148
        • Barber M.D.
        • Walters M.D.
        • Bump R.C.
        Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7).
        Am J Obstet Gynecol. 2005; 193: 103-113
        • Jelovsek J.E.
        • Barber M.D.
        Women seeking treatment for advanced pelvic organ prolapsed have decreased body image and quality of life.
        Am J Obstet Gynecol. 2006; 194: 1455-1461
        • Sung V.W.
        • Kauffman N.
        • Raker C.A.
        • Myers D.L.
        • Clark M.A.
        Validation of decision-making outcomes for female pelvic floor disorders.
        Am J Obstet Gynecol. 2008; 198: 575.e1-575.e6
        • Lowenstin L.
        • Gamble T.
        • Sanses T.V.
        • et al.
        Changes in sexual function after treatment for prolapse are related to the improvement in body image perception.
        J Sex Med. 2012; 7: 1023-1028
        • Wu J.M.
        • Hundley A.F.
        • Fulton R.G.
        • Myers E.R.
        Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050.
        Obstet Gynecol. 2009; 114: 1278-1283
        • Sung V.W.
        • Weitzen S.
        • Sokol E.R.
        • Rardin C.R.
        • Myers D.L.
        Effect of patient age on increasing morbidity and mortality following urogynecologic surgery.
        Am J Obstet Gynecol. 2006; 194: 1411-1417
        • Abbasy S.
        • Kenton K.
        Obliterative procedures for pelvic organ prolapse.
        Clin Obstet Gynecol. 2010; 53: 86-98
        • Rogers R.
        Sexual function in women with pelvic floor disorders.
        Am J Urogynecol Rep. 2002; 21: 1-3
        • Lindau S.T.
        • Schumm L.P.
        • Laumann E.O.
        • et al.
        A study of sexuality and health among older adults in the United States.
        N Engl J Med. 2007; 357: 762-774
        • Woloski-Wruble A.C.
        • Oliel Y.
        • Leefsma M.
        • Hochner-Celnikier D.
        Sexual activities, sexual and life satisfaction, and successful aging in women.
        J Sex Med. 2010; 7: 2401-2410
        • Mahajan S.T.
        • Elkadry E.A.
        • Kenton K.S.
        • Shott S.
        • Brubaker L.
        Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery.
        Am J Obstet Gynecol. 2006; 194: 722-728
        • Elkadry E.A.
        • Kenton K.S.
        • FitzGerald M.P.
        • Shott S.
        • Brubaker L.
        Patient-selected goals: a new perspective on surgical outcome.
        Am J Obstet Gynecol. 2003; 189: 1551-1558
        • FitzGerald M.P.
        • Brubaker L.
        Colpocleisis and urinary incontinence.
        Am J Obstet Gynecol. 2003; 189: 1241-1244
        • Smith A.L.
        • Karp D.R.
        • Lefevre R.
        • Aguilar V.C.
        • Davila G.W.
        LeFort colpocleisis and stress incontinence: weighing the risk of voiding dysfunction with sling placement.
        Int Urogynecol J. 2011; 22: 1357-1362
        • Zebede S.
        • Smith A.L.
        • Plowright L.P.
        • Hegde A.
        • Aguilar V.C.
        • Davila G.W.
        Obliterative LeFort colpocleisis in a large group of elderly women.
        Obstet Gynecol. 2013; 121: 279-284
        • Gutman R.E.
        • Bradley C.S.
        • Ye W.
        • Markland A.D.
        • Whitehead W.E.
        • Fitzgerald M.P.
        • for the Pelvic Floor Disorders Network
        Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse.
        Int Urogynecol J. 2010; 21: 461-466
        • Barber M.D.
        • Amundsen C.L.
        • Paraiso M.F.
        • Weider A.C.
        • Romero A.
        • Walter M.D.
        Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery.
        Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18 (799-86)