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Revista chilena de obstetricia y ginecología
versión On-line ISSN 0717-7526
PIZARRO-BERDICHEVSKY, Javier et al. Colpoperineocleisis de Labhardt: una alternativa segura y eficaz para el tratamiento del prolapso genital en pacientes sin actividad sexual. Rev. chil. obstet. ginecol. [online]. 2012, vol.77, n.3, pp.201-210. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262012000300006.
Introduction: Genital prolapse affects up to 50% of multiparous women, impacting their quality of life and self-image. At our Institution Labhardt's colpoperineocleisis is usually proposed to older patients, without sexual activity, regardless the type or grade of prolapse. Objective: To evaluate the results with this technique and identify potential risk factors predicting the failure. Methods: Analysis of a retrospective cohort of patients treated with this technique between 2008 and 2010. Univariate and multivariate analysis were carried out to identify risk factors and failure-free curves were built to estimate durability. Results: 68 patients met the inclusion criteria. Average age was 71.9 ± 5.7 years; 95.6% of patients were classified as stage III or IV based on POP-Q system. Operative time was 54 ± 20 min. At 21 months of follow-up, recurrence rate was 14.7%. De novo stress urine incontinence (SUI) was diagnosed in 5.9% of patients. In univariate analysis, post operative vaginal discharge was identified as predicting factor for defect recurrence. In Cox analysis, this condition remained significant (OR 6.3), In addition, failure to observe the surgical technique was also identified as risk factor for defect recurrence (OR 7.2). Conclusion: Labhardt 's colpoperineocleisis is a safe technique, with low complication rate, acceptable recurrence rate, and low de novo SUI rate. Mainstay for success is to avoid infection and observe the surgical technique. Comparative studies with other occlusive techniques might be carried out, as well as exploring the role of infection as predisposing condition for failure.
Palabras clave : Pelvic organ prolapse; urogynecological surgery; quality of life; frail elderly.