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

Lee, Woo Seok; So, Jae Sung; Hur, Min; Park, Hyoung Moo

Abstract

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.