LeForte Colpocleisis (Dr Wedisha Gankanda)

Introduction 

Leforte colpocleisis is a surgical procedure  performed to treat pelvic organ prolapse in women, particularly in those who frail and have completed their childbearing not requiring their sexual function. Leforte colpocleisis aims to restore pelvic organs and alleviate the symptoms.

Case

We describe a 76 year old female, who had to undergo colpocleisis for uterine procidentia with an ulcer following failed treatment with vaginal ring pessary. 

Patient had uneventful recovery, Quality of life was markedly improved.

Steps of Leforte Colpocleisis:

Preoperative Assessment: Before the procedure, a thorough evaluation including medical history, physical examination, ultrasound scan was done. Betadine pack was used to heal the decubitous ulcer. 

Anesthesia: The patient is placed under combined spinal epidural aneasthesia to ensure comfort and minimize pain during the procedure.This procedure is amenable under local aneasthesia in frail patients.

Incision and Tissue Removal: A surgical incision is made in the anterior vaginal wall, rectangular pattern. The vaginal mucosa is carefully dissected anteriorly and posteriorly and repositioned to create a solid closure.

Suturing: The vaginal walls are sutured together(keeping a foley catheter in between walls as a guide )reinforcing the support structures and narrowing the vaginal opening. This closure restores the anatomical position of the pelvic organs and reduces the risk of recurrent prolapse. Finally the guiding foley catheter is removed leaving two tunnels at either side.

Postoperative Care: After the procedure, the patient is monitored ,Pain management and antibiotics are prescribed. Patients are advised to avoid strenuous activities and heavy lifting during the recovery period.Post operatively :Vulval estrogen cream application was done

Conclusion

Leforte colpocleisis offers a minimally invasive and effective solution for women seeking relief from pelvic organ prolapse, improving their quality of life and restoring pelvic support.