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Making What Is Old New Again: A Narrative Review Informing Expert Consensus on Obliterative Management of Primary Uterovaginal Prolapse
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Making What Is Old New Again: A Narrative Review Informing Expert Consensus on Obliterative Management of Primary Uterovaginal Prolapse

International Urogynecology Journal·September 21
Obstetrics & GynecologyLimited evidencePelvic Organ ProlapseUterovaginal ProlapseSystematic Review With Consensus Process (Modified Delphi)ColpocleisisObliterative Vaginal SurgeryOlder Adult

Summary

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What was studied

This narrative review compared specific colpocleisis techniques for obliterative surgical management of primary uterovaginal prolapse, evaluating anatomical success, subjective bulge symptom improvement, and perioperative complications, covering literature published from December 2020 through November 2025.

Key findings

Of 587 studies identified, only 24 cohort studies and case series met inclusion criteria; all were rated low quality by GRADE criteria. No meta-analysis was possible due to the absence of comparative trials. Two consensus statements were agreed upon via a modified Delphi process at the U-POP Conference.

Study limitations

All 24 included studies were low quality (GRADE); most relevant literature predates 2000; no comparative trials existed, preventing meta-analysis; significant variability in operative techniques across studies limits generalizability.

Clinical implications

Colpocleisis remains a safe and effective option for women with uterovaginal prolapse who are not sexually active, but no high-quality evidence yet favors one specific technique over another. Clinicians should anticipate forthcoming standardization efforts and support enrollment in prospective comparative trials.

Caveats

  • All included studies were cohort studies or case series rated low quality by GRADE; no randomized or comparative trials were available, so consensus statements are expert opinion rather than evidence-based recommendations
  • Findings may not apply broadly: colpocleisis is generally reserved for women who do not desire future vaginal intercourse, limiting the generalizability of outcomes to the wider prolapse population
  • The consensus conference received industry funding (Coloplast, Boston Scientific, Neomedic, Medtronic), which may introduce potential bias in the Delphi consensus process

Related Questions

Explore related topics

What are the anatomical success rates and complication rates of Le Fort colpocleisis versus total colpocleisis for pelvic organ prolapse?Should a concomitant anti-incontinence procedure be added when performing colpocleisis in women with stress urinary incontinence?How do patients feel about regret and satisfaction after colpocleisis for advanced pelvic organ prolapse?

Publication Details

Year
2026
Journal
International Urogynecology Journal
Sample Size
n=24
Source
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