Abstract：
OBJECTIVE: Colpocleisis is a surgical procedure intended to treat pelvic organ prolapse. Compared with other modes of pelvic reconstructive surgery, colpocleisis is associated with lower morbidity and higher satisfaction, and has a success rate of 91-100% and a reoperation rate of less than 2%. However, there is limited information on how to treat recurrent prolapse after colpocleisis.
METHODS: We performed a review of the existing literature regarding colpocleisis failure and retreatment. A total of 118 articles were reviewed, with 16 articles suitable for inclusion. We also describe a case from our own institution of a \"repeat colpocleisis\" for recurrent prolapse after previous colpocleisis.
RESULTS: \"Repeat colpocleisis\" was the most common surgical technique used (18 out of 24 patients, 75.0%). The median follow-up time after the repeat surgery was 12 months, with only 1 patient with recurrence reported owing to recurrent rectocele 2 years after surgery, treated successfully with perineorrhaphy. Other less common techniques included perineorrhaphy, reversal of colpocleisis with native tissue repair, and vaginal hysterectomy with vaginal repair. Our case report describes the surgical management of a patient who had previously undergone LeFort colpocleisis with recurrence of prolapse, subsequently undergoing repeat colpocleisis.
CONCLUSIONS: The colpocleisis failure, though rare, presents a surgical challenge owing to both its rarity and the paucity of information in the literature regarding the optimal mode of management. In this review, the most common technique for surgical management of colpocleisis failure was repeat colpocleisis, with good short-term success rates noted. Additional studies with longer-term follow-up are needed.
METHODS: We performed a review of the existing literature regarding colpocleisis failure and retreatment. A total of 118 articles were reviewed, with 16 articles suitable for inclusion. We also describe a case from our own institution of a \"repeat colpocleisis\" for recurrent prolapse after previous colpocleisis.
RESULTS: \"Repeat colpocleisis\" was the most common surgical technique used (18 out of 24 patients, 75.0%). The median follow-up time after the repeat surgery was 12 months, with only 1 patient with recurrence reported owing to recurrent rectocele 2 years after surgery, treated successfully with perineorrhaphy. Other less common techniques included perineorrhaphy, reversal of colpocleisis with native tissue repair, and vaginal hysterectomy with vaginal repair. Our case report describes the surgical management of a patient who had previously undergone LeFort colpocleisis with recurrence of prolapse, subsequently undergoing repeat colpocleisis.
CONCLUSIONS: The colpocleisis failure, though rare, presents a surgical challenge owing to both its rarity and the paucity of information in the literature regarding the optimal mode of management. In this review, the most common technique for surgical management of colpocleisis failure was repeat colpocleisis, with good short-term success rates noted. Additional studies with longer-term follow-up are needed.
摘要：
目的：Colpocleisis是一种用于治疗盆腔器官脱垂的外科手术。与其他骨盆重建手术方式相比，Colpocleisis与较低的发病率和较高的满意度相关，成功率为91-100％，再次手术率不到2％。然而,关于如何治疗阴道炎后复发性脱垂的信息有限。
方法：我们对现有文献中关于阴道闭锁失败和再治疗进行了综述。共审查了118篇文章，有16篇文章适合纳入。我们还描述了一个来自我们自己机构的“重复阴道切口”的病例，该病例用于先前的阴道切口后的复发性脱垂。
结果：“重复结肠切除术”是最常用的手术技术（24例患者中有18例，75.0%）。重复手术后的中位随访时间为12个月,只有1例患者因手术后2年直肠前突复发而复发，经会阴修补术成功治疗。其他不太常见的技术包括会阴修补术，通过天然组织修复逆转结肠粘连，阴式子宫切除术加阴道修补术。我们的病例报告描述了先前经历过LeFortcolpocleisis并复发脱垂的患者的手术治疗。随后进行重复阴道镜检查。
结论：宫锁失败，虽然罕见，由于其稀有性和有关最佳管理模式的文献中信息匮乏，因此提出了手术挑战。在这次审查中,最常见的手术治疗方法是重复阴道炎，注意到良好的短期成功率。需要进行长期随访的其他研究。
方法：我们对现有文献中关于阴道闭锁失败和再治疗进行了综述。共审查了118篇文章，有16篇文章适合纳入。我们还描述了一个来自我们自己机构的“重复阴道切口”的病例，该病例用于先前的阴道切口后的复发性脱垂。
结果：“重复结肠切除术”是最常用的手术技术（24例患者中有18例，75.0%）。重复手术后的中位随访时间为12个月,只有1例患者因手术后2年直肠前突复发而复发，经会阴修补术成功治疗。其他不太常见的技术包括会阴修补术，通过天然组织修复逆转结肠粘连，阴式子宫切除术加阴道修补术。我们的病例报告描述了先前经历过LeFortcolpocleisis并复发脱垂的患者的手术治疗。随后进行重复阴道镜检查。
结论：宫锁失败，虽然罕见，由于其稀有性和有关最佳管理模式的文献中信息匮乏，因此提出了手术挑战。在这次审查中,最常见的手术治疗方法是重复阴道炎，注意到良好的短期成功率。需要进行长期随访的其他研究。
