A 65-year-old P3+0 female complains of procidentia. She has past history significant of MI and is diabetic and hypertensive. Ideal management of prolapse in the patient is:
High-Yield Explanation
In females more than 60 years of age, who have medical complications like, in this patient previous H/ O MI, hypertension and diabetes, Vaginal hysterectomy is not possible as the anaesthetist will not agree to give anaesthesia.
In such patients procidentia/3° degree prolapse can be managed by Le forts colpocleisis:
In Le forts repair/colpocleisis:
The vaginal epithelium is removed followed by suturing of the anterior and posterior walls of denuded vagina therapy completely obliterating the vagina.
The procedure is done under local anaesthesia.
Before performing this procedure, PAP smear and pelvic USG should be done to rule out cancers and pelvic pathology.