A 75-year-old woman with multiple comorbidities has procidentia (uterine prolapse with the entire uterus outside the vagina). She is not sexually active and wishes to avoid major surgery. The most appropriate management is:
- A Abdominal sacrohysteropexy
- B Vaginal hysterectomy with vault suspension
- C Le Fort's partial colpocleisis ✓
- D Sacrospinous hysteropexy
Correct answer: C. Le Fort's partial colpocleisis
Explanation
Le Fort's colpocleisis is the procedure of choice for elderly, medically unfit, non-sexually active women with procidentia. It is minimally invasive, has low morbidity, and high success. It involves partial closure of the vaginal canal, creating a septum with lateral drainage channels. Vaginal hysterectomy is more morbid. Sacrospinous hysteropexy and sacrohysteropexy preserve the uterus but are more extensive procedures.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.