An 82-year-old frail woman with severe cardiac disease has complete procidentia. She declines any major surgery. Her medical team opts for definitive conservative treatment. The most suitable procedure is:
- A Sacrohysteropexy
- B Le Fort partial colpocleisis ✓
- C Manchester operation
- D Posterior intravaginal slingplasty
Correct answer: B. Le Fort partial colpocleisis
Explanation
Le Fort partial colpocleisis surgically obliterates the vaginal canal by approximating the anterior and posterior vaginal walls, leaving channels at the sides for drainage. It is a short procedure performed vaginally under regional or local anesthesia, ideal for elderly, medically unfit women who are no longer sexually active. It requires an adequate perineal body and prior exclusion of genital tract malignancy. The other options are major reconstructive procedures unsuitable for a frail patient.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.