Pelvic organ prolapse can be seen in eldery age group patients who have complaints about incontinence and forcefully urination during physical examination. In this age group should be careful when reconstructive surgery methods choosing because of additional systemic diseases effect the risk of morbidity of the operation. Surgical methods applied in uterine prolapse can be performed by abdominal, vaginal and laparoscopic methods. The surgical method to be chosen should be based on the patient's request, the degree of organ prolapse, whether there is an additional incontinence, and the surgeon's experience. Elderly patients who no longer desire sexual intercourse or are medically unstable can be treated effectively with a vaginal closure or colpocleisis. LeFort colpocleisis is one of the surgical methods and can be done by providing patient information to appropriate patients.

In this video presentation, we aimed to demonstrate LeFort  colpocleisis in a patient with Grade 4 pelvic organ prolapse.

A 72-year-old woman presented to our clinic with urgency, rarely urge incontinence, difficulty in urinating for about 1 year and a mass complaint in the pelvic region for 6 months. In her obstetric history, the number of gravida was 4 and the number of parity was 4. It was learned that the patient delivered all births vaginally. In her medical history, it was learned that she used metoprolol 50 mg once a day for 5 years due to a heart rhythm disorder. On physical examination, total uterine prolapse (grade 4), stress test negative, right inguinal hernia were detected. In the uroflowmetry test, the maximum flow rate was 20.2 ml / s, the average flow rate was 6.8 ml / s, and the voiding volume was 114.1 cc. Post voiding residual urine was not detected. Detailed information was given to the patient about her condition. It was learned that the patient had no sexual intercourse expectation. Lefort colpocleis surgery was recommended the patient. The patient underwent general anesthesia and given lithotomy position. Native tissue border was left 1-3 cm from the urethral membrane and cervix. For the uterine drainage, lateral sulcus was created and vaginal closure was partially performed. Total operation time was 58 min and blood loss was 40 cc. Vaginal tampon was removed on the first postoperative day. Urethral catheter was removed on the 10th day. Anticholinergic agent was prescribed for the complaints of ongoing urgency after surgery. During follow-up at the 6th month, the patient's complaints were relieved and pelvic organ prolapse disappeared.

Pelvic organ prolapse is common among with gynecological problems in the female population, and 11% of women under 80 undergo surgery for this reason. In pelvic organ prolapse, the patient's level of complaint can be very variable. Stress or urge incontinence may not always be seen. Less invasive treatments should be chosen, especially in those women who with advanced age and comorbid diseases. LeFort colpocleis surgery is a suitable surgical method to be preferred due to low morbidity, early wound healing and early discharge.