Reframing the Outdated: Le Fort Colpocleisis as a Definitive, Low-Morbidity Solution for Recurrent Vault Prolapse in High-Risk Elderly Women

Abstract Pelvic organ prolapse (POP) remains a significant cause of morbidity among elderly women, particularly those with recurrent vaginal vault prolapse following multiple reconstructive surgeries. While contemporary urogynecological practice favors reconstructive approaches that preserve vaginal function, such procedures may be associated with higher morbidity, longer operative time, and increased recurrence in high-risk elderly patients. Le Fort colpocleisis, an obliterative vaginal procedure, offers a durable and minimally invasive alternative for carefully selected patients who no longer desire vaginal intercourse. This article revisits the historical evolution, surgical rationale, and clinical outcomes of Le Fort colpocleisis, supported by a representative case of recurrent vault prolapse managed successfully in a high-risk elderly patient. Keywords: Pelvic organ prolapse, vaginal vault prolapse, Le Fort colpocleisis, obliterative surgery, elderly women.