Colpocleisis (Ancient Greek: kolpos, meaning "hollow" + cleisis, meaning "closure") is a surgical procedure involving closure of the anterior and posterior vaginal walls.

The procedure is indicated in women with recurrent or severe pelvic organ prolapse who no longer desire penetrative vaginal sexual intercourse. There are two different types of colpocleisis: partial and complete. Partial (LeFort) colpocleisis is indicated in patients who still have their uterus, whereas complete colpocleisis is indicated in patients who have already had a hysterectomy.

For the procedure itself, a partial (LeFort) colpocleisis includes the following steps: The vagina is first pulled outward on traction and everted so the cervix is nearest to the viewer. The epithelial layer of the anterior and posterior vaginal walls are dissected off, and then sutures are approximated and run along the cervix and the lateral walls to close off the vagina. The vagina is then inverted back to normal anatomical position. The partial (LeFort) colpocleisis is more commonly performed than the complete colpocleisis. See procedure section for complete colpocleisis steps. The most common post-operative complication after a partial colpocleisis is a urinary tract infection.

The predominant socioeconomic demographic of patients undergoing colpocleisis are patients older than 71 years old, of white race, and have Medicare for insurance. Shared decision-making is essential to ensure patients understand the irreversible nature of the procedure. Informed consent discussions often involve family members or caregivers, especially when the patient is elderly or has cognitive decline.

The most common indication for colpocleisis is pelvic organ prolapse. There are reconstructive and obliterative surgical options for pelvic organ prolapse. Reconstructive surgery options include mesh-augmented procedures and native tissue repairs, whereas obliterative surgery such as colpocleisis is often considered in older patients with no desire for sexual activity. The patient's decision between a reconstructive versus obliterative procedure depends on multiple factors such as risks and benefits of each procedure, current and future sexual activity, and the patient's medical comorbidities.

Indications for colpocleisis include severe pelvic organ prolapse not relieved by conservative methods, patients who cannot tolerate reconstructive surgery, and patients who no longer plan to have vaginal intercourse

For patients with complete uterine prolapse who still have their uterus and are not interested in continued sexual function, partial colpocleisis is indicated. For patients with pelvic organ prolapse who have already had their uterus removed (post-hysterectomy) and are not interested in continued sexual function, complete colpocleisis is indicated. If the vagina is completely everted, then total colpectomy and complete colpocleisis is the first-line procedure indicated.

Before surgery, a Pap smear, transvaginal ultrasound, and endometrial biopsy are usually obtained. Gynecologic surgeries lasting greater than 30 minutes should also include venous thromboembolism prophylaxis with low molecular weight heparin or unfractionated heparin to help prevent clot formation. Preoperative bowel preparation with antibiotics may lower infection rates for colorectal surgery, but this has not been effectively proven for use in gynecologic surgery and is therefore not indicated. Preoperative assessment for urinary stress incontinence is also performed.