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Quality-of-life improvements in patients after various surgical treatments for pelvic organ prolapse

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Abstract

Objective

To compare the improvements in quality of life of patients with pelvic organ prolapse (POP) treated using various surgical methods.

Materials and methods

The PUBMED, MEDLINE and Cochrane Library online databases were searched using the keywords “pelvic organ prolapse”, “surgery”, “PFDI-20” and “PFIQ-7” for articles published from January 2010 to December 2022 that included quality-of-life scores before and after surgery.

Results

Forty-nine articles were include. The mean postoperative PFDI-20 and PFIQ-7 scores decreased by 67.50% and 76.98%, respectively, compared with those before surgery. In 76.9% of patients, this change did not decrease with increased postoperative time. The improvement rate in PFDI-20 scores after colpocleisis did not differ statistically from that after sacrocolpopexy and was significantly higher than that after other procedures. The improvement rate in PFIQ-7 scores after colpocleisis did not statistically differ from that after high uterosacral ligament suspension and was significantly higher than that after other procedures. The improvement rate in PFDI-20 scores after transvaginal mesh-based repair (TVM) did not significantly differ from that after sacrospinous ligament fixation and was significantly lower than that after other procedures except traditional vaginal wall repair. The improvement rate in PFIQ-7 scores after TVM did not significantly differ from that after new procedures and was significantly lower than that after other procedures.

Conclusions

Surgical treatment can significantly improve the quality of life of patients with POP. Colpocleisis may offer more advantages than those of other surgical procedures, and improvement was lower after TVM than after other procedures.

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Data availability

All relevant data are within the manuscript and its supplementary tables.

References

  1. Juliato CR, Santos Junior LC, Haddad JM et al (2016) Mesh surgery for anterior vaginal wall prolapse: a meta-analysis. Revista brasileira de ginecologia e obstetricia: revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia 38:356–364

    Article  PubMed  Google Scholar 

  2. Felder L, Heinzelmann-Schwarz V, Kavvadias T (2022) How does colpocleisis for pelvic organ prolapse in older women affect quality of life, body image, and sexuality? A critical review of the literature. Womens Health 18:17455057221111068

    CAS  Google Scholar 

  3. Yuk JS, Lee JH, Hur JY et al (2018) The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean national health insurance database-based cross-sectional study 2009–2015. Sci Rep 8:1334

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  4. Tinetti A, Weir N, Tangyotkajohn U et al (2018) Help-seeking behaviour for pelvic floor dysfunction in women over 55: drivers and barriers. Int Urogynecol J 29:1645–1653

    Article  PubMed  Google Scholar 

  5. Chauvin C, Chereau E, Ballester M et al (2012) Potential relevance of pre-operative quality of life questionnaires to identify candidates for surgical treatment of genital prolapse: a pilot study. BMC Urol 12:9

    Article  PubMed  PubMed Central  Google Scholar 

  6. Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113

    Article  CAS  PubMed  Google Scholar 

  7. Mattsson NK, Karjalainen PK, Tolppanen AM et al (2020) Pelvic organ prolapse surgery and quality of life-a nationwide cohort study. Am J Obstet Gynecol 222:588 e581-588 e510

    Article  Google Scholar 

  8. Jelovsek JE, Gantz MG, Lukacz ES et al (2021) Subgroups of failure after surgery for pelvic organ prolapse and associations with quality of life outcomes: a longitudinal cluster analysis. Am J Obstet Gynecol 225:504 e501-504 e522

    Article  Google Scholar 

  9. Ko KJ, Lee KS (2019) Current surgical management of pelvic organ prolapse: Strategies for the improvement of surgical outcomes. Investig Clin Urol 60:413–424

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mearini L, Zucchi A, Nunzi E et al (2015) The S.A.C.S. (satisfaction-Anatomy-Continence-Safety) score for evaluating pelvic organ prolapse surgery: a proposal for an outcome-based scoring system. Int Urogynecol J 26:1061–1067

    Article  PubMed  Google Scholar 

  11. Ghanbari Z, Ghaemi M, Shafiee A et al (2022) Quality of life following pelvic organ prolapse treatments in women: a systematic review and meta-analysis. J Clin Med 11:7166

    Article  PubMed  PubMed Central  Google Scholar 

  12. da Silveira SDRB, Haddad JM, de Jarmy-Di Bella ZI et al (2015) Multicenter, randomized trial comparing native vaginal tissue repair and synthetic mesh repair for genital prolapse surgical treatment. Int Urogynecol J 26:335–342

    Article  Google Scholar 

  13. Sukgen G, Turkay U (2020) Effect of pelvic organ prolapse reconstructive mesh surgery on the quality of life of Turkish patients: a prospective study. Gynecol Minim Invasive Ther 9:204–208

    Article  PubMed  PubMed Central  Google Scholar 

  14. NICE Guidance - Urinary incontinence and pelvic organ prolapse in women: management: (c) NICE (2019) Urinary incontinence and pelvic organ prolapse in women: management. BJU Int 123:777–803

    Article  Google Scholar 

  15. Lallemant M, Clermont-Hama Y, Giraudet G et al (2022) Long-term outcomes after pelvic organ prolapse repair in young women. J Clin Med 11:6112

    Article  PubMed  PubMed Central  Google Scholar 

  16. Patel N, Faldu P, Fayed M et al (2022) Chronic pelvic pain, quality of life, and patient satisfaction after robotic sacrocolpopexy for pelvic organ prolapse. Cureus 14:e28095

    PubMed  PubMed Central  Google Scholar 

  17. Wang G, Zhou S, Wang S et al (2022) Effect of new-style anterior and posterior vaginal wall repair combined with modified ischial spine fascia fixation on patients with pelvic organ prolapse and their postoperative quality of life. Front Surg. https://doi.org/10.3389/fsurg.2022.994615

    Article  PubMed  PubMed Central  Google Scholar 

  18. Zhang Y, Wang W, Lu Y et al (2022) Mid-term efficacy of surgical treatments for post-hysterectomy vaginal vault prolapse: a retrospective study. Gland Surg 11:992–1002

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wang P, Li M, Sun H et al (2022) Function, quality-of-life and complications after sacrospinous ligament fixation using an antegrade reusable suturing device (ARSD-Ney) at 6 and 12 months: a retrospective cohort study. Ann Transl Med 10:582

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Zhang YA, Wang W, Li XL et al (2022) The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up. Open Med 17:801–807

    Article  Google Scholar 

  21. Szymczak P, Grzybowska ME (2022) Perioperative and long-term anatomical and subjective outcomes of laparoscopic pectopexy and sacrospinous ligament suspension for POP-Q stages II¨CIV apical prolapse. J Clin Med 11:2215

    Article  PubMed  PubMed Central  Google Scholar 

  22. Li J, Sima Y, Hu C et al (2022) Transvaginal single-port versus multi-port laparoscopic sacrocolpopexy: a retrospective cohort study. BMC Surg 22:82

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Gholamian E, Haghollahi F, Tarokh S et al (2022) Clinical outcomes in patients with advanced pelvic prolapse who underwent LeFort surgery or pessary placement-a prospective cohort study. Caspian J Intern Med 13:405–411

    PubMed  PubMed Central  Google Scholar 

  24. Levy G, Padoa A, Marcus N et al (2022) Surgical treatment of advanced anterior wall and apical vaginal prolapse using the anchorless self-retaining support implant: long-term follow-up. Int Urogynecol J 33:3067–3075

    Article  PubMed  PubMed Central  Google Scholar 

  25. Niu K, Zhai Q, Fan W et al (2022) Robotic-assisted laparoscopic sacrocolpopexy for pelvic organ prolapse: a single center experience in China. J Healthcare Eng 2022:6201098

    Article  Google Scholar 

  26. Linder BJ, Gebhart JB (2022) Comparison of outcomes between pessary use and surgery for symptomatic pelvic organ prolapse: a prospective self-controlled study. Investig Clin Urol 63:214–220

    Article  PubMed  PubMed Central  Google Scholar 

  27. Daneshpajooh A, Pakmanesh H, Sohbati S et al (2022) Comparing laparoscopic sacrocolpopexy with vaginal sacrospinous ligament fixation in the treatment of vaginal apical prolapse; the first randomized clinical trial: a pilot study. Urol J 19:131–137

    PubMed  Google Scholar 

  28. Lu Z, Chen Y, Wang X et al (2021) Transvaginal natural orifice transluminal endoscopic surgery for uterosacral ligament suspension: pilot study of 35 cases of severe pelvic organ prolapse. BMC Surg 21:286

    Article  PubMed  PubMed Central  Google Scholar 

  29. Karjalainen PK, Mattsson NK, Jalkanen JT et al (2021) Minimal important difference and patient acceptable symptom state for PFDI-20 and POPDI-6 in POP surgery. Int Urogynecol J 32:3169–3176

    Article  PubMed  Google Scholar 

  30. Sharma JB, Kumar M, Roy KK et al (2021) Role of preoperative and postoperative pelvic floor distress inventory-20 in evaluation of posthysterectomy vault prolapse. J Mid-life Health 12:122–127

    Article  Google Scholar 

  31. van der Vaart LR, Vollebregt A, Milani AL et al (2022) Pessary or surgery for a symptomatic pelvic organ prolapse: the PEOPLE study, a multicentre prospective cohort study. BJOG 129:820–829

    Article  PubMed  Google Scholar 

  32. Zhu H, Sun Y, Zheng X (2021) A comparison of modified laparoscopic uterine suspension and vaginal hysterectomy with sacrospinous ligament fixation for treating pelvic organ prolapse. Am J Transl Res 13:5672–5678

    PubMed  PubMed Central  Google Scholar 

  33. Falconer C, Altman D, Poutakidis G et al (2021) Long-term outcomes of pelvic organ prolapse repair using a mesh-capturing device when comparing single- versus multicenter use. Arch Gynecol Obstet 303:135–142

    Article  PubMed  Google Scholar 

  34. Shkarupa D, Zaytseva A, Kubin N et al (2021) Native tissue repair of cardinal/uterosacral ligaments cures overactive bladder and prolapse, but only in pre-menopausal women. Central Eur J Urol 74:372–378

    Google Scholar 

  35. Lu M, Zeng W, Ju R et al (2021) Long-term clinical outcomes, recurrence, satisfaction, and regret after total colpocleisis with concomitant vaginal hysterectomy: a retrospective single-center study. Female Pelvic Med Reconstr Surg 27:e510–e515

    Article  PubMed  Google Scholar 

  36. Wang W, Zhang Y, Shen W et al (2020) Long-term efficacy of transvaginal high uterosacral ligament suspension for middle-compartment defect-based pelvic organ prolapse. Ann Transl Med 8:1645

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sohbati S, Hajhashemi M, Eftekhar T et al (2020) Outcomes of surgery with vaginal native tissue for posterior vaginal wall prolapse using a special technique. J Med Life 13:554–561

    Article  PubMed  PubMed Central  Google Scholar 

  38. Zhao Y, Xia ZJ, Hu Q et al (2020) Subjective and objective evaluation of total pelvic floor reconstruction with six-arm mesh in patients with severe pelvic organ prolapse: a 1-year retrospective study. Ther Clin Risk Manag 16:861–870

    Article  PubMed  PubMed Central  Google Scholar 

  39. Sharifiaghdas F (2020) Trans-obturator approach and the native tissue in the treatment of high stage prolapse of the anterior vaginal wall: midterm results of a new surgical technique. Urol J 18:97–102

    PubMed  Google Scholar 

  40. Yin H, Zeng F, Xue M et al (2020) Therapeutic effect of robot-assisted laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. Zhong nan da xue xue bao Yi xue ban = Journal of Central South University Medical sciences 45:709–714

    PubMed  Google Scholar 

  41. Wang X, Hu C, Chen Y et al (2020) LeFort colpocleisis for recurrent pelvic organ prolapse. Int Urogynecol J 31:381–384

    Article  PubMed  Google Scholar 

  42. Winkelman WD, Haviland MJ, Elkadry EA (2020) Long-term pelvic floor symptoms, recurrence, satisfaction, and regret following colpocleisis. Female Pelvic Med Reconstr Surg 26:558–562

    Article  PubMed  Google Scholar 

  43. Karon M, Chatterjee S (2019) Sacrocolpopexy: patient outcomes support the use of non-crosslinked acellular dermal matrix as an alternative to the synthetic polypropylene mesh. J Gynecol Surg 35:337–344

    Article  PubMed  PubMed Central  Google Scholar 

  44. Wang J, Wang X, Hua K et al (2019) Laparoscopic sacrocolpopexy plus colporrhaphy with a small intestine submucosa graft versus total pelvic floor reconstruction for advanced prolapse: a retrospective cohort study. Int Neurourol J 23:144–150

    Article  PubMed  PubMed Central  Google Scholar 

  45. Wei D, Wang P, Niu X et al (2019) Comparison between laparoscopic uterus/sacrocolpopexy and total pelvic floor reconstruction with vaginal mesh for the treatment of pelvic organ prolapse. J Obstet Gynaecol Res 45:915–922

    Article  PubMed  PubMed Central  Google Scholar 

  46. Malanowska E, Starczewski A, Bielewicz W et al (2019) Assessment of overactive bladder after laparoscopic lateral suspension for pelvic organ prolapse. Biomed Res Int 2019:9051963

    Article  PubMed  PubMed Central  Google Scholar 

  47. Mourad S, El Shawaf H (2019) Safety and effectiveness of laparoscopic sacrocolpopexy as the treatment of choice for pelvic organ prolapse. Arab J Urol 17:30–39

    Article  PubMed  PubMed Central  Google Scholar 

  48. Joo E, Kang MH, Yoo EH et al (2019) Assessment of the effect of transobturator tape surgery on women’s sexual function using a validated questionnaire. Obstetr Gynecol Sci 62:120–126

    Article  Google Scholar 

  49. Kissane LM, Meyer I, Martin KD et al (2018) Impact of age on mid- to long-term outcomes of transvaginal native tissue repair for apical vaginal prolapse. Neurourol Urodyn 37:2860–2866

    Article  PubMed  PubMed Central  Google Scholar 

  50. Li C, Shu H, Dai Z (2018) Laparoscopic inguinal ligament suspension with uterine preservation for pelvic organ prolapse: a retrospective cohort study. Int J Surg 54:28–34

    Article  ADS  PubMed  Google Scholar 

  51. Huang LX, Li RL, Sha LX et al (2018) Clinical efficacy of pelvic autologous tissue reconstruction in treating pelvic organ prolapse in 36 patients. Medicine 97:e12765

    Article  PubMed  PubMed Central  Google Scholar 

  52. Mamik MM, Rogers RG, Qualls CR et al (2013) Goal attainment after treatment in patients with symptomatic pelvic organ prolapse. Am J Obstet Gynecol 209(488):e481-485

    Google Scholar 

  53. Szymanowski P, Szepieniec WK, Szweda H (2021) Preperitoneal laparoscopic lateral repair in pelvic organ prolapse—a novel approach. Ginekol Pol 92:689–694

    Article  PubMed  Google Scholar 

  54. Cormio L, Mancini V, Liuzzi G et al (2017) Surgical management of female pelvic organ prolapse with and without urinary incontinence: a single center experience. Medicine 96:e7914

    Article  PubMed  PubMed Central  Google Scholar 

  55. Wang X, Chen Y, Hua K (2017) Pelvic symptoms, body image, and regret after LeFort Colpocleisis: a long-term follow-up. J Minim Invasive Gynecol 24:415–419

    Article  PubMed  Google Scholar 

  56. Cao TT, Sun XL, Wang SY et al (2016) Porcine small intestinal submucosa mesh for treatment of pelvic organ prolapsed. Chin Med J 129:2603–2609

    Article  PubMed  PubMed Central  Google Scholar 

  57. Meyer I, McGwin G, Swain TA et al (2016) Synthetic graft augmentation in vaginal prolapse surgery: long-term objective and subjective outcomes. J Minim Invasive Gynecol 23:614–621

    Article  PubMed  PubMed Central  Google Scholar 

  58. Song X, Zhu L, Ding J et al (2016) Long-term follow-up after LeFort colpocleisis: patient satisfaction, regret rate, and pelvic symptoms. Menopause 23:621–625

    Article  PubMed  Google Scholar 

  59. Crisp CC, Book NM, Cunkelman JA et al (2016) Body image, regret, and satisfaction 24 weeks after colpocleisis: a multicenter study. Female Pelvic Med Reconstr Surg 22:132–135

    Article  PubMed  Google Scholar 

  60. Liang S, Zhu L, Zhang L et al (2015) Manometric comparison of anorectal function after posterior vaginal compartment repair with and without mesh. Chin Med J 128:438–442

    Article  PubMed  PubMed Central  Google Scholar 

  61. Culligan PJ, Gurshumov E, Lewis C et al (2014) Subjective and objective results 1 year after robotic sacrocolpopexy using a lightweight Y-mesh. Int Urogynecol J 25:731–735

    Article  PubMed  Google Scholar 

  62. Crisp CC, Book NM, Smith AL et al (2013) Body image, regret, and satisfaction following colpocleisis. Am J Obstet Gynecol 209(473):e471-477

    Google Scholar 

  63. Wetta LA, Gerten KA, Wheeler TL 2nd et al (2009) Synthetic graft use in vaginal prolapse surgery: objective and subjective outcomes. Int Urogynecol J Pelvic Floor Dysfunct 20:1307–1312

    Article  PubMed  PubMed Central  Google Scholar 

  64. Mathlouthi N, Elloumi J, Trabelsi H et al (2011) Anatomic and functional results after surgical treatment of uro genital prolapse: prospective study about 93 cases. Tunis Med 89:896–901

    PubMed  Google Scholar 

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  1. Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 North Garden Street, Beijing, 100191, China

    Yiqi Guan & Jinsong Han

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by YG. The first draft of the manuscript was written by YG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jinsong Han.

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Guan, Y., Han, J. Quality-of-life improvements in patients after various surgical treatments for pelvic organ prolapse. Arch Gynecol Obstet 309, 813–820 (2024). https://doi.org/10.1007/s00404-023-07140-3

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