Nguyen LN, et al. - In this review experts sought to assess additional treatments, symptoms, satisfaction, and quality of life 1 year following vaginal and abdominal-pelvic organ prolapse (POP) repair. Improvement was noted in the symptoms and most women were satisfied with surgery. Nonetheless, in the first year after POP repair, about 1 in 2 women had additional therapy.

Methods

• Researchers reviewed the adult women enrolled in a prospective POP database.
• They collected the baseline and outcomes data 1 year following surgery including the Pelvic Floor Distress Inventory (PFDI) and mailed surveys.
• Descriptive statistics, Fisher’s exact tests and t tests were used to analyze the data.

Results

• Results suggested that out of 222 women, 147 (66%) had vaginal and 75 (34%) had abdominal repair.
• As per the data, vaginal group patients were older (64.1 vs 59.7 years; p=0.003), but other demographic characteristics did not differ.
• Lower baseline anterior and apical prolapse grades were noted in vaginal group patients (anterior 2.7 vs 3.1, p=0.003; apical 2.1 vs 3.1, p < 0.001).
• Similar baseline PFDI scores were seen.
• After 1 year, scores improved significantly for both the groups, but 1-year PFDI scores were notably higher in the vaginal group (45.6 vs 32.6, p=0.032).
• When adjusted for age and prolapse grade, scores were not different (p=0.24).
• Most patients in the vaginal and abdominal groups reported moderately/markedly improved overall symptoms (72/108 vs 50/60, p=0.030) and quality of life (89/101 vs 54/59, p=0.601), at 1 year.
• Most patients were noted to be satisfied with the surgery (68/101 vs 48/59, p=0.067).
• Findings demonstrated the retreatment rates (pelvic floor physical therapy, medications, coping strategies, surgical procedures) to be similar (34/109 vs 15/62, p=0.381).
• Additional treatments, patient satisfaction or symptoms were not affected by use of the vaginal mesh.