Jelovsek JE, Gantz MG, Lukacz E, et al. - In view of the debates concerning the ideal measure of success after surgery for pelvic organ prolapse, researchers sought to summarize the correlations and overlap among the participants who met the anatomic, subjective, and retreatment definitions of success or failure after pelvic organ prolapse surgery. In addition, they determined rates of transition between success and failure over time; and compared scores from the Pelvic Organ Prolapse Distress Inventory, Short-Form Six-Dimension health index, and quality-adjusted life years among these definitions. From 4 randomized clinical trials conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network, they assessed a cohort of women (N = 1,250) who underwent surgery for ≥ stage II pelvic organ prolapse, for evaluating the definitions of surgical success at 3 or 6, 12, 24, 36, 48, and 60 months after surgery. Among the 433 of 1,250 women (34.6%) who were reported to have surgical failure outcomes at ≥ 1 time point, 85.5% (370 of 433) met only 1 component of the composite outcome at the assessment of initial failure. Findings suggest a possible overestimation of true failure rates after prolapse surgery in the current literature. Both subjective and objective criteria for failure were initially met by only 13% of clinical trial individuals. They identified nearly one-quarter of failures as intermittent, which transitioned between success and failure over time with most intermittent failures being in a state of “surgical success” at their last follow-up. Per findings, current composite definitions of success or failure may lead to the overestimation of surgical failure rates, potentially elucidating, in part, the discordance with low retreatment rates after pelvic organ prolapse surgery.