Prolapse Quality-of-life Questionnaire is a Reliable Postoperative Outcome Assessment

Abstract

Objectives: The prolapse quality-of-life (P-QOL) questionnaire is frequently used to assess changes in symptoms before and after surgery in patients with pelvic organ prolapse (POP). This study investigated whether P-QOL scores were significantly affected by pre- and postoperative conditions in patients with surgically treated POP.

Materials and methods: The study enrolled 158 patients who underwent surgery for POP at our hospital between May 2016 and May 2023. Seventy-two patients underwent laparoscopic sacrocolpopexy (LSC), whereas 86 underwent transvaginal mesh (TVM) surgery. To evaluate the POP-related conditions, the 60-min pad test and the Japanese version of P-QOL were used before surgery and 6 and 12 months after surgery.

Results: In patients with stage 4 POP, all P-QOL component scores, except for sleep/energy, significantly declined after surgery in the LSC group. Conversely, some component scores did not show a significant difference after the surgery in the TVM group. No significant differences in the rate of urinary incontinence, mesh exposure, or prolapse recurrence (PR) were observed between the two groups; however, the rate of PR was much higher in the TVM group than in the LSC group, although no significant differences were found in patients with stage 4 POP. Accordingly, some P-QOL component scores were significantly higher in the TVM group than in the LSC group (all P < 0.05).

Conclusion: The surgical outcomes of POP have a significant effect on P-QOL. Postoperative conditions can be evaluated using P-QOL scores.

Keywords: laparoscopic sacrocolpopexy; prolapse quality-of-life questionnaire; transvaginal mesh surgery.

Figure 1

All patients. Prolapse quality-of-life (P-QOL) domain scores before surgery (a), 6 months after surgery (b), and 12 months after surgery (c) in the laparoscopic sacrocolpopexy (LSC) group. P-QOL scores before surgery (d), 6 months after surgery (e), and 12 months after surgery (f) in the transvaginal mesh (TVM) group. They are expressed as a percentage of the full score. In both the LSC and TVM groups, each P-QOL domain score significantly decreased 6 and 12 months after surgery compared with preoperative values (all P < 0.0001)

Figure 2

Patients with stage ≤ 3 pelvic organ prolapse. Prolapse quality-of-life (P-QOL) domain scores before surgery (a), 6 months after surgery (b), and 12 months after surgery (c) in the laparoscopic sacrocolpopexy (LSC) group. P-QOL scores before surgery (d), 6 months after surgery (e), and 12 months after surgery (f) in the transvaginal mesh (TVM) group. They are expressed as a percentage of the full score. In both the LSC and TVM groups, each P-QOL component score significantly decreased 6 and 12 months after surgery compared with preoperative values (all P < 0.01)

Figure 3

Patients with stage 4 pelvic organ prolapse. Prolapse quality-of-life (P-QOL) domain scores before surgery (a), 6 months after surgery (b), and 12 months after surgery (c) in the laparoscopic sacrocolpopexy (LSC) group. P-QOL scores before surgery (d), 6 months after surgery (e), and 12 months after surgery (f) in the transvaginal mesh (TVM) group. They are expressed as a percentage of the full score. In the LSC group, each P-QOL domain score, except for sleep/energy, significantly decreased 6 and 12 months after surgery compared with preoperative values (all P < 0.05). In the TVM group, the role limitations score 6 months after surgery, personal relationships scores 6 and 12 months after surgery, and emotions score 12 months after surgery did not show any significant difference compared with the preoperative values. Except for them, each P-QOL domain score significantly decreased 6 and 12 months after surgery compared with preoperative values (all P < 0.05)