ANALYSIS OF LONG-TERM OUTCOMES OF SURGICAL TREATMENT OF PELVIC ORGAN PROLAPSE BASED ON PATIENT-REPORTED ASSESSMENTS
Keywords:
pelvic organ prolapse, surgical treatment, long-term outcomes, POP-Q, quality of life, sexual function, stress urinary incontinence, prolapse recurrenceAbstract
Objective: To evaluate the long-term outcomes of surgical treatment for pelvic organ prolapse (POP), identify factors affecting treatment effectiveness, and assess changes in patients’ quality of life and sexual function following surgery. Materials and Methods: The study included 58 women who underwent surgical treatment for pelvic organ prolapse. Patients were followed up for a period ranging from 1 to 3 years after surgery. Anatomical outcomes were assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system. Changes in quality of life and pelvic floor function were evaluated using the Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). Sexual function in sexually active patients was assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). According to the reconstruction technique, patients were divided into two groups: reconstructive procedures using native tissues (n=33) and surgeries involving synthetic prosthetic materials (n=25). Results: Most patients demonstrated significant improvement in pelvic organ anatomy and a reduction in clinical symptoms following surgical treatment. Sensations of pelvic pressure, heaviness, and discomfort decreased, while quality-of-life indicators improved. However, some patients developed prolapse recurrence, de novo stress urinary incontinence, chronic pelvic pain syndrome, and sexual dysfunction. Among sexually active women, some reported improvement in sexual life after surgery, whereas others experienced dyspareunia, decreased sexual satisfaction, and deterioration in the quality of intimate relationships. These complications negatively affected overall patient satisfaction with treatment outcomes. Conclusion: Surgical treatment of pelvic organ prolapse is an effective method for improving both anatomical and functional outcomes. Nevertheless, prolapse recurrence, de novo stress urinary incontinence, chronic pelvic pain syndrome, and sexual dysfunction remain the major factors adversely affecting quality of life and patient satisfaction. Therefore, assessment of treatment effectiveness should include not only anatomical outcomes but also quality of life, sexual health, and patient-reported outcome measures.
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