Does surgical repair of pelvic prolapse improve patients' quality of life?
OBJECTIVE
The aims of this study were to evaluate the efficacy of surgical repair in patients with pelvic prolapse, and to assess the postoperative quality of life (QOL).


METHODS
A total of 70 patients (mean age: 66.7 years) underwent transvaginal two-corner bladder neck suspension in combination with transvaginal hysterectomy (63 cases), and anterior with (49) or without (21) posterior colporrhaphy. The status of recurrence and complications were followed in all patients at a mean follow-up period of 32.0 months. Postoperative patients' quality of life (QOL) consisting of four items (sensation of vaginal bulging, urinary incontinence, difficulty to urinate, and health-related QOL) was assessed in 52 cases whose were followed at least two years (mean: 41.6 months, range: 24.3-69.1).


RESULTS
Sixty-eight patients (97%) were recurrence-free. Nine of the 39 (23%) patients with difficulty to urinate before surgery had persistent symptoms postoperatively. Multivariate analysis revealed that cystometric abnormalities, voiding symptoms at seventh days after surgery, and weak detrusor contraction were independent prognostic factors for persistent voiding symptoms. As for the QOL, all items had significant improvement at 13 months after surgery as compared to baseline condition. A longitudinal study showed improvement of these symptoms sustained at least up to four years.


CONCLUSIONS
This study suggests that surgical repair can achieve results with long-term durability as well as improving the QOL. In addition, assessment of the detrusor function may be needed for patients who complain difficulty to urinate in avoiding persistent such symptoms.
Hirata
Hiroshi
H
Department of Urology, Yamaguchi University School of Medicine, Minami-Kogushi, Ube 755-8505, Yamaguchi, Japan.
Matsuyama
Hideyasu
H
Yamakawa
Gen ichiro
Gi
Suga
Akinobu
A
Tatsumura
Masato
M
Ogata
Hidenobu
H
Takemoto
Masahiko
M
Tomimatsu
Ken
K
Naito
Katsusuke
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014563:Urodynamics; D014596:Uterine Prolapse / Q000601:surgery*