title: Long-term quality-of-life outcome after mesh sacrocolpopexy for vaginal vault prolapse.
abstract: OBJECTIVE
  To evaluate the long-term outcome of mesh sacrocolpopexy (MSC, which aims to restore normal pelvic floor anatomy to alleviate prolapse related symptoms) and its effect on patient's quality of life, as women with vaginal vault prolapse commonly have various pelvic floor symptoms that can affect urinary, rectal and sexual function.
  
  
  METHODS
  From January 2000 to June 2006, consecutive patients with confirmed stage 2-4 vaginal vault prolapse subsequently had a MSC. Detailed telephone interviews using the Cleveland Clinic Short Form-20 Pelvic Floor Distress Inventory (PFDI) questionnaire, with Urinary Distress Inventory (UDI), Pelvic Organ Prolapse Distress Inventory (POPDI) and Colorectal-Anal Distress Inventory (CRADI) subscales was completed by all patients to assess symptoms before and after MSC, improvement in sexual function and overall satisfaction.
  
  
  RESULTS
  In all, 21 patients had abdominal MSC; the median (range) follow-up was 52.2 (21-99) months. Total PFDI scores were significantly better after MSC (mean 44.0/300) than before (mean 113.9/300; P < 0.001). Analysis of the subscale scores showed that all patients reported a significant improvement of symptoms in the POPDI category (P < 0.001). CRADI subscale scores showed no significant change after MSC (before, mean 7.43/100 vs after 8.47/100; P = 0.542). There was an improvement of urinary symptoms on the UDI subscale after MSC but it was not statistically significant (P = 0.08). Analysis of score differences over time after MSC showed an insignificant decreasing slope (P = 0.227), suggesting long-term stability of symptoms after surgery; 90% of patients reported a significant improvement in sexual function and excellent long-term overall satisfaction with MSC.
  
  
  CONCLUSIONS
  Our results suggest that MSC is a safe and effective surgical option for treating vaginal vault prolapse, providing symptom improvement and stability in the long term.
authors.affiliation: Department of Urology and Renal Transplantation, Beaumont Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland. arunthomas75@gmail.com
authors.forename: Arun Z
authors.initials: AZ
authors.lastname: Thomas
authors.forename: Subhasis K
authors.initials: SK
authors.lastname: Giri
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Cox
authors.forename: Tom
authors.initials: T
authors.lastname: Creagh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*