title: Management of pelvic organ prolapse and quality of life: a systematic review and meta-analysis.
abstract: OBJECTIVE
  One of the main outcomes in the assessment of the treatment of pelvic organ prolapse in women is quality of life. Using quality of life as an outcome measure is increasing in the majority of clinical trials. The aim of current study was to determine the effects of the treatment of pelvic organ prolapse on patients' quality of life using systematic review and meta-analysis.
  
  
  METHODS
  A systematic search for finding randomized controlled studies on pelvic organ prolapse published before October 2012 was conducted. The JAMA users' guide to the medical literature quality assessment scales for randomized clinical trials was used to assess the quality of included articles. The mean difference in total quality of life score between before and after intervention (surgical or pelvic floor training) with 95 % confidence interval (CI) was considered as a primary summary measure. Egger's test was used to evaluate the publication bias. Heterogeneity was assessed using I(2) Index.
  
  
  RESULTS
  Fifty-seven RCT were critically appraised. Thirty-two articles were eligible after critical evaluation. Mean difference in change in the total quality of life score with 95 % CI for surgical treatment was 74.03 (66.3-81.6) by PFDI-20 and was 44.57 (22.53-66.65) by PFIQ-7. The mean difference in changed in the total quality of life score with 95 % CI was 1.32 (-2.8-5.4) for pelvic floor training (PFT).
  
  
  CONCLUSIONS
  We found that surgical interventions on prolapse can improve the quality of life of women. There was a relative effect of PFT on the quality of life of women with prolapse in systematic review. This effect was not seen in meta-analysis, probably because of finding few eligible studies to pool the effect size.
authors.affiliation: Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahdyie
authors.initials: M
authors.lastname: Doaee
authors.forename: Maziar
authors.initials: M
authors.lastname: Moradi-Lakeh
authors.forename: Abbas
authors.initials: A
authors.lastname: Nourmohammadi
authors.forename: Seid Kazem
authors.initials: SK
authors.lastname: Razavi-Ratki
authors.forename: Marzieh
authors.initials: M
authors.lastname: Nojomi
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D017063:Outcome Assessment, Health Care; D017773:Pelvic Floor / Q000502:physiology; D056887:Pelvic Organ Prolapse / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D026741:Physical Therapy Modalities; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D016896:Treatment Outcome