title: Quality of life after Uphold™ Vaginal Support System surgery for apical pelvic organ prolapse-A prospective multicenter study.
abstract: OBJECTIVE
  To study the effects on quality of life in women operated for apical pelvic organ prolapse using the Vaginal Uphold™ System.
  
  
  METHODS
  In this prospective cohort study, women (n=207) with symptomatic apical prolapse, with or without cystocele, were operated using the Uphold™ Vaginal Support System. Follow-up for quality of life was performed at 12 months after surgery, and assessed by the PFDI-20, and PFIQ-7, and sexual function by the PISQ-12. We used odds ratios (ORs) with 95% confidence intervals (CIs) for outcome association analyses using logistic regression.
  
  
  RESULTS
  At one-year follow-up majority of women experienced an overall postoperative improvement in quality of life (p<0.001). One year after surgery Uphold™ operation alone increased the risk for prolapse related bother as compared to Uphold™ combined with anterior colporraphy (POP-IQ-7; OR 2.1; 95% CI 1.01-4.3). The frequency of dyspareunia decreased postoperatively (p=0.004), however, after one-year, overall sexual function deteriorated significantly (p<0.001). The worsening in sexual function scores was mainly attributed to the partner related domain, whereas the behavioral-emotive and physical domains showed no significant changes.
  
  
  CONCLUSIONS
  Apical prolapse repair using Uphold™ improved quality of life among our patients but worsened overall sexual function postoperatively.
authors.affiliation: University of Helsinki and Helsinki University Central Hospital, Department of Obstetrics and Gynecology, Finland. Electronic address: paivi.rahkola-soisalo@hus.fi.
authors.forename: Päivi
authors.initials: P
authors.lastname: Rahkola-Soisalo
authors.affiliation: Stockholm Urogynecological Clinic, Sweden; Division of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
authors.affiliation: Division of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Falconer
authors.affiliation: Division of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Sweden.
authors.forename: Edward
authors.initials: E
authors.lastname: Morcos
authors.affiliation: Odense University Hospital, Department of Obstetrics and Gynecology, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Rudnicki
authors.affiliation: University of Helsinki and Helsinki University Central Hospital, Department of Obstetrics and Gynecology, Finland; Folkhälsan Research Center, Helsinki, Finland.
authors.forename: Tomi S
authors.initials: TS
authors.lastname: Mikkola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D052858:Cystocele / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D057566:Self Report; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D013526:Surgical Mesh / Q000009:adverse effects*
keywords: Cystocele; Pelvic organ prolapse; Quality of life; Transvaginal mesh; Uterine prolapse