title: Severe pelvic organ prolapse treated by vaginal native tissue repair: long-term analysis of outcomes in 146 patients.
abstract: OBJECTIVE
  The aim of this study was to assess the effectiveness and safety of vaginal native tissue repair (VNTR) as a surgical treatment for severe pelvic organ prolapse (POP) and, second, to evaluate the impact on the quality-of-life (QoL) and sexual function.
  
  
  METHODS
  Women with symptomatic POP (≥III stage according to POP Quantification System) with or without stress urinary incontinence (SUI) underwent VNTR. The clinical stage, 3-day voiding diary, and urodynamic testing were evaluated in the preoperative and postoperative times, respectively. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Questionnaire Short Form (ICIQ-UI SF), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12), and the prolapse quality-of-life questionnaire (P-QoL) were administered.
  
  
  RESULTS
  One hundred forty-six patients were recruited. The median follow-up was 48 months (36-63). Fifty-two women (36%) had a previous hysterectomy, and 16 (11%) had a previous prolapse/continence surgery. Preoperatively, 135 (92.5%), 109 (74.7%), and 98 (67.1%) patients had anterior, central, and posterior descent ≥III stage, respectively. Thirty-two patients (22%) had concomitant diagnosis of SUI. Median operative time was 85 min (37-154), and median postoperative hospital stay was 2 days (2-4). No intraoperative severe complications occurred. At the long-term follow-up, the subjective cure rate for prolapse was 97.3% and the objective cure rate was 91.1%. A significant improvement of ICIQ-UI SF, the P-QoL, and the PISQ-12 was recorded at the follow-up (p < 0.001).
  
  
  CONCLUSIONS
  VNTR is effective, safe, and durable and improves POP-related symptoms and sexual function.
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy. michelecarlo.schiavi@gmail.com.|Department of Gynecological and Obstetric Sciences, and Urological Sciences, Umberto I Hospital, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy. michelecarlo.schiavi@gmail.com.
authors.forename: Michele Carlo
authors.identifier: http://orcid.org/0000-0003-4149-170X
authors.initials: MC
authors.lastname: Schiavi
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Perniola
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Virginia Sibilla
authors.initials: VS
authors.lastname: Visentin
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Vena
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Di Pinto
authors.affiliation: Department of Surgery-Week Surgery, Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Marzio Angelo
authors.initials: MA
authors.lastname: Zullo
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Monti
authors.affiliation: Department of Gynecology, Obstetrics and Urology, Umberto I, ''Sapienza'' University of Rome, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012725:Sexual Behavior; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000601:surgery; D014563:Urodynamics; D014621:Vagina / Q000601:surgery
keywords: POP surgery; Pelvic organ prolapse; Sexual function; Vaginal native tissue repair