Prolapse Quality-of-Life Questionnaire is a Reliable Postoperative Outcome Assessment

Lack of connective tissue support leading the internal organs of the pelvis to descend is referred to as pelvic organ prolapse (POP) and can significantly impact quality of life. The incidence of POP continues to rise with an aging population and the rising prevalence of obesity. In women older than 50, the prevalence of POP is estimated between 30% and 50%, and the likelihood of surgery to correct POP or urinary incontinence (UI) at the age of 80 is 11.1%. Recent treatments for POP in Japan include transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC), and both have been shown to be effective. Traditionally, TVM has been used in patients who are at higher risk, such as older patients, and LSC has been used mainly in people who are a lower surgical risk. Previous studies have used residual urine volume, 60-minute pad weight testing, International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) to evaluate quality of life. The prolapse quality of life questionnaire (P-QOL) is often used to assess improvement in patients with POP, but previous studies have not included these results. This study was designed to assess whether P-QOL scores were affected by preoperative and postoperative factors in patients receiving POP repair surgery. This was a retrospective analysis of 158 patients who received LSC or TVM between May 2016 and May 2023. A total of 72 patients received LSC, and a total of 86 received TVM. The median follow-up period was 24.6 months in this cohort. The primary outcome was the performance of the P-QOL questionnaire and any factors that may influence its scoring. The median age and mean BMI were significantly higher in the TVM group compared with the LSC group, and more patients in the LSC group had stage 4 POP. In addition, median blood loss was significantly lower in the LSC group, while operative time was significantly longer. P-QOL domain scores significantly improved in all patients after surgery. There were no significant differences in the incidence of UI, mesh exposure, or prolapse recurrence between surgical types overall or specifically in individuals with stage 4 POP. The domains of general health perception, prolapse impact, and severity measures in the P-QOL questionnaire were reported as significantly higher (improved) in the TVM group compared with the LSC group. These results indicate that P-QOL scores were significantly improved at 6 and 12 months postoperatively compared with preoperative scores in every stage of POP, with the exception of the domains of sleep/energy in the LSC group and role limitations, personal relationships, and emotions in the TVM group in individuals with stage 4 POP. This is consistent with previous literature and with overall complication rates in both groups. The P-QOL is easy to use and accurate for the assessment of improvement in quality of life in POP patients and is applicable to both TVM and LSC surgical methods. Future research should focus on expanding the application of this questionnaire and including a larger population across a more diverse area, as well as implementing prospective methods of validation. In addition, the postoperative follow-up period should be extended to assess long-term outcomes and performance of P-QOL. (Abstracted from Gynecol Minim Invasive Ther. 2025 Jul 19;14(3):215-222. doi: 10.4103/gmit.gmit_74_24.)