Operation for pelvic organ prolapse: a follow-up study

Long-term results of surgery for pelvic organ prolapse in terms of objective and subjective cure rates, postoperative complications and side-effects were studied retrospectively.

Two hundred and sixty-nine women underwent surgery between 1986 and 1988 and were invited to a follow-up visit in 1998-99. One hundred and twenty-eight (47%) women attended the follow-up. In the time between surgery and follow-up, 67 (25%) women had died. The medical records were reviewed for women not attending follow-up (n = 131), revealing a higher age and a more severe prolapse in the lost to follow-up group.

The subjective cure rate, with cure of all symptoms of pelvic organ prolapse, was 46% (n = 59). The objective cure rate, with satisfactory anatomic outcome, was 56% (n = 72). If perfect results had been attained in the women who did not undergo follow-up examination, the subjective and objective cure rates would be 73% and 79%, respectively. Previous prolapse surgery, a traumatic delivery, urinary incontinence and a prolapse stage III or more seemed to be risk factors for an adverse outcome.

In evaluating the cure rate of pelvic floor surgery not only the anatomic outcome should be studied but also the outcome in terms of side-effects and/or symptoms as resolved, persistent or new onset. An unsatisfactory anatomic outcome was not necessarily associated with symptoms. The modest cure rate after surgery may be due to the aggravation with time of pelvic floor disorder, this confounding the results of surgery.