Do we really know the outcomes of prolapse surgery?

The exact success rate from conventional as well as new surgical procedures for pelvic organ prolapse is unknown possibly due to the lack of standardisation of outcome measures. Usually objective measures, e.g. Pelvic Organ Prolapse Quantification (POPQ) assessment have been used as the primary outcome in most studies which show that procedures such as anterior repair have a poor outcome. However these outcomes correlate poorly with subjective assessment and re-operation rates are lower than the anatomical failure rate suggesting that conventional surgery might not have as poor an outcome as previously suggested. Nonetheless, new procedures have been introduced for which efficacy and safety data are required via well conducted randomised controlled trials.