Summary: 2017 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse

Area of Science:

• Urology
• Gynecology
• Surgical Science

Background:

• Pelvic organ prolapse (POP) affects a significant number of women.
• Surgical intervention is a common treatment modality for POP.
• Standardized, evidence-based guidelines are crucial for optimal surgical management.

Purpose of the Study:

• To review and synthesize the evidence informing the 2017 International Consultation on Incontinence (ICI) pathway for surgical treatment of POP.
• To provide evidence-based recommendations for the surgical management of pelvic organ prolapse.

Main Methods:

• An evidence-based review of English-language, peer-reviewed literature on POP surgery published before December 2016.
• Prioritization of Level 1 evidence (RCTs, systematic reviews of RCTs), with inclusion of Level 2 or 3 evidence if Level 1 data were insufficient.
• Application of the Oxford grading system (A-D) for evidence evaluation and recommendation formulation.

Main Results:

• The review presents recommendations from each chapter, forming the basis of the 2017 ICI pathway for POP surgery.
• An interactive, web-based application of the pathway has been developed.
• Recommendations are graded based on the quality and consistency of supporting evidence.

Conclusions:

• The 2017 ICI pathway serves as an adjunct to informed patient-clinician consultation and consent for POP surgery.
• The pathway facilitates shared decision-making, acknowledging that individual patient factors are paramount.
• The ultimate surgical decision requires a comprehensive evaluation beyond the pathway's scope.