Pelvic Floor Distress Inventory Scores Improve after Prolapse Surgery Regardless of Surgical Approach but not after Observation Alone.

OBJECTIVE: To evaluate the effect of different surgical procedures on Pelvic Floor Distress Index (PFDI) scores in women with pelvic organ prolapse (POP).

MATERIALS AND METHODS: Women with prolapse were enrolled from 2008-2014. Baseline data and outcomes at one year were collected including subscales of the PFDI (UDI: Urinary Distress Inventory; POPDI: Pelvic Organ Prolapse Distress Inventory; CRADI: Colorectal and Anal Distress Inventory). Patients who had surgery (SGY) within the first year were compared to those who did not (N-SGY). Sub-analyses of SGY included vaginal vs. abdominal, with or without concurrent hysterectomy (HYST, N-HYST), placement of mesh (MESH, N-MESH), and concurrent posterior repair/perineorrhaphy (POST, N-POST).

RESULTS: 233/239 of patients underwent surgery in the first year. For SGY vs. N-SGY, SGY had significant improvements in PFDI and all subscale scores at one year while N-SGY did not. When comparing vaginal to abdominal approach, MESH to N-MESH and HYST to N-HYST, there were no differences between any scores at baseline or 1 year between the groups. However, all within group symptom scores improved from baseline to 1 year (p < 0.0001 for all). In comparing POST to N-POST, there were no differences between groups at 1 year in PFDI and UDI and POPDI subscale scores. CRADI scores were significantly higher at baseline for POST (p < 0.0001) but not at 1 year (p = 0.37). All within group scores statistically significant improved at 1 year.

CONCLUSION: Women who underwent surgical repair for prolapse had significantly improved overall PFDI and subscale scores regardless of surgical approach and concurrent procedures.