The aim of our observational cohort study was to assess the feasibility of performing a prospective study to determine the effect of prolapse surgery on voiding function and quality of life, measured by patient reported outcomes (PRO) and home-uroflowmetry.

This is an ongoing prospective study of women undergoing prolapse surgery at a tertiary Gynaecology unit. Interim analysis was performed. All patients had a standardized interview, validated questionnaires (Pelvic Floor Distress Inventory-20 (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7)), home-uroflowmetry and bladder diary for 3 consecutive days preoperatively and at 6 weeks and 6 months postoperatively. Primary outcomes were change in patient reported outcomes of voiding function and quality of life, based on Urinary Distress Inventory-6 (UDI-6) and Urinary Impact Questionnaire-7 (UIQ-7). Change in symptoms of voiding dysfunction (VD), urinary incontinence (UI) and overactive bladder (OAB) were evaluated based on PFDI-20. Change in voided volume, maximum flow rate (Qmax), average flow rate (Qave), voiding time and maximum urinary flow rate (MFR) centile as seen on home-uroflowmetry were assessed. Statistical analysis was carried out with SPSS version 28.

Since inception (06/2020), 13 women have been included. Two were excluded (no questionnaires available), leaving 11. Mean age and BMI at presentation were 57y and 28kg/m2 respectively. Surgical procedures performed included anterior repair (36%), posterior repair (9%), anterior and posterior repair (45%), uterosacral ligament suspension (9%) and sacrospinous fixation (18%). 
No concomitant stress incontinence procedures were performed.

Mean UDI-6 and UIQ-7 score were pre-operatively 1.21 and 1.71 respectively. At 6 months post-operatively, scores significantly improved, 0.48 (p=0.006) and 1.29 (p=0.01) respectively.

While symptoms of VD significantly improved at 6 weeks postoperatively (P=0.02), there was no significant difference between pre-operative and 6 months postoperative values (P=0.12). Symptoms of UI did not change significantly. Symptoms of OAB were significantly reduced at 6 months postoperatively (p=0.03) (see Table 1).

On home-uroflowmetry, MFR centile was significantly increased 6 months postoperatively (p 0.02). There was no significant difference in voided volume, Qmax, Qave and voiding time (see Table 2). 

Most participants completed all aspects of the study.

Prolapse repair does significantly improve patient reported outcomes of voiding function and quality of life. MFR centile was significantly improved as assessed by home-uroflowmetry. The study appears feasible based on this preliminary data.

More inclusions are ongoing. Follow-up will be continued until 1 year postoperatively. Additional analysis of the correlation between patient reported outcomes, voiding function, POPQ and 3D/4D translabial ultrasound findings will be performed.