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Cited by 767Pelvic floor disorders treatmentsUterine Myomas and TreatmentsUrinary Bladder and Prostate Research

Epidemiology and outcome assessment of pelvic organ prolapse

Barber, Matthew D., Maher, Christopher·2013·International Urogynecology Journal
DOI 10.1007/s00192-013-2169-9
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Abstract

Introduction and hypothesis The aim was to determine the incidence and prevalence of pelvic organ prolapse surgery and describe how outcomes are reported.Methods Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews, level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence-based recommendations based upon the Oxford grading system. A grade A recommendation usually depends on consistent level 1 evidence. A grade B recommendation usually depends on consistent level 2 and/or 3 studies, or "majority evidence" from RCTs. A grade C recommendation usually depends on level 4 studies or "majority evidence" from level 2/3 studies or Delphi processed expert opinion. A grade D "no recommendation possible" would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi .Results Pelvic organ prolapse (POP) when defined by symptoms has a prevalence of 3-6% and up to 50% when based upon vaginal examination. Surgery for prolapse is performed twice as commonly as continence surgery and prevalence varies widely from 6 to 18%. The incidence of POP surgery ranges from 1.5 to 1.8 per 1,000 women years and peaks in women aged 60-69. When reporting outcomes of the surgical management of prolapse, authors should include a variety of standardised anatomical and functional outcomes. Anatomical outcomes reported should include all POP-Q points and staging, utilising a traditional definition of success with the hymen as the threshold for success. Assessment should be prospective and assessors blinded as to the surgical intervention performed if possible and without any conflict of interest related to the assessment undertaken (grade C). Subjective success postoperatively should be defined as the absence of a vaginal bulge (grade C). Functional outcomes are best reported using valid, reliable and responsive symptom questionnaires and condition-specific HRQOL instruments (grade C). Sexual function is best reported utilising validated condition-specific HRQOL that assess sexual function or validated sexual function questionnaires such as the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ) or the Female Sexual Function Index (FSFI). The sexual activity status of all study participants should be reported pre- and postoperatively under the following categories: sexually active without pain, sexually active with pain or not sexually active (grade C). Prolapse surgery should be defined as primary surgery, and repeat surgery sub-classified as primary surgery different site, repeat surgery, complications related to surgery and surgery for non-prolapse-related conditions (grade C).Conclusion Significant variation exists in the prevalence and incidence of pelvic organ prolapse surgery and how the outcomes are reported. Much of the variation may be improved by standardisation of definitions and outcomes of reporting on pelvic organ prolapse surgery.

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  • Comparative studies generally indicate similar POP outcomes at 1 year postoperation following minimally invasive uterine-preserving surgery to hysterectomy with native tissue repair.

    “Despite marked outcome variation, 1,58 comparative studies generally indicate similar POP outcomes at 1 year postoperation following minimally invasive UP surgery to hysterectomy with native tissue repair.”

    From Hysterectomy versus uterine preservation for pelvic organ prolapse surgery: a prospective cohort study (2025) · cites this paper as [1]

  • The prevalence of symptomatic POP varies from 2-8% of adult women, and asymptomatic POP up to 50% when based upon pelvic examination.

    “This aligns with previous findings reporting the prevalence of symptomatic POP to vary from 2–8% of adult women [ 1 , 4 , 18 ], and asymptomatic POP up to 50% when based upon pelvic examination [ 1 ].”

    From Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study (2024) · cites this paper as [1]

  • The number of women needing reoperation may increase with longer follow-up time, as incidence of POP typically peaks among women over 60-70 years, while up to 37% of women in this study were under 54 years.

    “It is notable that the number of women needing reoperation may even increase with longer follow-up time, as the incidence of POP typically peaks among women over 60–70 years [ 1 , 4 , 5 ], while up to 37% of the women in our study were under 54 years.”

    From Recurrent pelvic organ prolapse after hysterectomy; a 10-year national follow-up study (2024) · cites this paper as [1]

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Authors
Barber, M. D., & Maher, C.
Affiliations
  • Cleveland Clinic (US)
  • The University of Queensland (AU)
Corresponding author
Maher, Christopher
ORCID
Venue
International Urogynecology Journal
Publisher
Springer Science and Business Media LLC
Published
2013-10-19
Volume
24
Issue
11
Pages
1783-1790
ISSN
  • 0937-3462 (ISSN-L)
  • 1433-3023
DOI
10.1007/s00192-013-2169-9
OpenAlex
W1969255443
Cited by
767
References
66
Citations by year
2026: 52 · 2025: 94 · 2024: 105 · 2023: 93 · 2022: 79 · 2021: 72 · 2020: 62 · 2019: 52 · 2018: 43 · 2017: 38 · 2016: 38 · 2015: 27 · 2014: 8 · 2012: 1
FWCI
3.86
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • International Urogynecology Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • International Urogynecological Association
  • European Association of Urology
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Keywords
pelvic organ prolapse, pelvic organ prolapse surgery, incidence, prevalence, surgical outcomes, POP-Q staging, anatomical outcomes, functional outcome, health-related quality of life, sexual function, urinary incontinence, outcome reporting standards, evidence-based recommendations, Sexual Function Questionnaire, vaginal vault prolapse, pelvic floor muscle training
MeSH terms
Female, Humans, Gynecologic Surgical Procedures, Incidence, Prevalence, Outcome Assessment, Health Care, Pelvic Organ Prolapse

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