Preoperative predictors and a prediction score for perception of improvement after mesh prolapse surgery
Abstract
Introduction and hypothesis Pelvic organ prolapse (POP) surgery using a mesh has a complication rate of 26%, and an estimated 10% of those operated on do not consider it brings improvement. The objective of this study was to identify preoperative predictors of improvement after POP repair with mesh to develop a predictive score.Methods This is a secondary analysis of the randomized multicenter trial PROSPERE, which compared morbidity after prolapse repair with mesh according to the vaginal or laparoscopic approach. Improved women [PGI-I score at 1-year follow-up = 1 (much better) or 2 (better)] were compared with unimproved women. Two hundred fifty-five women were included to derive the prediction score based on multiple logistic regression. An internal validation by bootstrapping estimated the unbiased performance of the model.Results Criteria independently related to improvement were: (1) cystocele stage > II [OR: 2.93 95% CI (1.22-7.04), p = 0.015]; (2) preoperative expectation related to bulge symptom improvement [OR: 2.57 95% CI (1.07-6.04), p = 0.031] and (3) absence of chronic pelvic pain [OR: 4.55 95% CI (1.77-11.46), p = 0.001]. A score (scored from 0 to 11) was constructed from the aOR of the predictive model: the ROC-AUC of the score was 0.75, and a score ≥ 9 predicted a 97% chance of improvement (95% CI 92-99), with a specificity of 85% (95% CI 68-94). The ROC-AUC corrected for optimism by the bootstrap procedure was 0.70.Conclusions This score could be used by surgeons in preoperative counseling of women.
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In a secondary analysis of the PROSPERE trial, the absence of chronic pelvic pain was a statistically significant factor associated with improvement at 1-year follow-up (OR 4.55, 95% CI 1.77-11.46).
“the absence of chronic pelvic pain [OR: 4.55 95% CI (1.77–11.46)]”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [18]
In a secondary analysis of the PROSPERE trial, anterior compartment prolapse greater than stage II was a statistically significant factor associated with improvement at 1-year follow-up (OR 2.93, 95% CI 1.22-7.04).
“factors reported as being related to improvement were an anterior compartment prolapse greater than stage II [OR: 2.93 95% CI (1.22–7.04)]”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [18]
In a secondary analysis of the PROSPERE trial, the woman's pre-operative expectations of improvement in symptoms of bulge was a statistically significant factor associated with improvement at 1-year follow-up (OR 2.57, 95% CI 1.07-6.04).
“the woman's pre‐operative expectations of improvement in symptoms of bulge [OR: 2.57 95% CI (1.07–6.04)]”
From How Can We Improve the Assessment and Indifferent Outcomes From Pelvic Organ Prolapse Management From Conservative and Surgical Therapies? ICI‐RS 2025 (2026) · cites this paper as [18]
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Kearney, R., Wagg, A., Bower, W., Chapple, C., Khullar, V., Robinson, D., Taithongchai, A., Hobson, P. T., Wein, A., & Abrams, P. (2026) · Neurourology and Urodynamics · doi:10.1002/nau.70272 · Cited by 1 · see citing works
“I) score of much better or better at 1‐year follow‐up, were compared with unimproved women [18].”
- Authors
- Chattot, C., Deffieux, X., Lucot, J.-P., Fritel, X., & Fauconnier, A.
- Affiliations
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Hôpital Jeanne de Flandre (FR)
- Centre Hospitalier Universitaire de Poitiers (FR)
- Corresponding author
- Chattot, Chloé
- Venue
- International Urogynecology Journal
- Published
- 2019-05-21
- Volume
- 31
- Issue
- 7
- Pages
- 1393-1400
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W2945159880
- Cited by
- 4
- References
- 33
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2020: 1
- FWCI
- 0.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Institut de Recherche en Santé de la Femme
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Hernia repair and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- pelvic organ prolapse, mesh repair, preoperative predictors, predictive score, perceived improvement, preoperative expectations, chronic pelvic pain, preoperative counseling
- MeSH terms
- Female, Humans, Perception, Surgical Mesh, Vagina, Treatment Outcome, Cystocele, Pelvic Organ Prolapse
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