Long-term Effectiveness of Abdominal Sacrocolpopexy for the Treatment of Pelvic Organ Prolapse

• Anatomic resolution of POP [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]
  A successful anatomic outcome is defined by (1) Stage 0 apical prolapse (apex is supported within two cm of vaginal length) AND (2) <= Stage 2 anterior and posterior prolapse AND (3) no re-operation or pessary treatment for POP
  
  
• Stress continence status (by symptoms) [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]

  Stress continent: must answer "no" to all of the following questions of the stress incontinence subscale of the Pelvic Floor Distress Inventory (PFDI):

  i. Do you usually experience urine leakage related to coughing, sneezing, or laughing? ii. Do you usually experience urine leakage related to physical exercise such as walking, running, aerobics, or tennis? iii. Do you usually experience urine leakage related to lifting or bending over?

  
  
• Obstructive/irritative urinary symptoms [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]
  1. Score on the irritative subscale of the Urinary Distress Inventory (UDI) on the Pelvic Floor Distress Inventory (PFDI)
  2. Score on the obstructive/discomfort subscale of UDI on PFDI
  
  

• Pelvic floor symptoms [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]
  Subscales of the Pelvic Floor Distress Inventory (PFDI) questionnaire
  
  
• Prolapse status [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]
  POP-Q value for each compartment (anterior, posterior, apical)
  
  
• Long-term negative outcomes of the surgical procedure [ Time Frame: up to 10 years ] [ Designated as safety issue: Yes ]
  mesh erosion, incisional hernias, bowel obstruction, or sacral osteomyelitis
  
  
• health-related quality of life [ Time Frame: up to 10 years ] [ Designated as safety issue: No ]
  SF-36, PFIQ, PISQ
  
  

The primary aims of this prospective cohort study are:

1. To determine the long-term (up to 10 years) anatomic success rate of sacrocolpopexy (defined as Stage 0 apical prolapse AND <= Stage 2 anterior and posterior prolapse AND no re-operation or pessary treatment for POP), and whether anatomic success differs between women who had vs. those who did not have concomitant Burch colposuspension at the time of sacrocolpopexy;
2. To determine whether there is a difference in long-term stress continence (by symptoms) between women who had vs. those who did not have concomitant Burch colposuspension at the time of sacrocolpopexy;
3. To determine whether there is a long-term difference between overall pelvic floor symptoms and pelvic-floor specific quality of life between women who had vs. those who did not have concomitant Burch colposuspension at the time of sacrocolpopexy.