The goal of this study is to evaluate whether adding perineoplasty is, in comparison to performing vaginal prolapse surgery without adding perineoplasty, superior with respect to efficacy and cost-effectiveness and non-inferior with respect to morbidity, in patients undergoing vaginal surgical correction of pelvic organ prolapse at 24 months after surgery.
Preoperative measurements, performed at baseline: * Patient characteristics (age, BMI, smoking, obstetric history) * Physical examination including POP-Q score. The genital hiatus (gh) at rest (as part of the POP-Q) will be used to assess the wideness of the vaginal introitus. * Pelvic Floor Distress Inventory (PFDI-20) questionnaire and Patient Global Impression of Severity (PGI-S) * Pelvic Floor Ultrasound 2DStudy measurements; * Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-ir), Dutch Perineal Support Questionnaire (DPSQ), General Quality of Life (EQ-5D-5L), Medical Consumption Questionnaire (iMCQ) and Productivity Cost Questionnaire (iPCQ) * Patient and surgeons considerations with respect to level III repair; Postoperative measurements: * Regular physical check-up will be at 4-8 weeks after procedure. * Physical examination including POP-Q score * Patient Global Impression of Improvement score (PGI-I) * Pelvic Floor Ultrasound 2D * iMCQ, iPCQ, EQ-5D-5L questionnaire Extra follow up: * Physical check-up 12 \& 24 months after surgery: * Physical examination including POP-Q score * Pelvic Floor Ultrasound 2D * PFDI-20, PGI-I, DPSQ, PISQ-ir, iMCQ, iPCQ, EQ-5D-5L questionnaire
Study Type
OBSERVATIONAL
Enrollment
305
Spaarne Gasthuis
Haarlem, Netherlands
Bergman Clinics
Hilversum, Netherlands
Surgical success
composite outcome defined as meeting the 3 following conditions: \[1\] "much improved" or "improved" in response to the patient global impression of improvement questionnaire, \[2\] no re-intervention performed in the same compartment within the first 12 months after index surgery, \[3\] no stage 2 or more POP in the operated compartment.
Time frame: 12 months
Morbidity
complications and re-interventions due to complications, pain
Time frame: 24 months
Effectiveness
disease specific and general quality of life
Time frame: 24 months
Anatomical outcomes
Time frame: 24 months
Societal costs
Time frame: 24 months
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