Superiority of Perineoplasty as Concomitant Surgical Procedure During Pelvic Organ Prolapse Repair

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

Inclusion criteria

• Female patient >18 years of age
• Complaints of pelvic organ prolapse
• Indication for prolapse surgery (level I and/or level II repair)
• Genital hiatus (GH) according to POP-Q staging of ≥4 cm and ≤7 cm

Exclusion criteria

• Unable to understand the Dutch language
• Pregnancy at baseline or intendancy to become pregnant during the study period
• Patients with previous surgery for POP (previous mid urethral sling operations for urinary stress incontinence not excluded)
• Unwilling and / or incapable of giving informed consent