Background: Patients with intractable pain in the pudendal nerve distribution may benefit from pudendal neuromodulation; however, some may have previously undergone pudendal nerve entrapment surgery (PNES), potentially altering nerve anatomy and function. Aim: We examined pudendal neuromodulation outcomes in patients with prior PNES. Methods: Patients with a history of PNES and quadripolar, tined pudendal lead placement for urogenital pain were reviewed. Symptoms and outcomes were collected from existing medical records. Outcomes: Patients with pudendal neuromodulation and prior PNES were compared to patients with no prior PNES who had pudendal lead placement. Results: Fifteen patients with a history of 1, 2, or 3 prior PNES (n = 13, 1, and 1, respectively) were evaluated. Most (10; 67%) were female, with bilateral pain (9; 60%), and symptoms of 5-26 years. After trialing the lead, bladder symptoms and pain were improved in 8 of 12 and 9 of 14 patients, respectively, and 80% of patients (12/15) underwent permanent generator implantation. When prior PNES patients were compared to those with no prior PNES (n = 43), gender (67% vs 77% female; P = .50) and age (median 63 vs 58 years; P = .80), were similar; however, BMI differed (mean 24 vs 29; P = .008) and a lower proportion (12/15; 80% vs 42/43; 98%; P = .049) had generator implantation. Importantly, median lead implant time (48 vs 50 minutes; P = .65) did not differ between the 2 groups. Clinical Implications: Pudendal neuromodulation has the potential to provide pain relief for a very difficult-to-treat population; furthermore, it does not appear that prior PNES surgery made lead placement significantly more challenging. Strengths & Limitations: Study strengths include being a tertiary referral center for urogenital pain and having a single surgeon perform all procedures in a regimented way. Limitations include the retrospective study design, small sample size and various approaches to PN Conclusion: Chronic pudendal neuromodulation can be a viable option even after prior PNES. Copyright (C) 2022, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Objective This study aimed to determine whether small fiber polyneuropathy (SFPN) diagnosis differs between Hunner lesion interstitial cystitis/bladder pain syndrome (HL IC/BPS) and non-Hunner lesion IC/BPS (NHL IC/BPS). Methods This was a pilot study of 20 women with IC/BPS. Results from baseline questionnaires, such as Genitourinary Pain Index, Interstitial Cystitis Symptom Index/Interstitial Cystitis Problem Index (ICSI/ICPI), Patient Health Questionnaire-2, were collected. Two punch biopsies were performed on each patient: distal leg and thigh. The samples were evaluated for intraepidermal nerve fiber density. One intraepidermal nerve fiber density less than the fifth percentile, regardless of site, indicated a positive SPFN diagnosis. Results Twenty patients were enrolled; 10 HL IC/BPS and 10 NHL IC/BPS. The HL IC/BPS group was found to be significantly older than the NHL IC/BPS group (63 vs 48 years, P = 0.007). No significant differences were found in employment or relationship statuses, or in levels of education or comorbidities between the 2 groups. Sixty percent (6/10) of patients had SFPN in the NHL IC/BPS group compared with 40% (4/10) in the HL IC/BPS group. No significant differences were seen in SFPN positivity (P = 0.3) or Genitourinary Pain Index, Patient Health Questionnaire-2, or Interstitial Cystitis Symptom Index/Interstitial Cystitis Problem Index scores between the NHL and HL IC/BPS groups. Conclusions Similar to previously published studies, 60% of NHL IC/BPS patients in this cohort were positive for SFPN compared with only 40% of the HL IC/BPS patients. Larger studies may be needed to realize the full impact of SFPN in IC/BPS.

Objectives This study aimed to evaluate changes in validated symptom scores at intake and discharge in women undergoing pelvic floor physical therapy (PFPT) for pain and other pelvic floor symptoms. Methods Consecutive women starting PFPT during 1 year were reviewed. History, demographics, and Pelvic Floor Distress Inventory Questionnaire - Short Form 20 (PFDI) total and domain scores (Pelvic Organ Prolapse Distress Inventory-6, Urogenital Distress Inventory-6, Colorectal-Anal Distress Inventory-8), Pelvic Floor Impact Questionnaire (PFIQ-7), and pain levels on a numeric rating scale (NRS) were collected at intake and discharge. Data were analyzed with descriptive statistics and sign tests. Results Of 474 women, mean age was 50.3 +/- 16.7 years (range, 18-87 years) and the most common indication for PFPT was pelvic pain (208/474; 43.9%). In women with complete data, pretreatment to posttreatment median scores improved on the PFDI (77.3 vs 41.8; P < 0.0001), Urogenital Distress Inventory (37.5 vs 16.0; P < 0.0001), and PFIQ (58.0 vs 19.0; P < 0.0001), and the minimal clinically important difference was met for the PFDI, PFIQ, and Colorectal-Anal Distress Inventory. Women with primarily pelvic pain (n = 208) achieved significant improvements in PFDI, PFIQ, and NRS scores (P < 0.0001 for all) as well as the minimal clinically important difference for these measures. Pain patients with a history of pelvic surgery (n = 50) also had significant improvements in PFIQ and NRS but not PFDI scores. Conclusions Most women referred to PFPT demonstrated symptom improvements as measured by validated instruments.

OBJECTIVES Chronic pelvic pain in women often requires multimodal treatment regimens. We describe our method of transvaginal trigger point injections (TPIs) and report outcomes using change in pain scores. METHODS This was a retrospective review of women treated with in-office pelvic floor muscle injections from January 2012 to August 2015. Lidocaine 1% and 2%, bupivacaine 0.5%, or ropivacaine 0.5% with or without the addition of triamcinolone 40 mg was used for the injections. Pain was reported on a 0- to 10-point numerical rating scale before and after injection. Differences in pretreatment and posttreatment pain scores were analyzed after the first injection and after subsequent injections. Repeated-measures analysis was used to determine if any variable affected treatment response. RESULTS One hundred one women with a mean age of 44 years had a total of 257 separate visits for pelvic floor muscle injections. Triamcinolone was used at 90.2% (230/255) of the TPI visits. After the initial TPI visit, there was significant decrease in total levator numerical rating scale score (maximum score, 20; mean, -6.21 ± 4.7; P < 0.0001), and 77% (70/91) of patients had improved. These significant improvements were noted at all visits 1 through 4 and whether bilateral or unilateral injections were done. Only the total amount of local anesthestic used had a significant effect on the change in total levator pain scores (P = 0.002). Minor adverse effects including leg numbness, dizziness, nausea, bleeding, and headache occurred at 10% of visits. CONCLUSIONS Pelvic floor muscle injections decrease pain levels in women with pelvic floor dysfunction.

OBJECTIVE:To evaluate the effect of different surgical procedures on Pelvic Floor Distress Inventory (PFDI) scores in women with pelvic organ prolapse. MATERIALS AND METHODS:Women with prolapse were enrolled from 2008 to 2014. Baseline data and outcomes at 1 year were collected including subscales of the PFDI. Patients who had surgery (SGY) within the first year were compared to those who did not (N-SGY). Subanalyses of SGY included vaginal vs abdominal, with or without concurrent hysterectomy (HYST, N-HYST), placement of mesh (MESH, N-MESH), and concurrent posterior repair/perineorrhaphy (POST, N-POST). RESULTS:A total of 233/239 patients underwent surgery in the first year. For SGY vs N-SGY, SGY had significant improvements in PFDI and all subscale scores at 1 year while N-SGY did not. When comparing vaginal to abdominal approach, MESH to N-MESH and HYST to N-HYST, there were no differences between any scores at baseline or 1 year between the groups. However, all within group symptom scores improved from baseline to 1 year (P <.0001 for all). In comparing POST to N-POST, there were no differences between groups at 1 year in PFDI and Urogenital Distress Inventory and Pelvic Organ Prolapse Distress Inventory subscale scores. Colorectal-Anal Distress Inventory scores were significantly higher at baseline for POST (P <.0001) but not at 1 year (P = 0.37). All within group scores statistically significant improved at 1 year. CONCLUSION:Women who underwent surgical repair for prolapse had significantly improved overall PFDI and subscale scores regardless of surgical approach and concurrent procedures.

To evaluate additional treatments, symptoms, satisfaction and quality of life 1 year after vaginal and abdominal pelvic organ prolapse (POP) repair.

BACKGROUND:Persistent genital arousal disorder (PGAD) is a rare life-altering condition characterized by unwanted, uncomfortable genital sensations or spontaneous orgasms without physical or emotional stimulation. Its etiology remains unclear, and a variety of treatments have been attempted with incomplete resolution. We propose that chronic pudendal neuromodulation (CPN) may be a useful treatment for PGAD symptoms.METHODS:A retrospective chart review was performed for women older than 18 years with a diagnosis of PGAD that had staged neuromodulation with placement of a tined lead at the pudendal nerve. Demographic, operative, and postoperative data were collected. A survey was then sent to these women to assess additional demographic data, preoperative and postoperative symptoms, and patient satisfaction. Descriptive statistics were performed.RESULTS:Six women underwent CPN for PGAD. Mean age was 52 (SD, 9) years. Five (83%) of 6 were still implanted at time of survey, at a mean of 38 months after implantation; 1 device was removed for nonuse. Four of 6 completed surveys and were still using their device. Three of 4 had met their treatment goals and were satisfied with CPN; 3 of 4 felt CPN was the most useful treatment modality they had used overall. Chronic pudendal neuromodulation also improved chronic pelvic pain (4/4), bowel function (3/4), and bladder function (3/4).CONCLUSIONS:Chronic pudendal neuromodulation can be an effective treatment for decreasing frequency of PGAD symptoms and providing symptom relief.

The purpose of the study was to explore attitudes/beliefs in men attending an urban health fair to explore barriers to prostate cancer (PCa) screening. Five hundred and forty-four men attending the PCa booth at the fair in 2014 or 2015 completed questionnaires about PCa. Data were examined using Pearson’s χ2, Fisher’s Exact, and Wilcoxon rank tests after grouping men by African American (AA) and non-African American ethnicity. Three hundred and twenty-six (60%) men were AA and two hundred and eighteen (40%) were non-AA (89% white). Median age (54 vs. 56 years) and prior PCa screening were similar between AA and non-AA; income (p = .044) and education (p = .0002) differed. AA men were less likely to have researched prostate-specific antigen (PSA) on the internet (p = .003), but more used TV (p = .003) and media (p = .0014) as information sources. Family members had a stronger influence over screening decisions for AA men (p = .005). After reading PSA information, AA men were more likely to still be confused (p = .008). A higher proportion of AA men were less worried about dying from PCa (p = .0006), but would want treatment immediately instead of watchful waiting (p < .0001). Interestingly, a higher proportion of AA men indicated that they would prefer not to know if they had PCa (p = .001). Ultimately, more AA men had a PSA done (98.4% vs. 95.1%; p = .031). When considering screening eligible men, a higher proportion of AA men had an abnormal PSA (13.1% vs. 5.3%; p = .037). AA men’s beliefs surrounding PCa differ from non-AA men, and should be considered when developing culturally appropriate education, screening, and treatment strategies for this group.

Introduction: Abdominal pelvic organ prolapse repair is efficacious for uterovaginal and apical prolapse. We describe the safety and efficacy of robotic prolapse repair in a large teaching institution. Methods: Consecutive robotic-assisted prolapse repairs at a single institution between 2006 and 2014 were retrospectively reviewed for patient characteristics, operative information, and outcomes. Results: A total of 196 women (mean age, 61 +/- 9 years) underwent robotic prolapse repair (189 sacrocolpopexy, 6 sacrohysteropexy, 1 enterocele repair). Concomitant procedures included hysterectomy (88), midurethral sling (84), and/or Burch colposuspension (7). Mean odds ratio time was 242 +/- 69.9 minutes, and median length of stay was I day. Intraoperative complications were as follows: cystotomy (4), vaginotomy (4), conversion to open (2), bowel injury/aborted ( 1), adhesions/aborted (1), and ureteral injury (1). Women with complications had greater blood loss than those without complications (P = 0.0015). Immediate (<30 days) postoperative complications were rare: port-site hernia (2), discitis (1), ileus (I), and ulnar neuropraxia (3). At median follow-up of 9 months (range, 0-85 months), 14 women had recurrent grade 3 prolapse, and 4 had grade 2 apical prolapse. Nine of 14 women had additional prolapse repair at a mean of 9.5 +/- 6.3 months. Vaginal mesh exposure was detected in 12 (6.3%) of 192 women. There were 6 procedures for mesh exposure and 2 procedures for exposed sutures. One mesh erosion into the bladder required open excision. Conclusions: In this large series of robotic prolapse repair, complications are infrequent. Short-term apical outcomes are excellent. Few women required additional compartment repairs within 1 year with 6% rate of mesh exposure.

AimsTo examine the relationship between coexisting depressive symptoms and outcomes after staged neuromodulation procedures for refractory urological symptoms.MethodsAdults who enrolled in a prospective database and completed a Personal Health Questionnaire Depression Scale (PHQ‐8) at baseline were reviewed. The PHQ‐8 and Generalized Anxiety Disorder (GAD‐7) assessed depressive/anxiety symptoms pre and 6 months post device implant. Urological symptoms were assessed with The Interstitial Cystitis Symptom Index/Problem Index (ICSI‐PI) and Overactive Bladder Questionnaire (OAB‐q) at baseline, 3 and 6 months, and Global Response Assessments (GRA) post implant. Subjects, grouped by PHQ <10 and PHQ ≥10, were compared with Pearson's Chi‐square, Fisher's Exact or Wilcoxon rank test, and Spearman's correlations.ResultsIn 117 PHQ <10 and 84 PHQ ≥10 patients, age differed (mean 59 vs 52 years; P = 0.001), and PHQ <10 had lower GAD‐7, ICSI‐PI, and OAB‐q scores at baseline (P < 0.0001, P = 0.0003, and P < 0.0008, respectively). Implantation rates were similar between groups. Reoperation and complication rates within the first 6 months did not differ, similar proportions (majority) were improved on the GRA at each time point, and ICSI‐PI and OAB‐q scores improved significantly. PHQ scores only improved significantly for those with baseline PHQ ≥10. Baseline PHQ strongly correlated with GAD‐7 at baseline and 6 months, and baseline ICSI‐PI. Change in PHQ positively correlated with the change in GAD‐7, 6 month ICSI‐PI, and change in ICSI‐PI from baseline to 6 months.ConclusionsCoexisting depressive symptoms do not limit the efficacy of neuromodulation and PHQ improvements correlate with improved anxiety and bladder symptoms.

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy III1 Apr 2017PD54-04 NEUROMODULATION FOR CHRONIC UROGENITAL PAIN: A COMPARISON OF PUDENDAL AND SACRAL NERVE STIMULATION Austin Fan, Kim A. Killinger, Kenneth M. Peters, and Judith Boura Austin FanAustin Fan More articles by this author , Kim A. KillingerKim A. Killinger More articles by this author , Kenneth M. PetersKenneth M. Peters More articles by this author , and Judith BouraJudith Boura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2414AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Little evidence exists regarding the effect of chronic neuromodulation on urogenital pain. We evaluated outcomes between pudendal vs. sacral nerve neuromodulation. METHODS Adults in our prospective database with primary/secondary diagnosis of pelvic pain (excluding interstitial cystitis) and quadripolar lead placed at the pudendal or sacral nerve were reviewed. History, pain scores (0-10; none to severe), Global Response Assessment (GRA), Interstitial Cystitis Symptom/Problem Index (ICSIPI) and Overactive Bladder symptom severity (OABq ss)/health related quality of life (HRQOL) collected at baseline, 3 and 6 months, and 1 and 2 years were analyzed with descriptive statistics and repeated measures over 1 year. RESULTS Of 87 that had a lead placed, 72 (83%) had generator implantation and 65 had complete baseline data. 37/65 had a pudendal (12/37 had failed sacral stimulation) and 28 had a sacral lead. Group characteristics were similar except for pudendal had lower body mass index (median 24.8 vs. 28.6; p=0.009) and fewer with primary urinary urgency/frequency (8.1% vs. 39.3%; p=0.003). Pudendal patients more commonly had a primary diagnosis of pelvic pain that approached but was not statistically significantly (62.2% vs. 38.5%; p=0.06). Median follow up was 1.2 vs. 2.6 years in the pudendal and sacral groups respectively (p=0.0011). Median pelvic pain scores were similar between pudendal and sacral groups at baseline and each follow up, and both improved significantly over 1 year (p=0.0003 and p<0.0001). The pudendal group had lower ISCIPI and OABq/ss scores at baseline (p=0.007 and p=0.035, respectively), but both groups improved over 1 year on the ICSIPI (p<0.0001 for both groups), OABq/ss (p=0.005 and p=0.0002 respectively), and OABq HRQOL (p=0.027 and p<0.0001, respectively). Similar proportions in the pudendal and sacral groups had pain at each follow up except for at 6 months (17/19; 90% vs. 8/14; 57%; p=0.047); for those with pain, similar proportions (between 33% and 50%) had moderate/marked improved in pain on the GRA at each time point. CONCLUSIONS Both groups experienced modest but similar improvements in pelvic pain. Pudendal was effective in those who failed sacral neuromodulation and was used preferentially in patients with a primary diagnosis of pain. Neuromodulation should be considered in the management of chronic pelvic pain. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1046-e1047 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Austin Fan More articles by this author Kim A. Killinger More articles by this author Kenneth M. Peters More articles by this author Judith Boura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Aims: To explore factors that may predispose patients to reoperation after sacral neuromodulation (SNM). Methods: Patients enrolled in our longitudinal neuromodulation database were reviewed. Medical records data, and voiding diaries, Interstitial Cystitis Symptom-Problem Indices (ICSI-PI), and Overactive Bladder Questionnaires (OAB-q) at baseline and 3 months were analyzed with Pearson's chi(2), Fisher's Exact test, Wilcoxon rank tests, and multivariable logistic regression. Results: Of 407 patients, 134 (33%) had at least one reoperation over median 28.9 months follow-up (range 1.6-121.7); 78/407 (19%) were revised, and 56/407 (14%) were explanted. The most common reason for reoperation was lack of efficacy/worsening symptoms (n = 87). The reoperations group had a higher proportion of women(P = 0.049), lower mean body mass index (BMI; P = 0.010), more reprogramming events (P<0.0001), longer median follow-up (P = 0.0008), and higher proportions with interstitial cystitis (P = 0.013), using hormone replacement therapy (P = 0.0004), and complications (P<0.0001). Both reoperations/no reoperations groups had similar improvements in ICSI-PI (P<0.0001 for both), OAB-q severity (P<0.0001 for both) and quality of life (P<0.0001 for both). On multivariate analysis, only longer follow-up (P = 0.0011; OR 1.048; CI 1.019, 1.078) and having a complication (P<0.0001; OR 23.2; CI 11.47, 46.75) were significant predictors of reoperations. In women only, using HRT at time of implant was also predictive of reoperation (P = 0.0027; OR 3.09; CI 1.48, 6.46). Conclusions: In this largest known series to date, one third of the patients required reoperation and the most common reason was lack of efficacy/ worsening symptoms. Ongoing study is needed as the technology continues to evolve. (C) 2015 Wiley Periodicals, Inc.

AimsTo evaluate neuromodulation outcomes in patients with prior back surgery.MethodsAdults in our prospective observational sacral/pudendal neuromodulation study were retrospectively evaluated. History and operative details were reviewed, and outcomes were measured at 3, 6, 12, and 24 months with overactive bladder questionnaire (OAB q) symptom severity (SS)/health related quality of life (HRQOL), interstitial cystitis symptom/problem indices (ICSI − PI), voiding diaries, and global response assessments (GRA). Data were examined with Pearson's χ2, Fisher's exact, Wilcoxon rank sum tests, and logistic regression multivariate analysis.ResultsFive hundred and sixty patients were evaluated (mean age 58.8 ± 17 years; 83% female; 79% had a sacral lead placed), 109 (19%) had history of back surgery; 66 surgeries were lumbar. Back surgery patients were older (mean 63 ± 15 vs. 58 ± 17 years; P = 0.003) and a higher proportion had urge urinary incontinence (UUI) (64% vs. 50% P = 0.008). Generator implant rates were similar (94% vs. 91%; P = 0.34). OABq‐SS and HRQOL and ICSI − PI composite scores did not differ between groups at any time point. On bladder diaries, median incontinence episodes daily at baseline and between stages were worse in the prior back surgery group but all bladder diary parameters improved significantly in both groups with the exception of mean voided volume which only improved significantly in the non‐back surgery group. Most patients in both groups reported moderate/marked improvement in overall bladder symptoms.ConclusionsThis study suggests that prior back surgery does not appear to impact clinical outcomes; therefore, neuromodulation may be offered in this patient population.

OBJECTIVE To evaluate the impact of functional bladder capacity (FBC) on clinical outcomes after a staged neuromodulation procedure.MATERIALS AND METHODS Adults in our prospective neuromodulation database were evaluated. Data were collected from medical records, voiding diaries (FBC defined as average volume per void), Interstitial Cystitis Symptom Index-Problem Index, Overactive Bladder Questionnaire, and Global Response Assessment over 3 months. Descriptive statistics, Pearson's chi-square tests, Wilcoxon rank sum tests, logistic regression, repeated measures analyses, and Spearman correlation coefficients were performed.RESULTS Of the 216 patients (mean age 59 years; 84% female), most had urinary urgency and frequency with or without urge incontinence (71%), a sacral lead placement (82%), and implantable pulse generator (IPG) implantation (92%). Baseline FBC was similar between implanted and not implanted patients (P =.17); however implanted patients had a median 19 mL increase in FBC after lead placement compared to a 2.7 mL decrease in explanted patients (P =.0014). There was a strong association between percent change in FBC after lead placement and IPG implantation (P =.021; C-statistic 0.68), but baseline FBC (mL) was not associated. Baseline FBC (mL), or percent change in FBC after lead placement, was not related to symptom improvement. When grouped by baseline FBC < 150 mL and FBC >= 150 mL, FBC only improved significantly in the < 150 group but both demonstrated significant improvements in symptoms.CONCLUSION FBC improvements were associated with IPG implantation but not other symptom measures. Patients with low FBC (baseline FBC < 150) also achieved significant improvements in symptoms. (C) 2017 Elsevier Inc.

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse I1 Apr 2017PD02-11 ADDITIONAL TREATMENTS, SATISFACTION, AND QUALITY OF LIFE IN WOMEN AFTER TRANSVAGINAL AND ABDOMINAL PELVIC ORGAN PROLAPSE REPAIR Laura Nguyen, Natalie Gaines, Larry Sirls, Kim Killinger, Morgan Gruner, Michelle Jankowski, and Kenneth Peters Laura NguyenLaura Nguyen More articles by this author , Natalie GainesNatalie Gaines More articles by this author , Larry SirlsLarry Sirls More articles by this author , Kim KillingerKim Killinger More articles by this author , Morgan GrunerMorgan Gruner More articles by this author , Michelle JankowskiMichelle Jankowski More articles by this author , and Kenneth PetersKenneth Peters More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.204AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated satisfaction, quality of life, and additional treatments after transvaginal (TV) and abdominal (ABD) pelvic organ prolapse (POP) repair. METHODS Adult women enrolled in a prospective POP database were reviewed. Baseline and outcomes data one year after surgery were collected from medical records, validated Pelvic Floor Distress Inventory (PFDI), and mailed surveys, and analyzed with descriptive statistics, Fishers Exact, and two sample t tests. RESULTS Two hundred twenty-two patients were identified from the database, of whom 147 (66%) had TV and 75 (34%) had ABD repair. TV patients were older (mean 64.1 vs. 59.7 years; p=0.003) but no differences in BMI, race, marital status or other demographics were identified. Preoperative mean anterior (TV 2.7 vs. ABD 3.1; p=0.003) and apical (TV 2.1 vs. ABD 3.1; p<0.001) POP grades were more severe in the ABD patients compared to the TV patients. Baseline PFDI scores however were similar between groups (TV 115.8 vs. ABD 111.6, p=0.605). At one year PFDI scores were improved in both groups, though were significantly higher in the TV group (45.6 vs. 32.6; p=0.032). Absolute score improvement from baseline to 1-year did not differ (TV -67.6 vs. ABD -76.1, p=0.353). The majority of patients in both groups reported moderately or markedly improved overall symptoms (TV 79/101; 78% and ABD 51/59; 86% p=0.199) and quality of life (80/101; 79% and 51/59; 87% p=0.252). Similar proportions of patients in both groups (TV 52/109; 48% vs. ABD 21/62; 34%, p=0.108) had additional POP treatments including pelvic floor physical therapy, medications, coping strategies, and surgical procedures. Specifically, there was no difference in rates of additional surgical treatments for prolapse between groups (TV 32/109; 29% vs. ABD 10/62; 11%, p=0.053). Most TV and ABD patients were satisfied (68/101; 68% and 48/59; 81%, p=0.055, respectively) and would recommend to a friend (85/99; 86% and 55/57; 96%, p=0.052). CONCLUSIONS This study suggests that although symptoms, satisfaction and quality of life improve after both TV and ABD prolapse repair, women seek additional treatments as early as the first year after POP repair. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e55 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Laura Nguyen More articles by this author Natalie Gaines More articles by this author Larry Sirls More articles by this author Kim Killinger More articles by this author Morgan Gruner More articles by this author Michelle Jankowski More articles by this author Kenneth Peters More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...