The Role of Preoperative Diagnostic Testing in Patients Undergoing Uterovaginal Prolapse Repair: A Systematic Review.

INTRODUCTION AND HYPOTHESIS: The clinical value of preoperative laboratory testing for women with primary uterovaginal prolapse (U-POP) is not well-established. Our primary objective was to evaluate the role of preoperative laboratory testing for women undergoing U-POP repair. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we retrieved studies from MEDLINE, EMBASE, and clinicaltrials.gov through January 2026 to perform a systematic review. Our population included women undergoing surgery for U-POP where preoperative laboratory testing was evaluated. Owing to limited evidence specific to U-POP, we broadened our search to all prolapse procedures. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to assess the quality of the articles included. Consensus statements were developed and presented in-person at the U-POP consensus conference in Winston Salem, NC, USA. RESULTS: We screened 4,870 abstracts and reviewed 63 full-text articles yielding 15 studies, with 5 studies specific to U-POP. All the studies included were Grades B-C. Routine preoperative blood testing in patients undergoing surgical intervention for prolapse did not impact perioperative or postoperative outcomes. Preoperative or intraoperative positive urine cultures were associated with postoperative urinary tract infections. CONCLUSIONS: Clinicians should not order routine preoperative blood studies for low-risk patients undergoing surgery for primary U-POP but should consider treating positive urine cultures, depending on symptoms.