Postoperative Difference in the Prolapse Quality-of-Life Questionnaire Score in Patients Undergoing Laparoscopic Sacrocolpopexy or Transvaginal Mesh Surgery for Pelvic Organ Prolapse Based on a Nearest-neighbor Propensity Score Matched Analysis.

OBJECTIVES: Both laparoscopic sacrocolpopexy (LSC) and transvaginal mesh surgery (TVM) result in favorable outcomes for patients undergoing pelvic organ prolapse (POP) repair. However, their effects on postoperative quality of life (QOL) are yet unknown, particularly when performed on patient groups with similar backgrounds. This study aimed to compare the postoperative POP-related symptoms between patient groups without statistically significant preoperative differences. MATERIALS AND METHODS: We retrospectively evaluated 245 patients with POP who underwent LSC or TVM. In our hospital, 97 patients were treated by LSC, whereas 148 were treated by TVM. The postoperative QOL between the matched 68 LSC-treated patients and 68 TVM-treated patients were compared using the nearest-neighbor propensity score matching. The Japanese version of the prolapse QOL questionnaire (P-QOL) was administered to assess POP-related conditions. The rates of urinary incontinence (UI), mesh exposure, and prolapse recurrence were also calculated. RESULTS: The nearest-neighbor propensity score matching showed no statistically significant differences between the matched LSC and TVM groups. In the matched patients, compared with the preoperative scores, the 3-12-month postoperative P-QOL component scores decreased significantly. When comparing the 1-year postoperative values with the preoperative values, differences in the presence of UI, mesh exposure, prolapse recurrence rates, and the P-QOL component scores were not statistically significant between the two matched groups. CONCLUSION: Using nearest-neighbor propensity score matched analysis, this study suggested TVM as a favorable option to treat POP, given the postoperative improvement in P-QOL scores in addition to the shorter operative time and lower complication rates.