Rationale: Pelvic organ prolapse (POP) is characterized by a pelvic floor organ (e.g. bladder, uterus, bowel) protruding (prolapsing) from the opening of the vagina. The main treatment options for POP are conservative treatment with a pessary or surgical correction. In the Netherlands, the prevalence of symptomatic POP in women between 45-85 years is 11.4% and the average number of women who receive surgery based on complaints of POP or urinary/fecal incontinence are as high as 10-20%. Multiple (combinations of) POP are defined, based on the prolapsed organ: anterior, apical and posterior compartment prolapse. Based on the physical complaints, recurrence surgery and the prolapsed compartment(s) the best surgical treatment option is selected. The different options are: anterior/posterior colporrhaphy, sacrospinal fixation (SSF), (modified) Manchester Fothergill (MF), rectopexy, sacrocolpopexy (SCP) and vaginal hysterectomy (VH). Surgical correction has turned out to be high[y effective, however the estimated risk of reoperation over a period of 4 years is 30%, while reasons for recurrences are poorly understood. At the University of Twente (UT) we have the unique possibility of visualizing the pelvic floor, and pelvic organ prolapse in upright position.
Hypothesis: Recurrences and continuation of physical complaints might be related to the pre-operative and post-operative (incomplete) assessment of the prolapse (POP-Q) in supine position. Crucial anatomical details, related to surgical treatment and success are missed or underdiagnosed.