Can the PFDI (Pelvic Floor Distress Inventory) or PFIQ (Pelvic Floor Impact Questionnaires) be used to predict outcome in pelvic reconstructive surgery?

Abstract

Objective: To determine a syndrome score threshold on PFDI or PFIQ predictive of a significant improvement in post-operative functional results.

Design: A retrospective case review (Canadian Task Force Classification II-2).

Setting: University and research hospital.

Population: Women diagnosed with pelvic organ prolapse and repaired with synthetic vaginal mesh.

Methods: Quality of life was arbitrarily considered to have improved significantly if the score decreases by more than 50% between pre-operatively and 36 months post-operatively. We investigated the pre-operative cut-off score predictive of no quality of life improvement at M36 from a prospective trial for surgical pelvic organ prolapse treatment.

Results: The most accurate pre-operative cut-off score predicting a failure to improve quality of life at 36 months post-operatively was 62/300 (PFDI Score). This cut-off value had a positive predictive value of 83.6% and specificity of 62.1%. No significant threshold was obtained from the PFIQ score.

Conclusion: The intensity of symptoms before surgery may interfere as a predictive factor for outcome.

Keywords: 36 months post-operatively; AUC; Area under the curve; Chirurgie vaginale; Genital prolapse; International Pelvic Organ Prolapse staging system; M0; M36; PFDI; PFIQ; POP; POP-Q; Pelvic Floor Disorder Inventory; Pelvic Floor Impact Questionnaire; Pelvic Organ Prolapse; Predicting outcome; Prolapsus des organes pelviens; Prédiction des résultats; QOL; Quality of life; ROC; Receiver operating characteristic; Vaginal surgery; pre-operative evaluation.