Quality of Life Outcomes in Pelvic Organ Prolapse Patients After Total Vaginal Hysterectomy: A Prospective Study Using PFDI-20

Abstract

Pelvic organ prolapse (POP) is a common gynecological condition that can significantly impair women's quality of life through pelvic, urinary, and bowel symptoms. This study aimed to evaluate changes in Pelvic Floor Distress Inventory-20 (PFDI-20) scores in patients with POP before and three months after undergoing total vaginal hysterectomy (TVH). A prospective, analytical, observational study employing a cohort design was conducted at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between January and July 2024. Patients diagnosed with POP who underwent total vaginal hysterectomy were included in the study. The PFDI-20 questionnaire was administered preoperatively and three months postoperatively. The instrument consists of three subscales: the Pelvic Organ Prolapse Distress Inventory (POPDI-6), the Colorectal–Anal Distress Inventory (CRADI-8), and the Urinary Distress Inventory (UDI-6). Statistical analyses were performed to compare preoperative and postoperative scores. A total of 30 patients met the inclusion criteria and completed both assessments. The mean age of participants was 61.73 years (range 49–74 years), with a mean parity of 3.97 (range 1–8). Significant reductions in POPDI-6, CRADI-8, UDI-6, and total PFDI-20 scores were observed three months after TVH compared with preoperative values (p = 0.001). Overall, postoperative PFDI-20 scores were markedly lower than preoperative scores, indicating substantial improvement in pelvic floor–related symptoms. These findings suggest that total vaginal hysterectomy provides significant improvement in pelvic floor distress symptoms among women with pelvic organ prolapse.