Pelvic organ prolapse (POP) is frequently associated with lower urinary tract symptoms (LUTS), significantly impacting women's quality of life (QOL) [1]. Surgical correction of POP may lead to either resolution or emergence of de novo LUTS postoperatively [2]. This study uses standardized assessment tools to evaluate trends in LUTS and QOL improvements before and after POP surgery

This prospective study included 51 women with POP-Q stage II or greater undergoing pelvic reconstructive surgery. LUTS and QOL were assessed preoperatively and at 1 week, 1 month, and 6 months postoperatively using validated questionnaires: the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Pelvic Floor Impact Questionnaire (PFIQ-7). Surgical interventions followed standardized protocols, and data were analyzed using SPSS 19.0. Statistical tests included the Friedman test for repeated measures and the Wilcoxon test for multiple comparisons, with p ≤ 0.05 considered statistically significant [3].

The mean age of participants was 60.37 ± 11.87 years. Vaginal hysterectomy with McCall’s culdoplasty and anterior-posterior repair was the most performed procedure (61%). Preoperatively, LUTS were highly prevalent, including nocturia (84.3%), urgency (74.5%), and hesitancy (96.1%). At six months postoperatively, significant symptom resolution was observed in nocturia (39.53% complete resolution, p < 0.0005), urgency (50% resolution, p <0.0005), and hesitancy (95.9% resolution, p < 0.0005). The mean ICIQ-FLUTS score significantly decreased from 10.67 ± 5.14 preoperatively to 2.27 ± 2.39 postoperatively (p < 0.0005). The mean PFIQ-7 score improved from 88.89 ± 54.87 to 8.57 ± 18.37 (p < 0.0005), indicating substantial enhancement in QOL. De novo stress urinary incontinence (SUI) developed in three patients.

This study demonstrates a significant reduction in storage, voiding, and incontinence symptoms following POP surgery, with notable improvements in QOL. While some patients developed de novo SUI, overall LUTS improved in the majority. These findings emphasize the need for preoperative counselling regarding LUTS outcomes and individualized patient management

POP surgery significantly improves LUTS and QOL, supporting its role in enhancing urinary health and patient well-being. This first prospective study from Pakistan underscores the importance of preoperative counselling regarding LUTS outcomes and supports the role of POP surgery in improving QOL

1.	De Boer, T.A., Slieker-ten Hove, M.C., Burger, C.W., Vierhout, M.E., & Kluivers, K.B. (2010). Pelvic organ prolapse and overactive bladder. Neurourology and Urodynamics, 29(1), 30-39.
2.	Ugianskiene, A., Petros, P., & Jauniskis, L. (2017). Retrospective study on de novo postoperative urinary incontinence after pelvic organ prolapse surgery. European Journal of Obstetrics & Gynecology and Reproductive Biology, 219, 10-14.
3.	Barber, M.D., Walters, M.D., & Bump, R.C. (2005). Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). American Journal of Obstetrics and Gynecology, 193(1), 103-113.