Design

• Retrospective case note review of SSF procedures from January 2023 to January 2024

• Results compared to previous annual audits from 2015-17, and to the RCOG / British Society of Urogynaecology green-top guideline.

• Methods

  • 48 patients identified from surgical coding; 41 included (full notes available) 

  • Used a standard proforma for each: demographics, pre-operative and post-operative symptoms and findings at 3 month follow up; Pelvic Organ Prolapse Quantification (POP-Q) and International Consultation on Incontinence Questionnaire (ICIQ) scores

  Results

  • 8/41 vaginal hysterectomy concurrently; 6/41 re-do pelvic floor repairs with primary SSF 

  • Anterior wall prolapse recurrence (Table 1) continues to improve from previous years of 15% and 10.9% respectively and within RCOG guidance of 8-30% 

  • 88% (36/41) had complete data of ICIQ scores pre & post-operatively

  • Clear documentation of POP-Q in 96% (40/41) 

  • Universal improvement in vaginal symptoms & QOL scores

  • Conclusion:

    • Service is currently meeting/exceeding national standards

    • Overall low complication rates 

    • Significant improvements in ICIQ / POP-Q score documentation

    • Recommend for future improvement attaining 100% POP-Q documentation and aim to retrospectively analyse the patients with post-op worsened urinary symptoms to identify any area of improvement in their care.

    References

    RCOG/BSUG Joint Guideline 2015 Post-Hysterectomy Vaginal Vault Prolapse

    
     

    Complications

    Apical prolapse

    Anterior wall prolapse recurrence

    Intraoperative complication

    Haematoma*

    Buttock pain >3 months

    Urinary symptoms ongoing/worsened