LAUSR

POP (pessary or surgery) and a composite of the two. Informed consent was obtained and surveys with validated questionnaires (PFDI-20, ISI, PISQ-IR, PGI-I) were used to assess pelvic floor symptoms, patient satisfaction and improvement. RESULTS: Three hundred thirty-three women met criteria. Mean age and BMI were 43 (+5.3) years and 27.9 (+5.8) kg/m, respectively. The majority of women had a preoperative POP-Q stage of 2 (50.2%) or 3 (47.1%). A total of 29.1% (97) patients had an abdominal colpopexy and 70.9% (236) had a vaginal colpopexy. Patients who underwent abdominal colpopexy were more likely to have had a prior hysterectomy (20.6% vs 4.2%, p<.001) while the vaginal group was more likely to undergo concurrent hysterectomy and anterior repair (94.1% vs 78.4%, p<.001 and 66.5% vs 10.3%, p<.001, respectively). The composite recurrence rate was 32.0% (31) in the abdominal group and 24.2% (57) in the vaginal group (p1⁄4.15), with a retreatment rate of 10.3% (10) in the abdominal group and 5.9% (14) in the vaginal group (p1⁄4.16). The survey response rate was 45% (149) with a median response time of 2880 (1146-5540) days. The majority of patients (80.5%) reported prolapse improvement, which did not differ by colpopexy approach. However, more women in the abdominal group reported satisfaction with their surgery (100% vs 89.8%, p1⁄4.02). 26.8% (40) of women complained of a pelvic floor symptom (pain, bowel and/or bladder) and this did not differ by colpopexy approach. The composite recurrence rate in respondents was 13.7% (7) in the abdominal group and 15.3% (15) in the vaginal group (p1⁄4.80) with an overall retreatment rate of 5.9% (3) in the abdominal and 5.2% (5) in the vaginal group (p1⁄4.85). CONCLUSION: For women 49 years of age, 1 in 3 will experience subjective POP recurrence and/or retreatment after apical prolapse surgery but only 5-10% will undergo retreatment. There does not appear to be a difference in the incidence of recurrence between the vaginal and abdominal routes of surgery. While 1 in 4 women report pelvic floor symptoms postoperatively, the majority report high satisfaction rates.