{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:08:32Z","timestamp":1789124912432,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007154","name":"Wake Forest University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007154","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and Hypothesis<\/jats:title>\n                    <jats:p>Anatomic success after pelvic organ prolapse (POP) surgery correlates poorly with symptom relief, prompting reliance on patient-reported outcomes (PROs). The Pelvic Floor Distress Inventory (PFDI-20) is widely used, yet how it is applied to define subjective surgical success is unclear. We aimed to evaluate how subjective success is defined using the PFDI-20 and its components after primary uterovaginal prolapse repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>As part of the U-POP &amp; LUTD 2026 Global Consensus Conference, a systematic review (PRISMA; PROSPERO CRD420251171050) of MEDLINE, EMBASE, and ClinicalTrials.gov was conducted from inception to 8 December 2025. English-language studies of women undergoing primary uterovaginal prolapse repair that reported a PFDI-20\u2013 or POPDI-6\u2013based definition of success were included. Screening and extraction were performed in duplicate, and the certainty of evidence was assessed using GRADE. Findings informed expert consensus statements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 5379 records, 28 studies (4196 women) were included. Surgical success was most commonly defined as the absence of a vaginal bulge symptom\u2014a negative response to question 3 of the PFDI-20\u2014in 21 of 28 studies. Other definitions combined question 3 with additional items, required a negative POPDI-6 subscale, or used a statistically significant change in total PFDI-20 score. Only one study applied a minimal clinically important difference (MCID), and none applied a patient acceptable symptom state (PASS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subjective success after primary uterovaginal prolapse repair is most often defined by a single PFDI-20 item, with MCID and PASS thresholds rarely applied. Consistent, validated definitions are needed to improve comparability across trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06896-x","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:33:19Z","timestamp":1789122799000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How is Subjective Surgical Success Defined Using the Pelvic Floor Distress Inventory (PFDI-20) After Primary Uterovaginal Prolapse Repair? A Systematic Review and Consensus Statements from the U-POP &amp; LUTD 2026 Global Consensus Conference"],"prefix":"10.1007","author":[{"given":"Alessandro Ferdinando","family":"Ruffolo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6671-9536","authenticated-orcid":false,"given":"Marisa Nhat-Quynh","family":"Duong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Serati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis Anne","family":"Dieter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr Sherif El","family":"Haraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"6","key":"6896_CR1","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1097\/AOG.0b013e3181c2ce96","volume":"114","author":"JM Wu","year":"2009","unstructured":"Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278\u201383. https:\/\/doi.org\/10.1097\/AOG.0b013e3181c2ce96.","journal-title":"Obstet Gynecol"},{"issue":"3","key":"6896_CR2","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1097\/AOG.0b013e3181b2b1ae","volume":"114","author":"MD Barber","year":"2009","unstructured":"Barber MD, Brubaker L, Nygaard I, Wheeler TL 2nd, Schaffer J, Chen Z, et al. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol. 2009;114(3):600\u20139. https:\/\/doi.org\/10.1097\/AOG.0b013e3181b2b1ae.","journal-title":"Obstet Gynecol"},{"issue":"6","key":"6896_CR3","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1097\/AOG.0000000000005212","volume":"141","author":"AA Dieter","year":"2023","unstructured":"Dieter AA, Halder GE, Pennycuff JF, Singh R, El-Nashar SA, Lipetskaia L, et al. Patient-reported outcome measures for use in women with pelvic organ prolapse: a systematic review. Obstet Gynecol. 2023;141(6):1098\u2013114. https:\/\/doi.org\/10.1097\/AOG.0000000000005212.","journal-title":"Obstet Gynecol"},{"issue":"1","key":"6896_CR4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.ajog.2004.12.025","volume":"193","author":"MD Barber","year":"2005","unstructured":"Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103\u201313. https:\/\/doi.org\/10.1016\/j.ajog.2004.12.025.","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"6896_CR5","doi-asserted-by":"publisher","first-page":"397.e1","DOI":"10.1016\/j.ajog.2016.10.010","volume":"216","author":"M Wiegersma","year":"2017","unstructured":"Wiegersma M, Panman CM, Berger MY, De Vet HC, Kollen BJ, Dekker JH. Minimal important change in the Pelvic Floor Distress Inventory-20 among women opting for conservative prolapse treatment. Am J Obstet Gynecol. 2017;216(4):397.e1\u2013397.e7. https:\/\/doi.org\/10.1016\/j.ajog.2016.10.010.","journal-title":"Am J Obstet Gynecol"},{"issue":"11","key":"6896_CR6","doi-asserted-by":"publisher","first-page":"3169","DOI":"10.1007\/s00192-020-04513-z","volume":"32","author":"PK Karjalainen","year":"2021","unstructured":"Karjalainen PK, Mattsson NK, Jalkanen JT, Nieminen K, Tolppanen AM. Minimal important difference and patient acceptable symptom state for PFDI-20 and POPDI-6 in POP surgery. Int Urogynecol J. 2021;32(11):3169\u201376. https:\/\/doi.org\/10.1007\/s00192-020-04513-z.","journal-title":"Int Urogynecol J"},{"issue":"11","key":"6896_CR7","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1007\/s00192-018-3755-7","volume":"29","author":"JT Kowalski","year":"2018","unstructured":"Kowalski JT, Mehr A, Cohen E, Bradley CS. 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