Validation of the Patient Global Impression of Improvement (PGI-I) for urogenital prolapse

Currently, there is no global outcome assessment index in prolapse research. Patient Global Impression of Improvement (PGI-I) has only been validated in incontinence. Our aim was to validate its use following prolapse surgery. Women with prolapse were recruited from waiting lists and assessed objectively (pelvic organ prolapse quantification system (POP-Q)). Quality of life (QoL) was assessed with prolapse QoL questionnaire (pQoL). Patient goal achievement (visual analogue scale (VAS)) determined subjective satisfaction and PGI-I indicated overall satisfaction. We established construct validity of PGI-I by correlating final PGI-I response with other measures of response, measured at 1 year: (POP-Q/pQoL/VAS) There was excellent test-retest reliability and correlation between PGI-I and other outcome measures. We believe this is the first study validating PGI-I as a global index of response to prolapse surgery. This may be a valuable addition not only in clinical practice but also in trials comparing surgical interventions.