Strengths and limitations
pelvic floor dysfunction, pelvic organ prolapse
This study presents new data regarding pelvic floor symptoms and their relation to pelvic organ prolapse in a random post-hysterectomy cohort. POP-Q data and PFDI-20 data of random samples are lacking in literature, but are necessary to correctly inform patients of the long-term perspective after hysterectomy. Due to our study population not seeking medical help, our data could be interpreted as a representative sample of the general population and could be used for epidemiological purposes.This study has several limitations. Insight into response bias showed a higher percentage of symptomatic participants (bulging in 13%) versus non-participants (7%). The size of the population is small after dividing participants into subgroups. As mentioned before, we do not have a non-hysterectomy control group, therefore we cannot draw specific conclusions about the influence of hysterectomy on pelvic floor dysfunction in the long-term.We encountered difficulty in comparing our results to other studies. No previously published data was compatible for comparison due to differences in setting and differences in outcome scales. Most studies did not apply a cut-off for clinical relevance. This can be interpreted as a weakness, but also as a strength given the unique character of our study.