Pelvic organ prolapse recurrence risk calculator for preoperative counseling.
Sullivan & El Haraki
Surgical Approach
Surgery Type
Planned or performed procedure
1 pt
Baseline POP-Q Measurements
Ba Point — Anterior Vaginal Wall
Most distal point of anterior wall; negative = above hymen
0 pts
Genital Hiatus (gh)
Measured at rest; distance from urethral meatus to posterior hymen
1 pt
Patient Characteristics
Hormonal Status
Includes vaginal estrogen and oral / systemic HRT as 0 pts
0 pts
2
out of 7
17%
estimated recurrence risk
95% CI: 11–26% (n=89)
Low Risk
Surgery Type1 ptBa Point (Anterior Wall)0 ptsGenital Hiatus1 ptHormonal Status0 ptsTotal Score2 / 7
Obliterative Procedure
<5%
expected recurrence
Colpocleisis carries a recurrence rate below 5% in published literature —
substantially lower than any reconstructive approach. Because this procedure
eliminates rather than repairs the prolapsed anatomy, the POP-PREDICT scoring
model does not apply. Standard risk factors such as Ba point and genital hiatus
are not predictive of recurrence after obliterative repair.
Patient counseling should address the permanent, non-reversible nature of this
procedure and the requirement to forgo vaginal intercourse postoperatively.
Low Risk
8–17%
recurrence
Moderate Risk
21–28%
recurrence
High Risk
40–45%
recurrence
Clinical Use: This score supports preoperative counseling and shared
decision-making. High-risk patients may benefit from more durable surgical approaches
(e.g., sacrocolpopexy over native tissue repair) or enhanced postoperative surveillance.
This tool does not replace clinical judgment.
* Score 7 is based on only 8 patients in the derivation cohort; the confidence interval
is wide (53–98%) and this estimate should be interpreted with caution.
Validated in 752 women across 4 prospective trials;
AUC 0.67, cross-validation AUC 0.64.