Jelovsek JE, Gantz MG, Lukacz ES, et al. - Researchers aimed at identifying clusters of women with similar failure patterns over time in a cohort of participants (N = 709) with stage 2 or greater pelvic organ prolapse (POP) who underwent surgical POP repair. In addition, they investigated correlations between clusters and the Pelvic Organ Prolapse Distress Inventory, Short-Form Six-Dimension health index (SF-6D), patient global impression of improvement (PGI-I), patient satisfaction items questionnaire (PSIQ), and quality-adjusted life years. Evaluation of outcomes was done for up to 5 years in this cohort. Thirty-nine percent (276/709) of the women included in the analysis experienced surgical failure. Researchers clustered failures into 4 mutually exclusive subgroups: A) asymptomatic intermittent anterior wall failures, B) symptomatic intermittent anterior wall failures, C) asymptomatic intermittent anterior and posterior wall failures and D) symptomatic all-compartment failures. Overall, these groups yield granularity concerning the nature of surgical failures after POP surgery. Anatomically, symptomatic intermittent anterior wall failures (N = 82) were similar to asymptomatic intermittent anterior failures but bothersome bulge symptoms and the lowest QOL, SF-6D scores, and perceived success were persistently present among women with symptomatic intermittent anterior wall failures. The most severe preoperative POP but the lowest symptomatic failure rate and retreatment rate were recorded among women with asymptomatic intermittent anterior and posterior wall failures (N = 28). Symptomatic and anatomic failure were recorded early after surgery among participants with symptomatic all-compartment failures (N = 16) and there was highest retreatment of any cluster.