The primary outcome of this study is the improvement of Urogenital Distress Inventory (UDI) at 24 months after baseline and the power calculation is performed using the non-inferiority assumption. The mean improvement in UDI in both groups is expected to be 35 with standard deviation 10.(22) A difference in mean improvement of 8 or less is considered non-inferior. As this condition is allowed for one third of the total group (those women in the non-UDI group, who would not have been operatively treated), this results in a difference in mean improvement of 2.7 or less between the UDI and non-UDI group. Then effectively 130 women in each group are needed to reach a power of 70% using one-sided testing at 0.05. Considering an expected percentage lost to follow up of ca. 10%, in total 290 women (145 in each group) will be included in this study.