scholarly journals Pelvic organ prolapse surgery and quality of life—a nationwide cohort study

2020 ◽  
Vol 222 (6) ◽  
pp. 588.e1-588.e10
Author(s):  
Nina K. Mattsson ◽  
Päivi K. Karjalainen ◽  
Anna-Maija Tolppanen ◽  
Anna-Mari Heikkinen ◽  
Harri Sintonen ◽  
...  
Author(s):  
Azhar Susanto ◽  
Amir Fauzi ◽  
Syakroni D Rusydi ◽  
Theodorus Theodorus ◽  
Abdullah Sahab

Objective: To know the effectiveness of pelvic organ prolapse surgery in decreasing depressive symptoms (based on PHQ9) and improving quality of life in women with pelvic organ prolapse. Methods: This experimental study without control is conducted at the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin Hospital Palembang/Faculty of Medicine Sriwijaya University, from October 03 2012 until May 31, 2014. Data containing selfadministrated questionnaire about depressive symptoms (PHQ9) and quality of life (PFIQ and PFDI) were recorded. Questionnaire was performed before and six months after surgery. Sample included 26 women with pelvic organ prolapse seeking pelvic organ prolapse surgery, which qualified the inclusion criteria. Data were analyzed using Chi Square and Fisher Exact test. Data analysis was done using SPSS 18.0. Results: According to paired T test there is a significant difference between mean PHQ9 score before (6.69±3.80) and 6 months after surgery (1.96±1.75)(p=0.001). Total PFIQ score decreased from 17.15±9.39 to 2.88±4.01 with 14.27±5.38 reduction. PFDI score before surgery were 29.85±15.73 and decreased to 11.50±10.99, with a reduction of 18.35±4.74. Conclusion: There was significant reduction in depressive symptoms and improved quality of life in women with prolapse after surgery, compared to before surgery. [Indones J Obstet Gynecol 2015; 3-4: 196-199] Keywords: depression, quality of life, uterine prolapse


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadesse Belayneh ◽  
Abebaw Gebeyehu ◽  
Mulat Adefris ◽  
Guri Rortveit ◽  
Janne Lillelid Gjerde ◽  
...  

Abstract Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL. Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores. Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3 ± 9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.


2021 ◽  
Vol 86 (3) ◽  
pp. 167-174
Author(s):  
Vladimír Velický ◽  

Summary Objective: The aim of the study was to determine the percentage of sexually active women with a higher degree of descent in the anterior and middle compartment (in one compartment at least ≥ III degree) and how the surgical solution affects the quality of sexual life and overall quality of life in women who underwent surgery. Methods: Patients who underwent prolapse surgery were included in the study. Before the operation, a complete urogynecological examination was performed, including ultrasound examination, history and POP-Q (pelvic organ prolapse quantification system) evaluation, and quality of life questionnaires were completed. We compared the quality of sexual life in sexually active women before and after surgery to ascertain the effect of surgery in this respect. Results: The study included 128 patients who underwent pelvic organ descent surgery from January 2018 to April 2019. Depending on the type of operation, they were divided into three groups: reconstruction with anterior vaginal implant fixed to the sacrospinous ligament, laparoscopic sacrocolpopexy and sacrospinous vaginofixation according to Amreich-Richter. The differences between the groups in the results of the surgical solution were not statistically significant due to the size of the monitored group. Sexual activity of the patients even in the advanced stage of pelvic organ setup was reported preoperatively by 45.9% of women and postoperatively – after 1 year – by 44.8% of women. Comparing the quality of life preoperatively and postoperatively, there was a very significant improvement in 58.0% of respondents, a significant improvement in 36.0% and a slight improvement in 2.0%: only in 3.0% of women, there was a deterioration (ranging from mild to very significant). Surgical treatment of the descent slightly worsened the quality of sexual life in 20.8% of women, did not change it in 33.3% and significantly improved it in 45.8% of them. Conclusion: A high percentage of patients are sexually active even at an advanced stage of descent. Comparing the quality of life preoperatively and postoperatively, there was a significant improvement or even complete resolution of the problems associated with descent in most women. For some women, the surgical treatment of the descent may slightly worsen the quality of sexual life; in others, its quality remains at the same level, but the largest section of the studied group feels a significant improvement in the perception of sexual activities.


2021 ◽  
Author(s):  
Musa Kayondo ◽  
Dan Kabonge Kaye ◽  
Richard Migisha ◽  
Rodgers Tugume ◽  
Paul Kalyebara Kato ◽  
...  

Abstract Background: Pelvic Organ Prolapse (POP) is a significant public health issue that negatively affects the Quality of Life (QOL) of women in both low- and high-income countries. About 20% of women will undergo surgery for POP over their lifetime. However, there is a paucity of information on the effect of surgery on QOL especially in resource limited settings. We therefore sought to determine the QOL among women with symptomatic POP living in rural southwestern Uganda and the impact of surgery on their quality of life.Methods: We conducted a prospective cohort study among 120 women with symptomatic POP awaiting surgery at the urogynecology unit of Mbarara Regional Referral Hospital. The QOL at baseline and at 1 year after surgery in the domains of physical performance, social interaction, emotion state, sexual life, sleep quality, personal hygiene and urinary bladder function was determined using a King’s Quality of Life questionnaire. A paired t- test was used to compare the difference in mean scores at baseline and at 1-year post-surgery. Results: Of the 120 participants that were enrolled at baseline, 117(98%) completed the follow-up at 1 year. The baseline QOL was poor. The domains with the poorest QOL were physical, social, sexual, emotional and sleep quality. The mean QOL scores in all the domains and the overall QOL significantly improved 1 year after surgery (p<0.001). The overall QOL improved by 38.9% after surgery (p < 0.001).Conclusion: The QOL was poor among women with symptomatic POP and surgery improved the QOL in all the domains of life. We recommend that surgery as an option for treatment of symptomatic POP should be scaled up to improve on the QOL of these women.


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