Quality of life and pelvic floor dysfunction symptoms after hysterectomy with or without pelvic organ prolapse

Author(s):  
Niina Humalajärvi ◽  
Pauliina Aukee ◽  
Matti V. Kairaluoma ◽  
Beata Stach-Lempinen ◽  
Harri Sintonen ◽  
...  
2019 ◽  
Vol 3 (1) ◽  

Pelvic floor dysfunction (PFD) as a term includes underlying different sub-conditions the major ones are pelvic organ prolapse (POP), urinary incontinence (UI), fecal incontinence (FI), sexual function. The direct effect of dysfunction in these areas can affect the quality of life on a personal and healthy level in patients with PFD.


Author(s):  
Sandra Rebouças Macêdo ◽  
José Ananias Vasconcelos Neto ◽  
José Tadeu Nunes Tamanini ◽  
Leonardo Bezerra ◽  
Rodrigo Aquino Castro

Abstract Objective To examine women with pelvic floor dysfunction (PFDs) and identify factors associated with sexual activity (SA) status that impacts quality of life (QoL). Methods We conducted a cross-sectional study that included women > 18 years old who presented with at least one PFD symptom (urinary incontinence [UI] and/or pelvic organ prolapse [POP]), in outpatient clinics specializing in urogynecology and PFD in Fortaleza, state of Ceará, Brazil, using a service evaluation form and QoL questionnaires. Results The analysis of 659 women with PFD included 286 SA (43.4%) women and 373 non-sexually active (NSA) (56.6%) women, with a mean age of 54.7 (±12) years old. The results revealed that age (odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.03–1.12) and post-menopausal status (OR = 2.28, 95% CI 1.08–4.8) were negatively associated with SA. Being married (OR = 0.43, 95% CI 0.21–0.88) was associated with SA. Pelvic organ prolapse (OR = 1.16, 95% CI 0.81–1.68) and UI (OR = 0.17, 95% CI 0.08–0.36) did not prevent SA. SF-36 Health Survey results indicated that only the domain functional capacity was significantly worse in NSA women (p = 0.012). Two King's Health Questionnaire domains in NSA women, impact of UI (p = 0.005) and personal relationships (p < 0.001), were significantly associated factors. Data from the Prolapse Quality-of-life Questionnaire indicated that NSA women exhibited compromised QoL. Conclusion Postmenopausal status and age negatively affected SA. Being married facilitated SA. Presence of POP and UI did not affect SA. However, NSA women with POP exhibited compromised QoL.


2011 ◽  
Vol 68 (11) ◽  
pp. 940-947 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Katarina Parezanovic-Ilic ◽  
Aleksandar Curcic ◽  
Nemanja Visnjevac

Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. Methods. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms) and quality of life impact (Pelvic floor impact questionnaire - short form) of pelvic organ prolapse, and Body Image Scale. Results. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory - 20 than controls subjects (134.91 vs 78.08; p < 0.01). The patients also measured significant decrease in condition- specific quality of life (89.23 vs 3.1; p < 0.01). They were more likely to feel self-conscious (78% vs 42%; p < 0.01), less likely to feel physically attractive (78% vs 22%; p < 0.01), more likely to have difficulty looking at themselves naked (70% vs 42%; p < 0.01), less likely to feel sexually attractive (64% vs 32%; p < 0.01), and less likely to feel feminine (56% vs 16%; p < 0.05), than controls. There were no differencies in their feeling of dissatisfaction with appearance when dressed, avoiding people because of appereance and overall dissatisfaction with their body. There was a positive correlation between decreased quality of life and body image in women with pelvic dysfunction. Conclusion. Women with pelvic floor dysfunction have decreased quality of life and body image.


2019 ◽  
Vol 11 ◽  
pp. 175628721986859
Author(s):  
Annah Vollstedt ◽  
William Meeks ◽  
Veronica Triaca

Background: Our aim was to investigate longer-term surgical and quality of life (QOL) outcomes in a cohort of women undergoing robotic-assisted laparoscopic sacrocolpopexy (RALS) for pelvic organ prolapse (POP). Methods: We performed a retrospective cohort study at a single institution of female patients undergoing RALS with and without concomitant robotic-assisted laparoscopic hysterectomy, urethral sling, and rectocele repair. Scores from the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) surveys were used to evaluate QOL outcomes. Clinical improvement was defined by a decrease in a patient’s PFDI and PFIQ postoperative score by ⩾70%. Results: Clinical improvement was seen in 62.6% by the PFIQ and in 64% by the PFDI survey. Younger patient age (OR 0.92, p = 0.011) and worse preoperative American Urological Association (AUA) Quality of Life score (OR 1.42, p = 0.046) were associated with clinical improvement. Within the PFIQ, 35.6% of patients saw clinical improvement with their bowel symptoms, compared with bladder (54.1%, p < 0.001) and prolapse (45.6%, p = 0.053) symptoms. Within the PFDI, 45.5% of patients reached clinical improvement with their bowel symptoms, compared with bladder (56.7%, p = 0.035) and prolapse (62.6%, p < 0.001) symptoms. Of the patients who had a rectocele repair, 46.3% reached clinical improvement in their CRADI-8 score, and 51% saw clinical improvement in the bowel portion of the PDFI. Conclusions: Significantly fewer patients reached clinical improvement within the portions of the surveys that focus on bowel symptoms, compared with symptoms related to urination and POP. Of those that had a concomitant rectocele repair, approximately half reached clinical improvement with their bowel symptoms.


2019 ◽  
Author(s):  
Abdul Hakeem Jokhio ◽  
raheela mohsin rizvi ◽  
Christine Mcarthur

Abstract Background: Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate “the prevalence of pelvic organ prolapse” associated factors, duration and impact on women's quality of life in rural Pakistan. Methods: A cross-sectional study was conducted with a three stage random sampling strategy.Three health centers were selected and selected Lady Health Workers from each health center interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health centres on women who reported symptoms of prolapse to verify and grade pelvic organ prolapse using Baden-Walker classification system. Results : Among the 5064 women interviewed (95.8% response rate), 521 women had clinically confirmed POP, a prevalence of 10.3% (95% CI 9-11%). Among women with POP 37.8% had grade III or IV prolapse. Women with four or more children had the highest proportion of pelvic organ prolapse (75%) followed by women aged 36-40 years (25%).Among women with POP, 60.8% reported their quality of life as greatly or moderately affected; 44.3% had it for more than 5 years; and 78.7% never consulted a doctor. Conclusions : Pelvic organ prolapse is highly prevalent in rural Pakistan, impacts on women’s everyday lives and remains mainly untreated. Measures should be taken to provide health care services to reduce this burden of disease among women. Keywords Community-based; Pelvic organ prolapse; Prevalence; Quality of life; Pakistan


2019 ◽  
Vol 87 (3) ◽  
pp. 130-136
Author(s):  
Mikhail Elikovich Enikeev ◽  
Dmitry Victorovich Enikeev ◽  
Dmitry Olegovich Korolev ◽  
Olesya Vyacheslavovna Snurnitsyna ◽  
Mikhail Vladimirovich Lobanov ◽  
...  

Objective: To assess the outcomes of surgical repair of anterior apical prolapse using the 6-strap mesh implant. Study Design: The prospective study included 100 patients with genitourinary prolapse. We used advanced 6-strap mesh implant. The results were assessed at 1 (n = 100) and 12 (n = 93) months after surgery. Maximum follow-up was over 4 years. The anatomical outcomes according to the Pelvic Organ Prolapse Quantification system and intraoperative and postoperative complications were assessed. Stage II and higher prolapse was considered to be a recurrence. The quality of life and sexual function were assessed using Pelvic Organ Prolapse Distress Inventory 20, Pelvic Floor Impact Questionnaire 7, and Pelvic Organ Prolapse/Incontinence Sexual Questionnaire 12. Results: Median age was 57 years (34–78 years (95% confidence interval)). All patients had stage III cystocele. The anterior vaginal wall descent in all the patients was associated with uterine descent: 37 (37%), stage II; 60 (60%), stage III; in 3 (3%), stage IV. In eight cases, postoperative de novo stress urinary incontinence developed. The quality of life improved in 93 (93%) women as judged by the Pelvic Floor Distress Inventory 20 data and in 87 (87%) women, according to the Pelvic Floor Impact Questionnaire 7 data. The desirable anatomical result (⩽stage I according to the Pelvic Organ Prolapse Quantification system) was achieved in 97 (97%) patients. With the exception of mesh fragment excision due to erosion (grade 3a), all the complications were classified as grade I according to the Clavien–Dindo classification. Conclusion: Genitourinary prolapse repair using 6-strap mesh is efficacious and relatively safe. The method demonstrates good anatomical results in relation to both anterior and apical prolapses with relatively short-term complications.


Author(s):  
Shavkatov Hasan Shavkatovich ◽  
◽  
B.B. Negmadjanov ◽  

Pelvic organ prolapse (PTP) - pelvic floor and organ omission syndrome pelvic floor in isolation or in combination, which is extremely negatively affected by the quality of life of patients. According to world data, between 2.9 and 53% of women report some form of PTP. Up to 47% of pelvic organ prolapsed patients are women of working age. According to the Women Health Initiative Study, among 16,616 women of perimenopaus age, the incidence of uterine prolapsed was 14.2%, cystocele was 34.3%, and reconcile was 18.6%. In most cases, PTP is almost asymptomatic, which indicates its greater prevalence in the population.


Author(s):  
Abdul Hakeem Jokhio ◽  
raheela mohsin rizvi ◽  
Christine Mcarthur

Abstract Background Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate the prevalence of pelvic organ prolapse associated factors, duration and impact on women's quality of life in rural Pakistan. Methods A large population-based cross-sectional study was conducted in which a three stage random sampling strategy was applied: randomly selected health centres and randomly selected Lady Health Workers from each health centre who then interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health centres on women who reported symptoms of prolapse to verify and grade pelvic organ prolapse using Baden-Walker classification system. Results Among the 5064 women interviewed (95.8% response rate), 521 women had clinically confirmed POP, a prevalence of 10.3% (95% CI 9-11%). Among women with POP 37.8% had grade III or IV prolapse. The highest rate of POP (25%) was found in women aged 36-40 years and a rate of 77.2% was found in women of parity 4 or more. Among women with POP, 60.8% reported their quality of life as greatly or moderately affected; 44.3% had it for more than 5 years; and 78.7% never consulted a doctor. Conclusions Pelvic organ prolapse is highly prevalent in rural Pakistan and impacts on women’s everyday lives and remains mainly untreated. Measures should be taken to provide health care services to reduce this burden of disease among women.


2020 ◽  
Vol 3 (3) ◽  
pp. 191-201
Author(s):  
Levy G ◽  
Zines Y ◽  
Paz-Levy D ◽  
Zaidin A ◽  
Shemer O ◽  
...  

Aim: In the process of opening a new Pelvic Floor Medicine Unit, we aimed to map the pelvic floor dysfunction and sexual issues using validated quality of life (QOL) questionnaires. Material and Methods: All the patients who attended the Pelvic Floor Medicine Unit clinic in Assuta University Medical Center in Ashdod, Israel, were given a validated Pelvic Floor Distress Inventory 20 (PFDI-20) and Prolapse Urinary Incontinence Sexual Questionnaire 12 (PISQ-12) questionnaires prior to meeting the physician. The patient’s age, parity, and route of delivery were collected from the medical record. All data has been statistically analyzed using Kruskal Wallis Test and Mann-Whitney U Test. Results: 647 patients were included in the study, of them 462 filled out the PFDI-20 questionnaires and 221 completed the PISQ-12 questionnaire filling. In the PFDI-20 results, POPDI-6 higher scores were found to be associated with higher parity (p=0.043) and with higher age (p=0.03). CARD-8 scores were found to be significantly associated with cesarean delivery only in patients’ history (p=0.023) and with higher age (p=0.05). UDI-6 scores were found significantly associated with older age (p<0.01). PISQ-12 scores were found associated with age (p=0.002), but not with either parity or route of delivery. Conclusions: Using validates questionnaires, we could demonstrate a correlation between parity and age, an association between aging and higher rates of bowel and sexual dysfunction, an association between higher parity and pelvic organ prolapse complaints, and an association between previous cesarean deliveries only and higher rates of bowel disfunction. The use of validated QoL questionnaires for describing the population suffering from PFDs presents an important tool in understanding the epidemiology of PFD in different communities.


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