scholarly journals Symptomatic Pelvic Organ Prolapse at Midlife, Quality of Life, and Risk Factors

2009 ◽  
Vol 113 (3) ◽  
pp. 609-616 ◽  
Author(s):  
Xavier Fritel ◽  
Noëlle Varnoux ◽  
Marie Zins ◽  
Gérard Breart ◽  
Virginie Ringa
2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall


2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall


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.


2020 ◽  
Vol 28 (2) ◽  
pp. 119-133
Author(s):  
Nicola Davies ◽  
Teresa Burdett

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.


2016 ◽  
Vol 22 (6) ◽  
pp. 410-414 ◽  
Author(s):  
Danilo Italo Pio Buca ◽  
Martina Leombroni ◽  
Eleonora Falò ◽  
Matteo Bruno ◽  
Alessandro Santarelli ◽  
...  

2012 ◽  
Vol 26 (1) ◽  
pp. 3
Author(s):  
Munir'deen A. Ijaiya ◽  
Hadijat O. Raji

Prolapse of the pelvic organs is a common condition encountered in gynecological practice that adversely affects the quality of life of affected women. It affects millions of women worldwide. The principles of treatment of pelvic organ prolapse include restoring anatomy and vaginal function, correcting associated urinary and or fecal incontinence, and preventing de novo prolapse and incontinence. There are various treatment options for pelvic organ prolapse. These vary from conservative treatments/ mechanical interventions to surgery. The choice of treatment depends on severity of symptoms, patient’s age, parity, and whether there is the need to conserve the uterus for reproductive function. In conclusion, thorough evaluation of symptoms and degree of prolapse is essential in order to provide the best possible treatment and ultimately improve quality of life.


Author(s):  
Parvathavarthini K. ◽  
Vanusha A.

Background: Pelvic organ prolapse is one of the common gynaecological problem in India among the parous and aged women. Though the pelvic organ prolapse is not life threatening if left untreated it can lead to many social issues and also it reduces the quality of life of a woman. Thus, this study aims at generating epidemiological data on uterine prolapse in a clinical setting and identifying its risk factors so that appropriate measures can be taken to prevent the same.Methods: It was a descriptive case control study. Using a study proforma the required information was collected from the patients admitted with uterine prolapse (case) and from amongst the patient’s attendees of Gynaecology ward (control). Obtained data were compared and analyzed using appropriate statistical methods.Results: Uterine prolapse contributes to about 5.9% of the total gynecological patients admitted during the study period. The mean age of presentation with uterine prolapse was 50.1years the mean number of deliveries was higher in case compared to the control with the mean of 4 deliveries. Out of 130 patients, only 13.9% of them had institutional delivery while the others had home delivery.Conclusions: Uterine prolapse is strongly associated with age, parity and place of delivery. As the risk factors for uterine prolapse are easily preventable public health awareness programme must be conducted on its risk factors there by reducing the incidence of prolapse and decreasing the morbidity caused by it.


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.


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