Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

2020 ◽  
Vol 28 (2) ◽  
pp. 119-133
Author(s):  
Nicola Davies ◽  
Teresa Burdett
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Integrated Approach ◽  
Pelvic Organ ◽  
Social Implications ◽  
Content Type ◽  
Practical Implications

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.

scholarly journals Pelvic organ prolapse surgery and health-related quality of life: a follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadesse Belayneh ◽  
Abebaw Gebeyehu ◽  
Mulat Adefris ◽  
Guri Rortveit ◽  
Janne Lillelid Gjerde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Prolapse Surgery ◽  
Stage Iii ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

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.

A 2-Year Evaluation of Quality of Life Outcomes of Patients With Pelvic Organ Prolapse Treated With an Elevate Prolapse Repair System

2016 ◽  
Vol 22 (6) ◽  
pp. 410-414 ◽  
Author(s):  
Danilo Italo Pio Buca ◽  
Martina Leombroni ◽  
Eleonora Falò ◽  
Matteo Bruno ◽  
Alessandro Santarelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Repair System ◽  
Life Outcomes ◽  
Prolapse Repair ◽  
Quality Of Life Outcomes

scholarly journals Treatment of pelvic organ prolapse

2012 ◽  
Vol 26 (1) ◽  
pp. 3
Author(s):  
Munir'deen A. Ijaiya ◽  
Hadijat O. Raji
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
De Novo ◽  
Treatment Options ◽  
Reproductive Function ◽  
Pelvic Organ ◽  
Pelvic Organs ◽  
Choice Of Treatment ◽  
Principles Of Treatment

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.

scholarly journals Robotic sacrocolpopexy for the management of pelvic organ prolapse: quality of life outcomes

2019 ◽  
Vol 11 ◽  
pp. 175628721986859
Author(s):  
Annah Vollstedt ◽  
William Meeks ◽  
Veronica Triaca
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Clinical Improvement ◽  
Pelvic Organ ◽  
Robotic Sacrocolpopexy ◽  
Robotic Assisted ◽  
Rectocele Repair ◽  
Bowel Symptoms

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.

scholarly journals Quality of life and vaginal symptoms of postmenopausal women using pessary for pelvic organ prolapse: a prospective study

2018 ◽  
Vol 64 (12) ◽  
pp. 1103-1107 ◽  
Author(s):  
Suelene C. Albuquerque Coelho ◽  
Marcos Marangoni-Junior ◽  
Luiz Gustavo Oliveira Brito ◽  
Edilson Benedito de Castro ◽  
Cássia Raquel Teatin Juliato
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Urinary Symptoms ◽  
Pelvic Surgery ◽  
Subjective Impression ◽  
Vaginal Symptoms ◽  
Sf 36 ◽  
A Prospective Study

SUMMARY OBJECTIVE: The use of pessary is an option for the conservative treatment of pelvic organ prolapse (POP). However, here are few studies assess the quality of life (QoL) after inserting the pessary for POP. We have hypothesized that the use of pessary would modify QoL in women with POP. METHODS: A prospective, observational study was performed that included 19 women with advanced POP. Pessary was introduced, and the SF-36 (general quality of life) and ICIQ-VS (vaginal symptoms and quality of life subdomain) questionnaires were applied before the introduction and after six months. A single question about the satisfaction regarding the use of the device was presented (subjective impression). RESULTS: The mean age of the women included was 76 years. Most of them were non-caucasian (52.6%), with no prior pelvic surgery (57.5%), with urinary symptoms (78.9%). A third of the patients reported sexual activity. After treatment, 22.2% of them presented vaginal infection, and 27.7% increased vaginal discharge. Urinary symptoms remained unaltered. Women reported 100% satisfaction after using the pessary (77.7% partial improvement; 22.3% total improvement). SF-36 had significant improvement in three specific domains: general state of health (p=0.090), vitality (p=0.0497) and social aspects (p=0.007). ICIQ-VS presented a reduction in the vaginal symptoms (p < 0.0001) and an improvement in QoL (P < 0.0001). CONCLUSION: The use of pessary for six months improved the QoL and reduced vaginal symptoms for women with advanced POP.

scholarly journals Improved quality of life after surgery for pelvic organ prolapse in Nepalese women

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Rolina Dhital ◽  
Keiko Otsuka ◽  
Krishna C Poudel ◽  
Junko Yasuoka ◽  
Ganesh Dangal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Organ

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

2014 ◽  
Vol 182 ◽  
pp. 16-21 ◽  
Author(s):  
Niina Humalajärvi ◽  
Pauliina Aukee ◽  
Matti V. Kairaluoma ◽  
Beata Stach-Lempinen ◽  
Harri Sintonen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ

Assessing residents’ perceptions of urban placemaking prior to hosting a major cultural event

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicholas Wise ◽  
Jelena Đurkin Badurina ◽  
Marko Perić
Keyword(s):  
Quality Of Life ◽  
Design Methodology ◽  
Large Scale ◽  
Age Groups ◽  
Content Type ◽  
Factors Affecting ◽  
Local Quality ◽  
Practical Implications ◽  
Level Of Agreement

PurposeMore research is needed to consider residents’ perceptions prior to hosting large-scale events. This paper contributes new insight on residents’ perceptions of placemaking analysed by considering awareness, enthusiasm and participation prior to hosting a large-scale event. Placemaking is becoming increasingly important and this insight can help planners understand how locals perceive change and event planning preparations.Design/methodology/approach454 residents of Rijeka, Croatia completed a survey (seven-point Likert scale) of 17 placemaking principles, asked in three ways: (1) how you feel; (2) how you believe people near you feel and (3) if you feel that planning/preparing for ECoC 2020 has made a difference. The data analysis considers socio-demographics and the significance of awareness, enthusiasm and participation as factors affecting residents’ perceptions of placemaking.FindingsThe study found respondents originally from Rijeka expressed statistically significant higher level of agreement. Where statistically significant differences exist, female respondents expressed statistically significant higher levels of agreement. For six statements, the distribution of results was not similar for all age groups. Awareness and enthusiasm seems to influence placemaking principles to a greater extent than participation in this study, but all have proven to have statistically significant positive impacts on the placemaking principles assessed.Practical implicationsPlanners need to focus on effective promotional activities aimed at awareness and enhance enthusiasm to help increase perceptions of placemaking and increase local quality of life.Originality/valueexplores perceptions of “self” and “how others feel” by assessing principles of placemaking associated with the case of Rijeka. This allows researchers to explore understandings of how people perceive the attitudes of their fellow residents.

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