Quality of Life After Conservative and Surgical Treatment of Pelvic Organ Prolapse

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.

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Quality of Life (QOL) Assessment Two Years Post Surgical Treatment for Pelvic Organ Prolapse Using Transvaginal Mesh

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2012.08.469 ◽

2012 ◽

Vol 19 (6) ◽

pp. S172

Author(s):

E.J. Stanford ◽

R.D. Moore ◽

J.-P.R.W. Roovers ◽

R. Beyer ◽

J.C. Lukban ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Transvaginal Mesh

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Effects of ultralow topical estriol dose on vaginal health and quality of life in postmenopausal women who underwent surgical treatment for pelvic organ prolapse

Menopause The Journal of The North American Menopause Society ◽

10.1097/gme.0000000000000851 ◽

2017 ◽

Vol 24 (8) ◽

pp. 900-907 ◽

Cited By ~ 21

Author(s):

Salvatore Caruso ◽

Stefano Cianci ◽

Salvatore Giovanni Vitale ◽

Maria Grazia Matarazzo ◽

Francesca Flavia Amore ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Postmenopausal Women ◽

Pelvic Organ ◽

Vaginal Health

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Health-related quality of life after pelvic organ prolapse surgery in Ethiopia: A 6 month follow-up study

10.21203/rs.3.rs-30009/v1 ◽

2020 ◽

Author(s):

Tadesse Belayneh ◽

Abebaw Gebeyehu ◽

Mulat Adefris ◽

Guri Rortveit ◽

Janne Lillelid Gjerde ◽

...

Keyword(s):

Quality Of Life ◽

Body Image ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background Pelvic organ prolapse (POP) affects health-related quality of life (HRQoL). Patient-reported outcomes (PRO) measures the quality of care from the patient’s perspective. PROs are an important measure of surgical outcome and used to calculate health gains after surgical treatment. We assessed HRQoL in women undergoing surgical repair of POP. Methods Two hundred fifteen women with stage III or IV prolapse underwent surgical POP repair between February 2018 and May 2019. Pelvic Organ Prolapse Quality of Life (P-QoL-20) was administered at baseline, 3 and 6 months postoperatively to assess HRQoL. Depressive symptoms and body image also evaluated. Linear mixed-effect models were used to compare pre and postoperative HRQoL scores and investigate potential predictors. Results Participant’s mean age was 49.3 ± 9.4 years. Most (81.9%) had stage III prolapse and underwent a vaginal hysterectomy, although 40% preferred uterine preservation. No differences were seen between women follow-up and those lost to follow-up in HRQoL (p > 0.05). The P-QoL, depressive symptoms, and body image were improved 6 months post-operatively. The change in P-QoL significantly associated with body image scores. The type of surgery did not show a significant difference. Being married showed an improvement in the personal relationship subscale score (β = 5.8, p < 0.01). Conclusions Our results indicated a potential improvement of HRQoL after surgical treatment. The result could be useful for patient counseling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for women suffering from POP to improve HRQoL.

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Improvement in the quality of life in women with stress urinary incontinence after surgery for pelvic organ prolapse

Medicinski pregled ◽

10.2298/mpns1908197m ◽

2019 ◽

Vol 72 (7-8) ◽

pp. 197-201

Author(s):

Ljiljana Mladenovic-Segedi

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Stress Urinary Incontinence ◽

Urge Urinary Incontinence ◽

Pelvic Organ ◽

Posterior Colporrhaphy ◽

Average Value

Introduction. Pelvic organ prolapse is commonly associated with symptomatic stress urinary incontinence, in up to 50% of patients. The aim of our research was to examine the quality of life of women with urinary incontinence and pelvic organ prolapse after conventional surgical treatment. Material and Methods. The research included 50 patients with stress urinary incontinence and pelvic organ prolapse that underwent vaginal hysterectomy with anterior and posterior colporrhaphy. The pelvic organ prolapse-quantification system was used to determine the degree of genital prolapse. All patients completed a questionnaire to determine the ?stress and urge? score preoperatively, as well as the Urinary Distress Inventory-6 and Urinary Impact Questionnaire-7 during the follow-up examination, a year after the surgery. Results. One year after surgery, 20 patients (40%) presented with a recurrence of cystocele. The average value of the Urinary Distress Inventory-6 questionnaire a year after surgery was 29.0 ? 10.8, while the average value of the Urinary Impact Questionnaire-7 questionnaire was 3.7 ? 16.3. After the surgery, 6 patients (12%) had persistent stress urinary incontinence and 4 patients (8%) had urge urinary incontinence. Among patients with persistent stress urinary incontinence, two patients reported pronounced symptoms of stress urinary incontinence and reoperation was performed. Conclusion. The classical surgical treatment of pelvic organ prolapse with anterior and posterior colporrhaphy leads to improvement in the quality of life of patients with pelvic organ prolapse and stress urinary incontinence. If the symptoms of stress urinary incontinence persist after classical surgical treatment, other anti-incontinence surgical modalities should be considered.

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Quality of life in women with pelvic floor dysfunction

Vojnosanitetski pregled ◽

10.2298/vsp1111940m ◽

2011 ◽

Vol 68 (11) ◽

pp. 940-947 ◽

Cited By ~ 7

Author(s):

Ljiljana Mladenovic-Segedi ◽

Katarina Parezanovic-Ilic ◽

Aleksandar Curcic ◽

Nemanja Visnjevac

Keyword(s):

Quality Of Life ◽

Body Image ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Tertiary Care ◽

Pelvic Organ ◽

Care Clinic

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.

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

BMC Women s Health ◽

10.1186/s12905-020-01146-8 ◽

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.

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

Journal of Integrated Care ◽

10.1108/jica-07-2019-0032 ◽

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.

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