Symptoms, quality of life, and factors affecting women’s treatment decisions regarding pelvic organ prolapse

• Published in: International Urogynecology Journal 2012-08, Vol.23 (8), p.1027-1033
• Main Authors: Chan, Symphorosa Shing Chee, Cheung, Rachel Yau Kar, Yiu, Ka Wah, Lee, Lai Loi, Pang, Albe Wai Lam, Chung, Tony Kwok Hung
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; China; Decision Making; Female; Gynecologic Surgical Procedures; Gynecology; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pelvic Organ Prolapse - complications; Pelvic Organ Prolapse - psychology; Pelvic Organ Prolapse - surgery; Pessaries - adverse effects; Prospective Studies; Quality of Life - psychology; Retrospective Studies; Severity of Illness Index; Treatment Outcome; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Stress - physiopathology; Urodynamics - physiology; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-012-1698-y

Introduction and hypothesis We performed an investigation of symptoms, quality of life (QOL), and factors affecting women’s treatment choice of pelvic organ prolapse (POP). Methods Three hundred and eight women presenting with POP were assessed by Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), Short Form-36 (SF-36), Pelvic Organ Prolapse Quantification (POP-Q) system, and urodynamic studies. Treatment was arranged according to each woman’s preference after counseling. Factors affecting treatment choice were evaluated. Descriptive statistics, chi-square or Fisher exact test, analysis of variance (ANOVA) test, and logistic regression analysis were used. Results Patients had high prevalence of urinary, prolapse, and bowel symptoms. Their QOL was impaired, with Urinary Impact Questionnaire (UIQ) higher than the Pelvic Organ Prolapse Impact Questionnaire (POPIQ) score and lower SF-36 score compared with the population norm. Logistic regression analysis indicated that complication from vaginal pessary, urodynamic stress incontinence (USI), stage of prolapse, and Pelvic Organ Prolapse Distress Inventory (POPDI) scoring were factors for choosing surgical treatment. Conclusions Women with POP had great symptomatic distress and impaired QOL. Complication from vaginal pessary, USI, stage of prolapse, and POPDI scores were factors increasing the likelihood of the patient choosing surgical treatment.