Association between pelvic floor disorder symptoms and QoL scores with depressive symptoms among pelvic organ prolapse patients

Pizarro-Berdichevsky, Javier; Hitschfeld, Mario J.; Pattillo, Alejandro; Blumel, Bernardita; González, Silvana; Arellano, Marco; Cuevas, Rolando; Alvo, Jacobo; Gorodischer, Ariel; Flores-Espinoza, Claudia; Goldman, Howard B.

doi:10.1111/ajo.12467

Cited by 29 publications

(34 citation statements)

References 18 publications

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“…Prolapse may increase symptoms of depression, while symptoms of depression may impact health behavior, symptom burden, QoL, and functional impairment pre-and post-operatively [56]. Our research found that surgery leads to a dramatic improvement not only in condition-speci c QoL but also in depressive symptoms.…”

Section: Discussionmentioning

confidence: 52%

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

Belayneh¹,

Gebeyehu²,

Adefris³

et al. 2020

Preprint

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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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Section: Discussionmentioning

confidence: 52%

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

Belayneh¹,

Gebeyehu²,

Adefris³

et al. 2020

Preprint

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“…Patients with POP reported worse self-perceived BI, and poor BI is associated with depression and poor psychosocial functioning. Depression is also associated with developing severe POP symptoms, functional impairment, and impaired HRQoL [38]. Thus, depression has a bidirectional relation with QoL in that depression leads to poor QoL and vice versa.…”

Section: Discussionmentioning

confidence: 99%

Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.

Belayneh

Gebeyehu

Adefris

et al. 2020

Preprint

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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.

show abstract

Section: Discussionmentioning

confidence: 99%

Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.

Belayneh

Gebeyehu

Adefris

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Bothersome descent of pelvic organs impairs health-related quality of life (HRQoL). Patient 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 aimed to evaluate the effect of prolapse surgery on patient HRQoL and to determine the predictive factors for change in HRQoL. Methods: Two-hundred-fifteen women who had POP stage III or IV were enrolled. Patient underwent vaginal native tissue repair and their HRQoL was evaluated at baseline, 3 and 6 months post-operatively. 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. 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 clinical meaningful improvement in quality of life measured with P-QoL-20. 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 symptom. 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, and BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with P-QoL score change. Conclusions: Surgical repair for prolapse effectively improves patient’s HRQoL and patient satisfaction is high. The result could be useful for patient counseling 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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Association between pelvic floor disorder symptoms and QoL scores with depressive symptoms among pelvic organ prolapse patients

Abstract: A 'positive' screening for DS was associated with worse PFDI-20 and P-QoL scores despite no difference in objective measurements. It may be that depressed patients interpret their symptoms differently.

Cited by 29 publications

References 18 publications

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

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

Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.

Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.

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