Ethnicity and variations of pelvic organ prolapse bother

Abstract

Introduction and hypothesis To determine if prolapse symptom severity and bother varies among non-Hispanic white, Hispanic, and Native American women with equivalent prolapse stages on physical examination. Methods This was a retrospective chart review of new patients seen in an academic urogynecology clinic from January 2007 to September 2011. Data were extracted from a standardized intake form, including patients’ self-identified ethnicity. All patients underwent a Pelvic Organ Prolapse Quantification (POPQ) examination and completed the Pelvic Floor Distress Inventory-20 (PFDI-20) with its Pelvic Organ Prolapse Distress Inventory (POPDI) subscale. Results Five hundred and eighty-eight new patients were identified with pelvic organ prolapse. Groups did not differ by age, prior prolapse, and/or incontinence surgery, or sexual activity. Based on POPDI scores, Hispanic and Native American women reported more bother compared with non- Hispanic white women with stage 2 prolapse (p<0.01). Level of bother between Hispanic and Native American women with stage 2 prolapse (p=0.56) was not different. In subjects with ≥ stage 3 prolapse, POPDI scores did not differ by ethnicity (p=0.24). In multivariate stepwise regression analysis controlling for significant factors, Hispanic and Native American ethnicity contributed to higher POPDI scores, as did depression. Conclusions Among women with stage 2 prolapse, both Hispanic and Native American women had a higher level of bother, as measured by the POPDI, compared with non-Hispanic white women. The level of symptom bother was not different between ethnicities in women with stage 3 prolapse or greater. Disease severity may overshadow ethnic differences at more advanced stages of prolapse.

Elder American Indian Women’s Knowledge of Pelvic Floor Disorders and Barriers to Seeking Care

“…This information gap includes lack of knowledge regarding its prevalence, barriers to care, health seeking behaviors and patient understanding of pelvic floor disorders. Prior work is limited to one study which describes the prevalence of urinary incontinence among women who were members of a South Dakota tribe [14] and another describing the level of bother American Indian women experience regarding pelvic organ prolapse compared to Hispanic and non-Hispanic white women [15]. …”

Concomitant apical suspensory procedures in women with anterior vaginal wall prolapse in the United States in 2011

“…An analysis of the 2003 National Census and National Hospital Discharge Survey showed that the rate of undergoing prolapse surgery was 14.8/10,000 women for Caucasian women compared with 5.6/10,000 women for African-American women [16]. Among women with stage 2 prolapse, Hispanic and Native American women had a higher level of bother, as measured by the POP-DI, compared with non-Hispanic white women; however, this difference was not noted among women with ≥ stage 3 prolapse [17]. As our database could not determine the degree of prolapse, it is difficult to determine the significance of these racial differences in receiving care.…”

A Transcription and Translation Protocol for Sensitive Cross-Cultural Team Research

“…Subtle pelvic floor support changes affect women’s quality of life (Dolan et al, 2004) and sexual activity (Brubaker et al, 2008). Some studies have found a correlation of pelvic organ prolapse with Hispanic ethnicity (Swift et al, 2005), and Hispanic women report more bother from stage II pelvic organ prolapse than non-Hispanic White women (Dunivan et al, 2014). …”

“…A translator makes “assumptions about meaning equivalence that make her analyst and cultural broker as much as a translator” (Temple & Young, 2004, p. 171). Ideally, translators share personal characteristics and life experience with those being interviewed, as well as a deep familiarity with the interview topic, context of the interviews, and culture of participants (Al-Amer, Ramjan, Glew, Darwish, & Salamonson, 2014; Brämberg & Dahlberg, 2013; Temple et al, 2006). Additional procedures to improve translation of interviews include involving a team of translators, cycles of translation and back-translation, documentation of translation decisions and phrases in a study-specific dictionary, and debriefing interviews with interpreters and translators after each interview and at the conclusion of the study (Lopez, Figueroa, Connor, & Maliski, 2008; Merry et al, 2011).…”