International Urogynaecology Consultation chapter 1 committee 4: patients’ perception of disease burden of pelvic organ prolapse

Abstract

Introduction and Hypothesis: This manuscript from Chapter 1 of the International Urogynecology Consultation (IUC) on Pelvic Organ Prolapse (POP) reports on the patient's perception of disease burden associated with pelvic organ prolapse. 4Materials and Methods: An international group containing a team of eight urogynaecologists, a physiotherapist and a statistician performed a search of the literature using pre-specified search terms in PubMed and Embase (January/2000 to August/2020). The division of sections within this report includes: 1). Perception of POP and the relationship with body image and poor health; 2). A vaginal bulge as it impacts health and well-being in women; 3). The impact of POP on Sexual life; 4). Body image and pelvic floor disorders; 5). POP and mood; 6). Appropriate use of treatment goals to better meet patients expected benefits; 7). Using health related quality of life questionnaires to quantify patient's perception of POP; 8). The financial burden of POP to patients and society. Abstracts were reviewed and publications were eliminated if not relevant or did not include populations with POP or were not relevant to the subject areas as noted by the authors. The manuscripts were next reviewed for suitability using the Specialist Unit for Review Evidence (SURE) checklists for cohort, cross sectional and case-control epidemiologic studies.Results: The original individual literature searches yielded 2312 references of which 190 were used in the final manuscript. The following perceptions were identified: 1) Women were found to have varying perceptions of POP including shame and embarrassment. Some regard POP as consequence of ageing and consider there is no effective therapy. 2) POP is perceived as a vaginal bulge and effects lifestyle and emotional wellbeing. The main driver for treatment is absence of bulge sensation. 3) POP is known to affect frequency of sexual intercourse but has less impact on satisfaction. 4) Prolapse specific body image and genital self-image is an important component of a women's emotional, physical and sexual wellbeing. 5) POP is commonly associated with depression and anxiety symptoms which impact HRQoL although are not correlated with objective anatomical findings. 6) Patient centered treatment goals are useful in facilitating communication, shared decision making and expectations before and after reconstructive surgery. 7) Disease specific HRQoL questionnaires are important tools to assess bother and outcome following surgery and there are now several tools with Level 1 evidence and a 5 Grade A recommendation. 8) The cost of POP to the individual and to society is considerable in terms of productivity. In general, conservative measures tend to be more cost effective than surgical intervention.Conclusions: Patient's perception of POP varies in different patients and has a far-reaching impact on their overall state of health and well-being. However, recognizing that it is a combination of body image and overall health (which affects mental health) allows clinicians...

Emerging trends on the mechanism of pelvic organ prolapse from 1997 to 2022: visualization and bibliometric analysis

“…The WoSCC data were downloaded as a tab-delimited text file and transported into Bibliometrics' Online Analysis Platform 1 , where the "Total volume" option was used for publication trend analysis of various years and the "National total" option was used for publication quantity analysis of countries.…”

“…Pelvic organ prolapse (POP) is characterized by the herniation of pelvic organs, like the uterus, bladder, small bowel, and rectum, into the vaginal cavity. Although POP is not fatal, it has a significant impact on patient quality of life ( 1 ). The incidence of POP increases with age ( 2 ).…”

Conservative Treatment Options to Prevent and Manage Pelvic Floor Dysfunction in Women

“…Дефект смыкания половой щели становится основной причиной рецидивов влагалищного дисбиоза [3]. К ранним симптомам начинающегося пролапса тазовых органов (ПТО) также относятся «хлюпающие» звуки при половом контакте, недержание мочи при напряжении, попадание воздуха во влагалище при физических упражнениях, слабая прерывистая струя или разбрызгивание мочи при мочеиспускании [4]. Симптомы ПТО постепенно прогрессируют, достигая 77% в группе женщин инволютивного периода жизни и влияют на снижение качества жизни пациенток [5].…”

Pelvic floor and sexual function 3 years after hysterectomy – A prospective cohort study

“…Additionally, there is a link between pelvic floor symptoms and sexual dysfunction which also negatively affect the quality of life in women 2 . The sensation of a bulge in the vagina is often the reason to seek help, however the correlation between anatomic and symptomatic prolapse varies significantly 3 . Pelvic floor dysfunction is defined as any departure from normal function of the pelvic floor muscles that is of bother to the patient with associated signs or findings 4 .…”

“… 2 The sensation of a bulge in the vagina is often the reason to seek help, however the correlation between anatomic and symptomatic prolapse varies significantly. 3 Pelvic floor dysfunction is defined as any departure from normal function of the pelvic floor muscles that is of bother to the patient with associated signs or findings. 4 Among the female population, pelvic floor dysfunction is a considerable problem and in 2050, it is estimated that 46% of American women will suffer from pelvic floor disorders.…”