Biopsychosocial profile of women with pelvic organ prolapse: A systematic review

Abstract

Female pelvic organ prolapse is a common condition associated with significant impact on women’s lives from a biopsychosocial perspective. The aim of this systematic review is to identify, appraise and summarize the biopsychosocial profile of women with pelvic organ prolapse. Searches were completed from inception to October 2022 from PubMed, Web of Science, EMBASE, CINAHL, Cochrane, PsycINFO and PEDro using a search string and in line with the Preferred Reporting Information for Systematic reviews and Meta-Analyses protocol. English language studies (randomized controlled trials, cohort studies, case–control studies, qualitative research) investigating female pelvic organ prolapse and using a validated patient-reported outcome measure and validated pelvic organ prolapse objective measurement were examined. Two reviewers independently screened titles, abstracts and full articles for eligibility. Data extraction included participant characteristics, pelvic organ prolapse grading and outcome measures. Risk of bias was assessed using the appropriate Joanna Briggs Institute Tool. Baseline mean score for each questionnaire or questionnaire domain in each category was presented in tertiles (low, moderate and high impact) to allow simple classification of impact. Of 8341 articles identified, 18 were included (n = 2075 women, age range = 22–85 years, parity range = 0–10). One objective outcome measure graded pelvic organ prolapse: Pelvic Organ Prolapse Quantification measurement. Eleven validated patient-reported outcome measures were utilized; two pelvic organ prolapse-specific (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Pelvic Organ Prolapse Quality of Life Questionnaire), the remainder pelvic health (International Consultation on Incontinence Questionnaire–Vaginal Symptoms, International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, Pelvic Floor Distress Inventory-20, Incontinence Impact Questionnaire-7, Female Sexual Function Index, Urinary Distress Inventory-6, Kings Health Questionnaire, Pelvic Floor Impact Questionnaire-7) or general health questionnaires (Short Form-36). Patient-reported outcome measures included in the review reported moderate levels of pain with sexual intercourse and low levels of bodily pain. Pelvic organ prolapse had a low to moderate impact in sleep/energy and quality of life and sexual function domains. Its impact on physical symptoms and general health perception domains was low. Patient-reported outcome measures results for physical functioning varied from low to high impact. More impact was demonstrated when using pelvic organ prolapse-specific patient-reported outcome measures. There are opportunities for improvement in the use of patient-reported outcome measures in clinical research which would facilitate increased understanding of the biopsychosocial profile of women with pelvic organ prolapse.

Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes

“…Once again, the normalization of urinary leakages and dyspareunia may be the main explanation. In the case of POP, females often have the feeling “like a tampon is falling out” 33 , as well as frequently related symptomatology such as pelvic pressure, groin and lower back pain, painful intercourse, or difficult bowel movements, among others 34 . The impact of these symptoms on the quality of life makes women seek professional healthcare and information and explains the higher level of knowledge of women who have POP compared to women who do not 35 .…”

Sexuality in Postmenopausal Women with Genital Prolapse

“…Their etiologies are multifactorial and their actual incidence is currently unknown [12]. They are often a taboo subject in our society at different levels and, unsurprisingly, also during clinical interviews [13], which makes self-completion questionnaires such as the FSM an emerging tool to facilitate diagnosis, as they facilitate data collection by allowing the patient to fill them in privately and anonymously [14]. The use of questionnaires in the pelvic floor consultation and especially in the sexuality consultation has been confirmed as a fundamental tool for both diagnosis and when establishing a therapy or medical treatment.…”

“…The decrease in estrogen levels leads to important changes in the anatomy and function of the genitalia, producing different symptoms that can affect daily life and ultimately have a negative impact on the sexual sphere. On the other hand, pelvic floor pathology, which affects one in three adult women, can also negatively influence the sexual activity of the patient suffering from it [13].…”