Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse

Abstract

Background Pelvic organ prolapse (POP) is a multifactorial, poorly understood condition impacting quality of life (QOL). The pathology and aetiology might imply population-specific differences in domains of the International Classification of Function, Disability and Health (ICF). There is, however, a lack of research in this regard in South Africa. Objectives To describe the dysfunction, activity limitations, participation restrictions and contextual factors in South African women with POP. Method One hundred women were conveniently sampled in a primary health care setting. They completed a self-compiled medical and exercise history questionnaire, the standardised Prolapse-Quality of Life (P-QOL) questionnaire and the Visual Faces Scale. The stage of prolapse was determined by the Pelvic Organ Prolapse Quantification (POP-Q) Scale. Means, medians, standard deviations, percentages and frequencies were calculated. Results Eighty-six per cent had a stage III POP, 57% had overactive bladder, 50% had constipation, 37% had stress urinary incontinence, 31% had urge urinary incontinence, 32% had incomplete emptying and 30% had anal incontinence. Comorbidities included cardiovascular disease (65%), depressive symptoms (12%) and hypothyroidism (18%). Other contextual factors included limited physical activity (80%), an increased body mass index (29 kg/m 2 ), older age (59 years) and unemployment (80%). Quality of life was affected in the severity, social, emotional and sleep/energy domains (median scores were 66.7% – 33.3%). Conclusion The dysfunction domain of the ICF was similar to other populations with POP. Activity and participation restrictions included social, emotional and sleep/energy aspects. Contextual factors seem to be population-specific, possibly leading to differences comparing QOL amongst different populations. Clinical implications Activity and participation restrictions, as well as contextual factors, may differ in different populations with POP. Interactions between contextual factors and movement impairment should be considered during management and be further investigated.

Impact of surgery on quality of life of Ugandan women with symptomatic pelvic organ prolapse: a prospective cohort study

“…The poor physical performance observed in this study was also reported in studies done in other low income countries [ 10 , 11 , 37 ]. A study done in South Africa by Brandt et al 2019 suggested that the poor physical performance in women with POP could be due to chronic pelvic pain caused by stretching and weakening of the pelvic ligaments which makes it difficult for these women to walk, bend and work.…”

“…Women with POP present with a variety of symptoms including urinary, bowel, sexual, and psychological which greatly compromise their quality of life (QOL) [ 6 – 9 ]. In the advanced stages, POP presents with debilitating physical symptoms like difficulty in walking, sitting and squatting, which negatively impacts the daily economic activities of these women like farming eventually resulting in poverty [ 10 , 11 ]. In addition, women with POP frequently report limitations to their sexual life such as: lack of sexual desire, arousal, orgasm, and pain during intercourse which ultimately leads to loss of sexual interest with some being abandoned by their husbands [ 5 , 7 , 12 – 14 ].…”

Impact of Surgery on Quality of Life of Ugandan Women With Symptomatic Pelvic Organ Prolapse: A Prospective Cohort Study

“…POP is associated with a variety of urinary, bowel, sexual and psychological symptoms, which may signi cantly compromise the quality of life of the patients (7,8). Most women with advanced stages of POP often have symptoms that cause di culty in walking, sitting and squatting, which affects the performance of their daily household work like farming hence reducing their economic productivity (9,10). In addition, women with POP frequently report limitations to their sexual life such as; lack of sexual desire, arousal, orgasm, and pain during intercourse which ultimately leads to loss of sexual interest with some being abandoned by their husbands (6,8,(11)(12)(13).…”

Comments on dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse

“…We want to highlight some points of the article ‘Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse (POP)’ (Brandt & Janse van Vuuren, 2019 ).…”