The relationship of vaginal prolapse severity tosymptoms and quality of life

Digesu, G. Alessandro; Chaliha, Charlotte; Salvatore, Stefano; Hutchings, Anna; Khullar, Vik

doi:10.1111/j.1471-0528.2005.00568.x

Cited by 231 publications

(179 citation statements)

References 23 publications

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“…This is a validated disease-specific questionnaire used to assess both symptoms and QoL in women with pelvic organ prolapse and is used to determine the impact of urogenital prolapse on daily life. 1 The pQoL marks each domain score from 0 to 100. We arbitrarily classified 'bother' as minimal, mild, moderate and marked if scores ranged from 0 to 25, 25-50, 50-75 and 75-100, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…1 Increased life expectancy and an expanding elderly population means that urogenital prolapse remains an important condition particularly since the majority of women may now spend one-third of their lives in the postmenopausal state. 2 In a retrospective cohort study of 149 554 women, the lifetime risk of having surgery for urogenital prolapse was 11%, and 29.2% of women required repeat surgery.…”

Section: Introductionmentioning

confidence: 99%

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Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration

Srikrishna

Robinson

Cardozo

et al. 2008

BJOG

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Objective To explore the expectations and goals of women undergoing surgery for urogenital prolapse using both a quantitative quality of life approach exploring symptom bother and a qualitative interview-based approach exploring patient goals and expectations.Design Prospective observational study.Setting Tertiary referral centre for urogynaecology.Population Forty-three women with symptomatic pelvic organ prolapse were recruited from the waiting list for pelvic floor reconstructive surgery.Methods All women were assessed with a structured clinical interview on an individual basis. The data obtained were transcribed verbatim and then analysed thematically based on the grounded theory. Individual codes and subcodes were identified to develop a coding framework. The prolapse quality-of-life (pQoL) questionnaire was used to determine the impact of pelvic organ prolapse on the woman's daily life. We arbitrarily classified 'bother' as minimal, mild, moderate and marked if scores ranged from 0 to 25, 25-50, 50-75 and 75-100, respectively. The degree of prolapse was objectively quantified using the pelvic organ prolapse quantification (POP-Q) system. Quantitative data were analysed using SPSS. Ethical approval was obtained from the Kings College Hospital Ethics Committee.Main outcome measures Quantitative data from POP-Q, subjective data from pQoL, qualitative data based on the structured clinical interview.Results Forty-three women were recruited over the first 1 year of the study. Their mean age was 56 years (range 36-78) and mean parity was 2 (range 0-6). The mean ordinal stage of the prolapse was 2 (range stages 1-4). Quantitative analysis of the pQoL data suggested that the main domains affected were prolapse impact on life (mean score 74.71) and personal relationships (mean score 46.66). Qualitative analysis based on the clinical interview suggested that these women were most affected by the actual physical symptoms of prolapse (bulge, pain and bowel problems) as well by the impact prolapse has on their sexual function.Conclusions While disease-specific QoL questionnaires allow broad comparisons to be made assessing patient bother, they may lack the sensitivity to assess individual symptoms. A qualitative approach may individualise patient care and ultimately improve patient satisfaction and overall outcome when treating women complaining of urogenital prolapse.Keywords Grounded theory, prolapse, qualitative analysis, quality of life. IntroductionUrogenital prolapse, while not life threatening, remains an important cause of morbidity in women and the effect on quality of life (QoL) has been extensively documented. 1 Increased life expectancy and an expanding elderly population means that urogenital prolapse remains an important condition particularly since the majority of women may now spend one-third of their lives in the postmenopausal state. 2 In a retrospective cohort study of 149 554 women, the lifetime risk of having surgery for urogenital prolapse was 11%, and 29.2% of women required repeat surgery. 3 The...

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration

Srikrishna

Robinson

Cardozo

et al. 2008

BJOG

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“…The issue that determination of the degree of prolapse before and after the treatment alone is insufficient for the assessment of the outcome has been raised by many authors [12][13][14]. Decisions about the management should also be based on the quality of life of the treated women.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Polish version of P-QoL questionnaire

Rzepka¹,

Zalewski²,

Stefanowicz³

et al. 2016

Ginekol Pol

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Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods:The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women.Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p < 0.001). All the questions regarding symptoms showed significant differences (p < 0.001) between both groups. Conclusions:The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse.

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“…10 Allesandero noted stronger relationship between posterior wall prolapse and bowel complains than anterior prolapsed and urinary complains. 11 Weber A found that women with prolapse have bowel symptoms but these are not correlated with severity of posterior vaginal wall prolapse. 12 Present study reveals that women with prolapse have bowel symptoms, but they are not correlated with severity of posterior vaginal wall descent.…”

Section: Discussionmentioning

confidence: 99%

Study of posterior vaginal wall prolapses and correlation with bowel function

Bijwe

Rajbhara

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONProlapse though not life threatening condition, severely affect quality of life in women causing physical, social, psychological, occupational, domestic limitations. 1 The incidence of urogenital prolapse increases with advancing age, menopause and parity.2 It is estimated that 50% of parous women lose pelvic floor support and, as a result, develop prolapse, but only 20% of these women are symptomatic. Anorectal dysfunction is probably less understood pelvic symptom in women with prolapse.These patients may experience pain with defecation, the need to splint or strain to have a bowel movement or anal incontinence. Meschia found a 2-fold increased risk of anal incontinence in patients with a rectocele greater than grade 2. Surgery is the definitive treatment.It is estimated that the lifetime risk of undergoing at least one surgical procedure for prolapse is 11% and the reoperation rate for recurrent prolapse is 30-40%. 3 The surgical indication should be based on the individual's symptoms rather than the degree of vaginal wall prolapse. ABSTRACTBackground: This study's objectives were to describe symptoms related to bowel symptoms in women with prolapse and to compare these symptoms as per the grading of posterior vaginal prolapse. Methods: Descriptive study, 63 women answered questionnaire for assessment of bowel function and were subjected to physical examination according to the International Continence Society's system for grading uterovaginal prolapse. Results: The distribution of pelvic organ support by overall POPQ stage was 6.4%stage 1,21%stage 2, 50% stage 3, and 23% stage 4. Women were asked to rate the extent to which they were bothered by their bowel function on a scale of 1 to 10, with 1 being not at all and 10 being extremely. Thirty-six women (58%) reported 1 to 4, 18 (29%) reported 5 to 7, and 8 (13%) reported greater than 8. According to the furthest extent of posterior vaginal prolapse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage I, 50 (35.2%) were in stage II, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV. Ninety-two percent of women reported having bowel movements at least every day. When asked whether straining was required for them to have a bowel movement, 67% reported never or rarely,3% reported sometimes,1.6%) reported always. When asked whether they ever needed to help stool come out by pushing with a finger in the vagina or rectum, 77.0% reported never or rarely, 15.1% reported sometimes, (5.6%) reported usually, and (1.6%) reported always. No women had fecal incontinence, there were no clinically significant associations between any of the questions related to bowel function and severity of posterior vaginal prolapse. Conclusions: Women with uterovaginal prolapse frequently have symptoms related to bowel dysfunction but this is not associated with the severity of posterior vaginal prolapse.

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The relationship of vaginal prolapse severity tosymptoms and quality of life

Cited by 231 publications

References 23 publications

Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration

Experiences and expectations of women with urogenital prolapse: a quantitative and qualitative exploration

Validation of the Polish version of P-QoL questionnaire

Study of posterior vaginal wall prolapses and correlation with bowel function

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