Pelvic Organ Prolapse

10.2310/fm.1308 ◽

2018 ◽

Author(s):

Lennox Hoyte ◽

Renee Bassaly ◽

Stuart Hart ◽

Mona McCullough ◽

Elisha Jackson

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Pelvic Organ Prolapse ◽

Healthcare Provider ◽

Treatment Options ◽

Pelvic Organ ◽

Vaginal Wall ◽

Life Threatening ◽

Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

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Sexual function and health-related quality of life following anterior vaginal wall surgery for stress urinary incontinence and pelvic organ prolapse

International Journal of Impotence Research ◽

10.1038/ijir.2011.22 ◽

2011 ◽

Vol 23 (4) ◽

pp. 151-157 ◽

Cited By ~ 3

Author(s):

T Shen ◽

L-J Song ◽

Y-M Xu ◽

B-J Gu ◽

L-H Lu ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Treatment of pelvic organ prolapse

Urogynaecologia ◽

10.4081/uij.2012.e3 ◽

2012 ◽

Vol 26 (1) ◽

pp. 3

Author(s):

Munir'deen A. Ijaiya ◽

Hadijat O. Raji

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

De Novo ◽

Treatment Options ◽

Reproductive Function ◽

Pelvic Organ ◽

Pelvic Organs ◽

Choice Of Treatment ◽

Principles Of Treatment

Prolapse of the pelvic organs is a common condition encountered in gynecological practice that adversely affects the quality of life of affected women. It affects millions of women worldwide. The principles of treatment of pelvic organ prolapse include restoring anatomy and vaginal function, correcting associated urinary and or fecal incontinence, and preventing de novo prolapse and incontinence. There are various treatment options for pelvic organ prolapse. These vary from conservative treatments/ mechanical interventions to surgery. The choice of treatment depends on severity of symptoms, patient’s age, parity, and whether there is the need to conserve the uterus for reproductive function. In conclusion, thorough evaluation of symptoms and degree of prolapse is essential in order to provide the best possible treatment and ultimately improve quality of life.

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Clinical epidemiological study of uterine prolapse

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185287 ◽

2018 ◽

Vol 8 (1) ◽

pp. 79

Author(s):

Parvathavarthini K. ◽

Vanusha A.

Keyword(s):

Risk Factors ◽

Pelvic Organ Prolapse ◽

Social Issues ◽

Uterine Prolapse ◽

Epidemiological Data ◽

Pelvic Organ ◽

Life Threatening ◽

The Mean ◽

Awareness Programme

Background: Pelvic organ prolapse is one of the common gynaecological problem in India among the parous and aged women. Though the pelvic organ prolapse is not life threatening if left untreated it can lead to many social issues and also it reduces the quality of life of a woman. Thus, this study aims at generating epidemiological data on uterine prolapse in a clinical setting and identifying its risk factors so that appropriate measures can be taken to prevent the same.Methods: It was a descriptive case control study. Using a study proforma the required information was collected from the patients admitted with uterine prolapse (case) and from amongst the patient’s attendees of Gynaecology ward (control). Obtained data were compared and analyzed using appropriate statistical methods.Results: Uterine prolapse contributes to about 5.9% of the total gynecological patients admitted during the study period. The mean age of presentation with uterine prolapse was 50.1years the mean number of deliveries was higher in case compared to the control with the mean of 4 deliveries. Out of 130 patients, only 13.9% of them had institutional delivery while the others had home delivery.Conclusions: Uterine prolapse is strongly associated with age, parity and place of delivery. As the risk factors for uterine prolapse are easily preventable public health awareness programme must be conducted on its risk factors there by reducing the incidence of prolapse and decreasing the morbidity caused by it.

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Symptomatic Pelvic Organ Prolapse at Midlife, Quality of Life, and Risk Factors

Obstetrics and Gynecology ◽

10.1097/aog.0b013e3181985312 ◽

2009 ◽

Vol 113 (3) ◽

pp. 609-616 ◽

Cited By ~ 86

Author(s):

Xavier Fritel ◽

Noëlle Varnoux ◽

Marie Zins ◽

Gérard Breart ◽

Virginie Ringa

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Pelvic Organ Prolapse ◽

Pelvic Organ

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A Collaborative Approach to Multicompartment Pelvic Organ Prolapse

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0040-1714289 ◽

2020 ◽

Author(s):

Brooke Gurland ◽

Kavita Mishra

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

Recovery Period ◽

Pelvic Organ ◽

Daily Functioning ◽

Collaborative Approach ◽

Life Threatening ◽

The Impact ◽

Female Pelvic Medicine

AbstractMulticompartment pelvic organ prolapse is common yet frequently underreported and unrecognized. Although not life-threatening, the impact on quality of life and daily functioning can be significant. Multidisciplinary evaluation and treatment with specialists in colorectal and female pelvic medicine and reconstructive surgery (FPMRS) help to identify patients who will benefit from surgical treatment of vaginal and rectal prolapse. Both abdominal and perineal combined procedures can be offered to patients with a single operation and concurrent recovery period without increasing complications.

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Quality of Life After Conservative and Surgical Treatment of Pelvic Organ Prolapse

Case Medical Research ◽

10.31525/ct1-nct04110821 ◽

2019 ◽

Author(s):

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Conservative And Surgical Treatment

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Pelvic organ prolapse surgery and health-related quality of life: a follow-up study

BMC Women s Health ◽

10.1186/s12905-020-01146-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tadesse Belayneh ◽

Abebaw Gebeyehu ◽

Mulat Adefris ◽

Guri Rortveit ◽

Janne Lillelid Gjerde ◽

...

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

Pelvic Organ ◽

Prolapse Surgery ◽

Stage Iii ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Abstract Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL. Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores. Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3 ± 9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.

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Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

Journal of Integrated Care ◽

10.1108/jica-07-2019-0032 ◽

2020 ◽

Vol 28 (2) ◽

pp. 119-133

Author(s):

Nicola Davies ◽

Teresa Burdett

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

Conservative Treatment ◽

Conservative Management ◽

Integrated Approach ◽

Pelvic Organ ◽

Social Implications ◽

Content Type ◽

Practical Implications

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

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