What factors affect quality of life of women with pelvic organ prolapse?
IUGA Academy. Chan S. Jun 30, 2018; 212823; 461 Topic: Pelvic Organ Prolapse
Dr. Shing Chee Chan
Dr. Shing Chee Chan

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461

What factors affect quality of life of women with pelvic organ prolapse?

Chan, SSC1; Lee, LL1; Cheung, RYK1

1: The Chinese University of Hong Kong

Introduction:Women who suffered from pelvic organ prolapse have impaired quality of life. Understanding the factors that affect their quality of life may be useful to manage this condition and provide more appropriate management to them.

Objective: This study evaluated the factors that affect the health-related quality of life (QOL) of women with pelvic organ prolapse (POP).

Methods: 398 Chinese women, who were referred for POP and without an active treatment, were recruited at an Urogynaecology center. They were asked to fill in validated Chinese Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) to explore their symptoms and health-related QOL. Demographic data were collected, followed by assessment by gynaecologist to confirm stage of POP and the involved compartments. A standard translabial ultrasound scan was performed. Offline analysis was done to look for levator ani muscle (LAM) avulsion at the pelvic floor muscle contraction volume and hiatal area at rest, during Valsalva and pelvic floor contractions were measured in a standard way. Descriptive statistics, independent sample t test and multivariable analysis using multiple regression were used for analysis. Significance level was set at P <0.05.

Results: A total of 398 women completed the study. Their mean age was 62.4±10.1 years (range 33-88), mean parity 3.0±1.6, and mean BMI 25.2±3.7 kg/m2. Twenty-three women had a history of hysterectomy, with 2 conducted for POP. In all, 9%, 66%, 22% and 3% had stage I, II, III and IV POP respectively. More severe stage of POP, presence of LAM avulsion, greater hiatal area at rest, during Valsalva and pelvic floor contraction and BMI <25kg/m2 were factors associated with higher POPDI scores, meaning more symptoms bothersome. Only more severe stage of POP associated with higher POPIQ score, meaning more impairment in QOL (Table 1). When multivariable analysis using multiple regression was conducted, stage of POP was the only factor that affects POPDI (beta = 0.15, P = 0.018) and POPIQ (beta = 0.14, P = 0.006).

Conclusions: Stage of POP was the only factor that affects the symptom bothersome and impairment of quality of life of women with POP. LAM avulsion or hiatal area were not found to associated with the health-related quality of life of women.

Table 1. Univariate analysis of pelvic floor related quality of life of women with POP.

Factors

POPDI

P

POPIQ

P

BMI

· <25kg/m2

· ≥25kg/m2

86.3 (64.2)

71.3 (56.1)

0.029

57.8 (78.0)

43.4 (63.9)

0.074

≥Stage II cystocele

· No

· Yes

63.3 (50.9)

79.3 (60.4)

0.057

41.8 (62.6)

51.2 (71.9)

0.401

≥Stage II uterine POP

· No

· Yes

64.5 (52.4)

85.3 (62.3)

0.001

44.0 (65.7)

53.9 (73.5)

0.185

Overall stage

· I

· II

· ≥ III

48.9 (45.0)

73.7 (54.2)

96.1 (71.2)

<0.005

47.3 (73.5)

43.0 (60.2)

70.2 (90.4)

<0.005

LAM avulsion

· No

· Yes

71.9 (57.4)

85.3 (61.9)

0.037

43.6 (60.4)

59.4 (83.8)

0.055

Hiatal area at rest ≥21 cm2

· No

· Yes

73.2 (56.3)

88.5 (65.3)

0.039

50.7 (71.2)

49.5 (74.1)

0.896

Hiatal area at VM ≥25 cm2

· No

· Yes

69.2 (57.1)

83.2 (59.6)

0.028

44.4 (62.4)

55.5 (78.5)

0.145

Hiatal area at PFMC ≥17 cm2

· No

· Yes

72.6 (56.8)

88.0 (62.8)

0.026

52.0 (73.9)

43.5 (64.3)

0.466

Disclosure:

Work supported by industry: no.

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