Correlation of pelvic organ prolapse staging with lower urinary tract symptoms, sexual dysfunction, and quality of life

Abstract

To evaluate the relationship between pelvic organ prolapse (POP) staging and clinical findings, lower urinary tract symptoms (LUTS), sexual dysfunction, and quality of life (QoL) using validated questionnaires. Women attending the urogynecology unit with LUTS and/or bulging (n = 388) were grouped according to the POP quantification (POPQ). LUTS, sexual dysfunction, and QoL were evaluated using the Urinary Distress Inventory-6 (UDI-6),the Overactive Bladder Awareness tool (OAB-V8), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and the Incontinence Impact Questionnaire-7 (IIQ-7). Data regarding baseline characteristics, clinical findings, and scores of questionnaires were compared among the POP stages using the Kruskal-Wallis test. Pearson's and Spearman's correlation analyses were used to evaluate the correlation of POP staging with clinical findings, pelvic floor dysfunction related symptom severity, and QoL. According to the POPQ, patients were classified as: stage 0 (27.8 %), stage 1 (21.4%), stage 2 (38.9%), and stages 3 and 4 (11.8%). Irritative, stress, obstructive subscale scores of UDI-6 and physical, travel, emotional subscale scores of IIQ-7 were significantly different among POPQ stages. Weak correlations between POPQ staging and irritative, stress, obstructive subscale scores of UDI-6 (r = 0.198, r = 0.192, and r = 0.146 respectively), and physical, travel, social, emotional subscale scores of IIQ-7 (r = 0.223, r = 0.154, r = 120 and r = 0.171 respectively) were found (p < 0.05). Clinical findings (Q-tip and stress test positivity, post-void residual volumes) showed moderate to weak correlations with POPQ stages (r = 0.425, r = 0.117, r = 0.163 respectively; p < 0.05). The correlation of lower urinary tract dysfunction and POP staging was shown to be best represented by UDI-6 and IIQ-7.