Potential relevance of pre-operative quality of life questionnaires to identify candidates for surgical treatment of genital prolapse: a pilot study

Christian Chauvin,Marcos Ballester,Elisabeth Chéreau,Emile Daraï

doi:10.1186/1471-2490-12-9

Christian Chauvin, Marcos Ballester + Show 2 more

Open Access

https://doi.org/10.1186/1471-2490-12-9

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Journal: BMC Urology	Publication Date: Mar 27, 2012
Citations: 31	License type: cc-by

Affiliation: Sorbonne Université, Tenon Hospital

Abstract

BackgroundTo evaluate prolapse-related symptoms, quality of life and sexuality of patients with validated questionnaires before and after surgery for genital prolapse and assess relevance of such an evaluation to select women for surgery.MethodsFrom November 2009 to April 2010, 16 patients operated on for genital prolapse of grade greater than or equal to 2 (POP-Q classification) were evaluated prospectively by three questionnaires of quality of life Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolaps/Urinary Incontinence Sexual Questionnaire (PISQ-12). Data were collected the day before surgery and 6 weeks postoperatively.ResultsEleven patients had laparoscopic surgery and five vaginal surgery. There was a significant decrease in pelvic heaviness, vaginal discomfort and urinary symptoms after surgery. The score of symptoms of prolapse, the PFDI-20 score was 98.5 preoperatively and 31.8 postoperatively (p < 0.0001). The score for quality of life, the PFIQ-7 score was 54.5 preoperatively and 7.4 postoperatively (p = 0.001). The score of sexuality, the PISQ-12 score was 35.3 preoperatively and 37.5 postoperatively (p = 0.1). Two of the 3 patients with a PFIQ 7 under or equal to 20 were not improved while all the women with a preoperative PFIQ-7 over 20 were improved after surgery.ConclusionsThis study suggests that surgery improves quality of life of patients with genital prolapse. Quality of life questionnaires could help select good candidates for surgery. Further studies are required to determine threshold to standardize indications of surgery.

Highlights

To evaluate prolapse-related symptoms, quality of life and sexuality of patients with validated questionnaires before and after surgery for genital prolapse and assess relevance of such an evaluation to select women for surgery
Genital prolapse, known as pelvic organ prolapse (POP), is a major public health issue in western populations where as many as 38% to 76% of women consulting for routine gynaecological care suffer from the condition [1]
A history of surgery for urinary incontinence was noted in one patient and a previous operation for genital prolapse in another

Summary

Introduction

To evaluate prolapse-related symptoms, quality of life and sexuality of patients with validated questionnaires before and after surgery for genital prolapse and assess relevance of such an evaluation to select women for surgery. There is no objective argument to correlate anatomical abnormalities with the impact on quality of life of patients with genital prolapse. It has been shown that the evaluation of symptoms or discomfort by analogue scales did not correlate with changes in quality of life after surgery [9]. Several quality of life questionnaires have been validated to evaluate changes after surgery for genital prolapse, but none of them have been used to clarify indications for surgery [10,11,12,13,14,15,16,17]. It would be useful to have predictors of changes in quality of life after treatment of genital prolapse to identify good candidates for this functional surgery

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Discussion

Conclusion