Abstract
Pelvic organ prolapse (POP) and the associated functional disorders are a major epidemiological problem that compromises the quality of life (QoL). The aim of this study was to assess the impact of lower urinary tract symptoms (LUTS) related to POP and vaginal native tissue repair (VNTR) on QoL. Two hundred patients with symptomatic POP were stratified into four groups according to the dominant storage phase function disorders: Urgency; stress urinary incontinence (SUI); mixed urinary incontinence (MUI), and without clinically significant symptoms from lower urinary tract (LUT). They underwent VNTR from January 2018 to February 2019. After 12 months, the QoL was assessed by the Prolapse Quality of Life (P-QoL) and visual analogue scale (VAS) questionnaires. The data were analyzed with Statistica package version 12.0 (StatSoft, Krakow, Poland), using the Kalmogorow–Smirnoff, Shapiro–Wilk W and the one-way analysis of variance with post hoc Tukey tests. The results of P-QoL showed significant improvement (p < 0.05) in all the study groups in most domains assessed before surgery and 12 months after surgery. Significant improvements in all the symptoms assessed by the VAS scale results were found in groups Urgency and MUI. The LUTS questionnaire revealed significant improvement in all voiding and post voiding symptoms in these groups. VNTR effectively eliminated LUTS and significantly improved the patients’ QoL associated with POP.
Highlights
Pelvic organ prolapse (POP) and the accompanying functional disorders are significant epidemiological, medical and social problems
There is a bulk of evidence that anatomical lesions of the levator ani muscle play an important role in the etiology of pelvic organ prolapse
The ten-point visual analogue scale (VAS) scale (0: no distress; 2: annoying; 4: uncomfortable; 6: dreadful; 8: horrible and 10: unbearable distress) embraced five questions in order to assess subjectively: 1: pain related to POP; 2: impact of urinary incontinence (UI) on functioning in everyday life; 3: impact of discomfort associated with gas and stool incontinence on everyday life; 4: vaginal discomfort on functioning in everyday life; and 5: the impact of POP on sexual functions [12]
Summary
Pelvic organ prolapse (POP) and the accompanying functional disorders are significant epidemiological, medical and social problems. The main factor in the etiology of POP is the weakness of the endopelvic fascia and the muscles of the pelvic floor. This may result in the herniation of the pelvic organs leading to prolapse [2]. There is a bulk of evidence that anatomical lesions of the levator ani muscle play an important role in the etiology of pelvic organ prolapse. There is sufficient evidence to state that delivery-related levator trauma is associated with the objective prolapse in clinical assessment especially of the anterior and central compartments, with an odds ratio of 5.7 (95% CI, 3.5–9.1) [3]. There is an association between urinary incontinence (UI), fecal incontinence, pain during sexual intercourse (and avoidance) in patients affected by POP, this latter correlation is not clearly and unanimously confirmed [4]
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