Abstract
Objective: To investigate barriers and variables associated with the delay in seeking urogynecologic care by women with pelvic floor dysfunction. Methods: Cross sectional study of 300 new patients presenting for outpatient evaluation of pelvic floor dysfunction from August 2011 through March 2012. Patients were mailed a survey prior to initial visit. Delay in seeking care was defined as 12 months or more from symptom manifestation, persistence or recurrence after prior intervention, or being informed about the condition to time of visit. Data are presented as proportion or mean (±standard deviation). Comparisons were made using chi-square and t tests. Results: Two hundred and thirty one (77.0%) surveys were returned. Mean age was 55.9 years (± 17.4). Majority (91.3%) were Caucasian, 57.4% sexually active, and 96.1% saw a health care provider annually. Commonly reported causes were child birth (32.6%) and aging (23.4%). Delay was seen in 140 women (61.4%). Of these, 81 (57.9%) had been previously asked about symptoms by their primary care provider. The most common reason reported for delay was “Did not have time to care for myself” (19.8%). There was no statistically significant difference in level of education (p=0.86), annual health care visits (p=0.74), and sexual activity (p=0.28) between women with and without delay. However, women who delayed seeking care were more likely to report increased symptom severity (p=0.005) and to have been asked about symptoms (p=0.01). Conclusion: There is significant delay in seeking care with an urogynecologist. Additional resources are needed to promote patient and primary care provider awareness.
Highlights
Pelvic floor dysfunction is a common health issue among women
The purpose of this study is to investigate characteristics associated with a delay in seeking urogynecologic care for pelvic floor dysfunction and potential barriers to seeking care
We conducted a cross-sectional study of new patients presenting to our office practice for evaluation of pelvic floor dysfunction including pelvic organ prolapse, urinary incontinence and fecal incontinence
Summary
Pelvic floor dysfunction is a common health issue among women. Women with pelvic floor dysfunction present with symptoms of pelvic organ prolapse; lower urinary tract symptoms such as recurrent urinary tract infection, urinary incontinence, overactive bladder, chronic myofascial pelvic pain and fecal incontinence. Among women with pelvic floor dysfunction, reasons for the delay in seeking care are not well studied or understood. Factors that have been cited as playing a role in the delay include the perceived seriousness of symptoms, under-reporting of symptoms by patients to their primary care provider, as well as a lack of recognition by providers that pelvic floor dysfunction is a significant problem [1]. Studies have shown that pelvic floor dysfunction contributes to depression, anxiety, poor life satisfaction, and impaired quality of life [2]
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