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Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.
Tadesse Belayneh
University of Gondar College of Medicine and Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2578-4203
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View the published version at BMC Women's Health.
Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL.
Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores.
Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3±9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.
Keywords
HRQoL, Pelvic reconstructive surgery, Quality of life, Uterine prolapse, Prolapse surgery
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CURRENT STATUS: Published
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Posted 21 Dec, 2020
Published
On 02 Jan, 2021
No community comments so far
Submission checks complete
On 10 Dec, 2020
Editorial decision: Accept
On 07 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 29 Nov, 2020
Reviewer #1 agreed
On 19 Nov, 2020
Review #1 received
Received 19 Nov, 2020
Reviewers invited
Invitations sent on 18 Nov, 2020
Editor assigned
On 16 Nov, 2020
Submission checks complete
On 16 Nov, 2020
Editor invited
On 16 Nov, 2020
No comments provided
Editorial decision: Major revision
On 12 Oct, 2020
Review #2 received
Received 11 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Review #1 received
Received 30 Sep, 2020
Reviewer #1 agreed
On 09 Sep, 2020
Reviewers invited
Invitations sent on 16 Jun, 2020
Editor assigned
On 19 May, 2020
First submitted
On 18 May, 2020
Submission checks complete
On 18 May, 2020
Editor invited
On 18 May, 2020
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This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Pelvic Organ Prolapse Surgery and Health-Related Quality of Life: A Follow-up Study.
Tadesse Belayneh
University of Gondar College of Medicine and Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2578-4203
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 21 Dec, 2020
Published
On 02 Jan, 2021
No community comments so far
Submission checks complete
On 10 Dec, 2020
Editorial decision: Accept
On 07 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 29 Nov, 2020
Reviewer #1 agreed
On 19 Nov, 2020
Review #1 received
Received 19 Nov, 2020
Reviewers invited
Invitations sent on 18 Nov, 2020
Editor assigned
On 16 Nov, 2020
Submission checks complete
On 16 Nov, 2020
Editor invited
On 16 Nov, 2020
No comments provided
Editorial decision: Major revision
On 12 Oct, 2020
Review #2 received
Received 11 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Review #1 received
Received 30 Sep, 2020
Reviewer #1 agreed
On 09 Sep, 2020
Reviewers invited
Invitations sent on 16 Jun, 2020
Editor assigned
On 19 May, 2020
First submitted
On 18 May, 2020
Submission checks complete
On 18 May, 2020
Editor invited
On 18 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background Symptomatic prolapse impairs quality of life. Health-related quality of life (HRQoL) is considered an important outcome of pelvic organ prolapse (POP) surgery. However, it is rarely reported, and measures are inadequately used. Thus, studies reporting patient-reported surgical outcomes in low-income contexts are needed. This study aims to evaluate the effect of prolapse surgery on patient HRQoL and determine the predictive factors for change in HRQoL.
Methods A total of 215 patients who had prolapse stage III or IV were enrolled. Patients underwent vaginal native tissue repair, and their HRQoL was evaluated at baseline, 3 and 6 months postoperatively. Effect of surgery on subjective outcomes were measured using validated Prolapse Quality of Life (P-QoL-20), Prolapse Symptom Score (POP-SS), Body Image in Prolapse (BIPOP), Patient Health Questionnaire (PHQ-9), and Patient Global Index of Improvement (PGI-I) tools. A linear mixed-effect model was used to compare pre- and postoperative P-QoL scores and investigate potential predictors of the changes in P-QoL scores.
Results In total, 193 (89.7%) patients were eligible for analysis at 3 months, and 185 (86.0%) at 6 months. Participant’s mean age was 49.3±9.4 years. The majority of patients had prolapse stage III (81.9%) and underwent vaginal hysterectomy (55.3%). All domains of P-QoL improved significantly after surgery. Altogether more than 72% of patients reported clinically meaningful improvement in condition-specific quality of life measured with P-QoL-20 at 6 months. An improvement in POP-SS, BIPOP, and the PHQ-9 scores were also observed during both follow-up assessments. At 6 months after surgery, only 2.7% of patients reported the presence of bulge symptoms. A total of 97.8% of patients had reported improvement in comparison to the preoperative state, according to PGI-I. The change in P-QoL score after surgery was associated with the change in POP-SS, PHQ, BIPOP scores and marital status (p < 0.001). However, age, type of surgery, and prolapse stage were not associated with the improvement of P-QoL scores. Conclusions Surgical repair for prolapse effectively improves patient’s HRQoL, and patient satisfaction is high. The result could be useful for patient counselling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for patients suffering from POP to improve HRQoL.
Figure 1
Figure 2