title: Management of complex pelvic floor disorders in a multidisciplinary pelvic floor clinic.
abstract: OBJECTIVE
  To identify symptom clusters, management strategies and survey patient satisfaction in our combined multidisciplinary pelvic floor clinic (PFC).
  
  
  METHODS
  Retrospective cohort study, patient satisfaction questionnaire.
  
  
  METHODS
  Secondary and tertiary referrals with complex pelvic floor disorders.
  
  
  METHODS
  symptom clusters and treatment received; patient satisfaction.
  
  
  RESULTS
  A total of 113 new cases over a 3-year period. There were two main symptom clusters: (i) obstructed defaecation with rectoceles (n = 55); of these, 23 had abdominal sacrocolpopexy with rectopexy, six had transvaginal rectocele repairs; and (ii) of the 33 with double incontinence, 10 had anal sphincter repairs, five had tension-free vaginal tapes and two had colposuspensions. Patient satisfaction audit: 73% found the care to be excellent/good, 12% satisfactory and 6% unsatisfactory.
  
  
  CONCLUSIONS
  Combined PFCs led to a more pragmatic approach in treating patients' symptoms. Combined surgery was undertaken in one-fourth of patients and is associated with cost savings and a single recuperation period. Overall, patients rated this service very highly.
authors.affiliation: Mayday University Hospital, Department of Urogynaecology and Colorectal Surgery, London Road, Croydon, Surrey, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Kapoor
authors.forename: A H
authors.initials: AH
authors.lastname: Sultan
authors.forename: R
authors.initials: R
authors.lastname: Thakar
authors.forename: M A
authors.initials: MA
authors.lastname: Abulafi
authors.forename: R I
authors.initials: RI
authors.lastname: Swift
authors.forename: W
authors.initials: W
authors.lastname: Ness
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000473:pathology*; D011788:Quality of Life; D020047:Rectocele / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*