Patient reported and anatomical outcomes after surgery for pelvic organ prolapse.
OBJECTIVE
Primary aim was to modify Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ) to assess pelvic organ prolapse (POP) in Arabic Muslim women. Secondary aim was to compare functional and anatomical outcomes of POP repair.


METHODS
Questionnaire. A characteristic (prayer) was added to PFIQ. Linguistic validation of questionnaires was then done. Twenty cases were enrolled in a pilot study to test internal consistency and reliability. Subsequent study. Prospective study included women with symptomatic POP >or= stage II. History, examination by POP-Q, and administration of PFDI and PFIQ, were done before and 6 months after surgery.


RESULTS
Questionnaire. Internal consistency of added question was good (Cronbach alpha = 0.78). Test-retest reliability of individual PFIQ items was variable. Subsequent Study. Between September 2004 and February 2007, 78 consecutive women were included. Cystocele, rectocele, and no site predominated in 74.4%, 17.9% and 7.7% of cases, respectively. Preoperatively 19.2%, 15.4% and 47.4% reported stress, urge, and mixed incontinence, respectively. Overall and individual urinary symptoms scores improved significantly after surgery. There were significant improvements in individual symptoms of constipation, splint to defecate and losing not well formed stools. Low self-esteem was most negative impact of prolapse on quality of life (QoL) followed by prayer. After surgery 90% of subjects had anatomical cure. After surgery, QoL issues are significantly related to anatomic location of prolapse as determined by POP-Q.


CONCLUSIONS
Modified PFIQ and PFDI are suitable to assess POP among Muslim women. Postoperatively, many prolapse-related symptoms and QoL significantly improve after surgery on the short term with an anatomic cure rate of 90%.
El-Azab
Ahmed S
AS
Urology Department, Section of Female Urology and Voiding Dysfunction, Assiut University Hospital, Assiut University, Assiut, Egypt. elazab@hotmail.com
Abd-Elsayed
Alaa A
AA
Imam
Hala M K
HM
D000203:Activities of Daily Living; D000328:Adult; D018912:Arabs; D003248:Constipation / Q000503:physiopathology / Q000601:surgery; D052858:Cystocele / Q000150:complications / Q000523:psychology / Q000601:surgery; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007514:Islam; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D011391:Prolapse; D011788:Quality of Life; D020047:Rectocele / Q000150:complications / Q000523:psychology / Q000601:surgery; D012007:Rectum / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery; D014570:Urologic Diseases / Q000150:complications / Q000601:surgery; D013520:Urologic Surgical Procedures