title: Diagnostic delay in secondary care for lower urinary tract and pelvic organ prolapse symptoms in women.
abstract: OBJECTIVE
  Many women suffering from lower urinary tract symptoms (LUTS) and pelvic organ prolapse (POP) symptoms. However, only a fraction actually seeks medical advice shortly after the onset of these symptoms. In this study, we sought to evaluate and compare the delay in seeking medical help in this patient population.
  
  
  METHODS
  A prospective cohort study was performed among 223 consecutive women who were referred to the urogynecology outpatient clinic for secondary assessment of LUTS and POP symptoms. The exclusion criteria included previous evaluation for the same symptoms, inability to communicate, or refusal to participate in the study. Each patient completed a detailed questionnaire of all pelvic floor symptoms (urinary, bowel and prolapse and sexual). Delay was measured from the time the symptoms were first noted by the patient to the first visit to our clinic.
  
  
  RESULTS
  Mean length of delay was 43.8 months without significant difference between the LUTS and POP groups. The symptoms affected daily activities in 41.7% of the total group with no significant between-group difference. The POP group had significant decrease in intercourse (11.8%) than the LUTS group (4.3%) (p = 0.043). The main reason for the delay was patients' delay in 65.9% of the total group with no significant between-group difference. About 22.5% of all women thought that their primary health physician was responsible for the delay and only 2.2% blamed the medical system for the delay.
  
  
  CONCLUSIONS
  There is a significant delay in seeking secondary medical help in women with POP and LUTS.
authors.affiliation: Department of Obstetrics and Gynecology, Tel Aviv University, Tel Aviv, Israel. haimkr@clalit.org.il
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.forename: Ram
authors.initials: R
authors.lastname: Eitan
authors.forename: Ram
authors.initials: R
authors.lastname: Edward
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003075:Coitus; D057210:Delayed Diagnosis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006802:Human Activities; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D056887:Pelvic Organ Prolapse / Q000175:diagnosis*; D011446:Prospective Studies; D012017:Referral and Consultation; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult