title: Improved quality of life after surgery for pelvic organ prolapse in Nepalese women.
abstract: BACKGROUND
  Pelvic organ prolapse (POP) is a common gynecological condition that can affect quality of life (QOL) in women. In Nepal, the prevalence of POP is high, but many affected women are still deprived of treatment. Vaginal hysterectomy with pelvic floor repair is one of the common treatment options for advanced POP. However, QOL outcomes after surgery have not been reported in low-income countries. Thus, we aimed to examine changes in QOL among Nepalese women with POP after such surgery.
  
  
  METHODS
  This longitudinal study was conducted in the selected central and peripheral hospitals in Nepal where vaginal hysterectomy was being performed free of cost for POP. A baseline study first measured the QOL domains (physical, psychological, social relationships and environment) among 252 women with advanced POP. Follow-up data was then collected at six weeks and three months after surgery. Among the 177 women that were available at six weeks post-surgery, 166 participated in the follow-up study at three months post-surgery. To evaluate QOL at baseline, 142 women with no history of POP were included as a comparison group.
  
  
  RESULTS
  The mean scores across QOL domains improved from baseline to 3 months after surgery. The baseline score for the physical domain increased from 11.2 to 12.8 at six weeks and 13.5 at three months post-surgery (p < 0.001); the psychological domain score increased from 11.6 to 13.1 at six weeks and 13.8 at three months post-surgery (p < 0.001); the social relationships domain score increased from 13.6 to 14.4 at six weeks and 15.0 at three months post-surgery (p < 0.001); and the environmental domain score increased from 12.9 to 13.9 at six weeks and 14.0 at three months post-surgery (p < 0.001).
  
  
  CONCLUSIONS
  QOL progressively improved among women undergoing surgery for POP. Such surgical services need to be scaled up for treatment of advanced POP in low-income countries.
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
authors: Rolina
authors: R
authors: Dhital
authors: Keiko
authors: K
authors: Otsuka
authors: Krishna C
authors: KC
authors: Poudel
authors: Junko
authors: J
authors: Yasuoka
authors: Ganesh
authors: G
authors: Dangal
authors: Masamine
authors: M
authors: Jimba
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000523:psychology*; D008137:Longitudinal Studies; D008875:Middle Aged; D009390:Nepal; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D011203:Poverty; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
references: East Afr Med J. 1995 Jan;72(1):2-9
references: 7781550
references: Int Urogynecol J. 2010 Jul;21(7):855-60
references: 20333505
references: Qual Life Res. 2010 Mar;19(2):157-66
references: 20047029
references: Am J Obstet Gynecol. 1996 Jul;175(1):10-7
references: 8694033
references: J Gen Intern Med. 2011 Sep;26(9):979-86
references: 21369770
references: J Reprod Med. 2009 Aug;54(8):488-92
references: 19769194
references: Reprod Health Matters. 2004 May;12(23):166-75
references: 15242225
references: Obstet Gynecol. 2009 Mar;113(3):609-616
references: 19300324
references: Curr Diabetes Rev. 2009 May;5(2):112-9
references: 19442096
references: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jul;18(7):799-806
references: 17111276
references: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jun;19(6):851-5
references: 18185902
references: BMC Womens Health. 2009 Apr 20;9:9
references: 19379514
references: J Indian Med Assoc. 1995 Feb;93(2):47-8
references: 7658035
references: BMC Cancer. 2012 Oct 02;12:441
references: 23031647
references: Obstet Gynecol. 2007 Jun;109(6):1396-403
references: 17540813
references: Indian J Public Health. 1999 Oct-Dec;43(4):140-3
references: 11243061
references: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Nov;18(11):1343-6
references: 17333434
references: Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):299-305
references: 9988790
references: Am J Obstet Gynecol. 2006 May;194(5):1455-61
references: 16647928