title: Pelvic organ prolapse: a disease of silence and shame.
abstract: OBJECTIVE
  The objectives of this study are to better understand women's experience with pelvic organ prolapse (POP) and to compare this experience between English-speaking and Spanish-speaking women.
  
  
  METHODS
  Women with POP were recruited from female urology and urogynecology clinics. Eight focus groups of 6 to 8 women each were assembled-4 groups in English and 4 in Spanish. A trained bilingual moderator conducted the focus groups. Topics addressed patients' perceptions, their knowledge and experience with POP symptoms, diagnostic evaluation, physician interactions, and treatments.
  
  
  RESULTS
  Both English-speaking and Spanish-speaking women expressed the same preliminary themes-lack of knowledge regarding the prevalence of POP, feelings of shame regarding their condition, difficulty in talking with others, fear related to symptoms, and emotional stress from coping with POP. In addition, Spanish-speaking women included fear related to surgery and communication concerns regarding the use of interpreters. Two overarching concepts emerged-first, a lack of knowledge, which resulted in shame and fear and second, public awareness regarding POP is needed. From the Spanish speaking, an additional concept was the need to address language barriers and the use of interpreters.
  
  
  CONCLUSIONS
  Both English-speaking and Spanish-speaking women felt ashamed of their POP and were uncomfortable speaking with anyone about it, including physicians. Educating women on the meaning of POP, symptoms, and available treatments may improve patients' ability to discuss their disorder and seek medical advice; for Spanish-speaking women, access to translators for efficient communication is needed.
authors.affiliation: From the *Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; †Departments of Urology, and ‡Obstetrics and Gynecology, Cedars-Sinai Medical Center, Beverly Hills; §Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, Sylmar; ∥Division of Urology, Department of Surgery, UCLA Medical Center, Los Angeles; ¶UCLA School of Nursing, Los Angeles, CA; #Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; and **Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Beverly Hills, CA.
authors.forename: Gena C
authors.initials: GC
authors.lastname: Dunivan
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Anger
authors.forename: Alexandriah
authors.initials: A
authors.lastname: Alas
authors.forename: Cecilia
authors.initials: C
authors.lastname: Wieslander
authors.forename: Claudia
authors.initials: C
authors.lastname: Sevilla
authors.forename: Stephanie
authors.initials: S
authors.lastname: Chu
authors.forename: Sally
authors.initials: S
authors.lastname: Maliski
authors.forename: Biatris
authors.initials: B
authors.lastname: Barrera
authors.forename: Karyn
authors.initials: K
authors.lastname: Eiber
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003144:Communication Barriers; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D007802:Language; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000208:ethnology; D056887:Pelvic Organ Prolapse / Q000208:ethnology / Q000523:psychology*; D012752:Shame; D014481:United States / Q000208:ethnology