title: Disability-adjusted life years (DALYs) in general population with pelvic organ prolapse: a study based on the prolapse quality-of-life questionnaire (P-QOL).
abstract: OBJECTIVE
  To evaluate the impact of pelvic organ prolapse (POP) on quality of life in symptomatic and asymptomatic women.
  
  
  METHODS
  This is a cross-sectional study in a general population of adult women. Symptomatic and asymptomatic women with POP were studied. Symptomatic women were defined as those who reported the presence/feeling of lump/bulge/pressure in the vagina and on vaginal examination had the sign of POP defined as the leading edge of the vagina wall/cervix presenting at or beyond the hymeneal remnants. All women were asked to self-complete the Prolapse Quality of life questionnaire (P-QOL) to estimate the disability-adjusted life-years (DALYs) lost due to symptomatic POP. DALYs for a symptomatic POP were calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the years lost due to disability (YLD). To determinate the optimal threshold of each P-QOL domain in relationship to the symptomatic POP population a receiver operating curve (ROC) and area under curve (AUC) analysis were used.
  
  
  RESULTS
  A total of 785 were recruited. Only 539 (68.7%) consented to participate in the study. The mean age was 47 years (range 18-82 years). The total scores for each of the P-QOL domains were found to be significantly higher in symptomatic prolapse subjects compared to asymptomatic subjects (p<0.05). Estimated DALY lost per year per 1000 women obtained were 217.0 vs 324.8, lost years of 14.5 vs 10.3 in 50 vs 60-year old women.
  
  
  CONCLUSIONS
  In this group of women with POP the quality of life is severely affected. The DALYs revealed lost years due to symptomatic POP.
authors.affiliation: Department of Public Health, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
authors.forename: Viera
authors.initials: V
authors.lastname: Svihrova
authors.affiliation: Department of Urology, Jessenius School of Medicine, Comenius University, Martin, Slovakia. Electronic address: svihra@jfmed.uniba.sk.
authors.forename: Jan
authors.initials: J
authors.lastname: Svihra
authors.affiliation: Department of Urology, Jessenius School of Medicine, Comenius University, Martin, Slovakia.
authors.forename: Jan
authors.initials: J
authors.lastname: Luptak
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Swift
authors.affiliation: Department of Urogynecology, St. Mary's Hospital, Imperial College, London, UK.
authors.forename: G Alessandro
authors.initials: GA
authors.lastname: Digesu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D058070:Asymptomatic Diseases; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000453:epidemiology*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012372:ROC Curve; D018154:Slovakia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Disability; P-QOL; POP-Q; Quality of life; Uterovaginal prolapse