Quality of life in women with pelvic floor dysfunction

Abstract

Background/Aim. Pelvic floor dysfunction is a frequent problem affecting more than 50% of women in peri- and postmenopause. Considering that ageing and menopause befall in the significant factors causing this issue, as well as the expected longevity of women in the world and in our country, pelvic floor dysfunction prevelence is foreseen to be even higher. The aim of the study was to evaluate impact of the symptoms of pelvic dysfunction on quality of life and examine body image satisfaction in adult women with pelvic organ prolapse presenting to tertiary care clinic for surgical treatment. Methods. This prospective case-control study included 50 patients who presented to tertiary care gynecology clinic for surgical treatment and 50 controls with normal pelvic floor support and without urinary incontinence who presented tertiary care gynecology clinic for other reasons. Both, patients and controls, completed two quastionnaires recommended for the evaluation of symptoms (Pelvic floor distress inventory - short forms) and quality of life impact (Pelvic floor impact questionnaire - short form) of pelvic organ prolapse, and Body Image Scale. Results. The patients scored significantly worse on the prolapse, urinary, colorectal scales and overall score of Pelvic floor distress inventory - 20 than controls subjects (134.91 vs 78.08; p < 0.01). The patients also measured significant decrease in condition- specific quality of life (89.23 vs 3.1; p < 0.01). They were more likely to feel self-conscious (78% vs 42%; p < 0.01), less likely to feel physically attractive (78% vs 22%; p < 0.01), more likely to have difficulty looking at themselves naked (70% vs 42%; p < 0.01), less likely to feel sexually attractive (64% vs 32%; p < 0.01), and less likely to feel feminine (56% vs 16%; p < 0.05), than controls. There were no differencies in their feeling of dissatisfaction with appearance when dressed, avoiding people because of appereance and overall dissatisfaction with their body. There was a positive correlation between decreased quality of life and body image in women with pelvic dysfunction. Conclusion. Women with pelvic floor dysfunction have decreased quality of life and body image.Uvod/Cilj. Disfunkcija karlicnog dna cest je problem koji se javlja kod vise od 50% zena u peri- i postmenopauzi. S obzirom na to da starenje i menopauza predstavljaju znacajne faktore za nastanak ovog problema, a kako se trajanje zivota zena u svetu, pa tako i kod nas, produzava, ocekuje se da ce prevalencija disfunkcije karlicnog dna u buducnosti biti jos veca. Cilj rada bio je da se ispita kvalitet zivota zena sa ostecenom funkcijom karlicnog dna kod kojih je planirano operativno lecenje, kao i da se ispita njihovo misljenje o sopstvenom fizickom izgledu. Metod. Istrazivanjem je obuhvaceno 50 bolesnica sa spadom genitalnih organa koje zahteva operativno lecenje bolesnica bez prisustva spada genitalnih organa i urinarne inkontinencije. Bolesnice su popunile upitnik koji se odnosio na prisustvo i tezinu tegoba disfunkcije karlicnog dna, Pelvic floor distress inventory - short form 20 (PFDI-20), upitnik o tome kako prisutne tegobe uticu na obavljanje svakodnevnih aktivnosti i kvalitet zivota (Pelvic floor impact questionnaire - short form) kao i upitnik o zadovoljstvu izgledom sopstvenog tela (Body Image Scale). Rezultati. Bolesnice ispitivane grupe imale su statisticki znacajno izrazenije simptome disfunkcije karlicnog dna nego bolesnice kontrolne grupe (vrednost PFDI-20 upitnika 134,91 prema 78,08; p < 0,01), kao i statisticki znacajnije snizen kvalitet zivota (89,23 prema 3,1; p < 0,01). Bolesnice su se stidele svog fizickog izgleda (78% prema 42%; p < 0,01), smatrale su da su manje fizicki privlacne (78% prema 22%; p < 0,01), manje zenstvene (56% prema 16%; p < 0,05), nezadovoljne izgledom bez odece (70% prema 42%; p < 0,01) i da su manje seksualno privlacne (64% prema 32%; p < 0,01). Ustanovljena je pozitivna korelacija izmedju stepena snizenja kvaliteta zivota i stepena nezadovoljstva fizickim izgledom. Nije nadjena razlika izmedju ispitivanih grupa u nezadovoljstvu izgledom kada su odevene i sveukupnim izgledom svog tela, kao i u izbegavanju drugih zbog izgleda. Zakljucak. Zene sa disfunkcijom karlicnog dna imaju snizen kvalitet zivota i nezadovoljne su sopstvenim fizickim izgledom.