Pilzek Anna L, Raker Christina A, Sung Vivian W
Division of Urogynecology Women and Infants Hospital, Alpert Medical School Brown University, 695 Eddy Street, Providence, RI, 02903, USA,
Int Urogynecol J. 2014 Mar;25(3):347-50. doi: 10.1007/s00192-013-2222-8. Epub 2013 Sep 18.
Our goal was to describe patients' personal treatment goals before pelvic floor dysfunction (PFD) surgery and goals achieved and not achieved 12 months after surgery, and to evaluate the association between postoperative symptoms and successful goal achievement.
We performed a secondary analysis using a de-identified database from a randomized trial comparing native tissue vs. graft-augmented rectocele repair. In their own words, women listed their top four treatment goals and 12 months after surgery whether those goals were or were not achieved. We categorized goals into symptom improvement (defecatory, bulge, incontinence, pain/discomfort) and functioning (physical, social, emotional, sexual). Women completed symptom questionnaires pre- and postoperatively. Goals were described using simple statistics. The association between defecatory, bulge, and incontinence symptoms and goal achievement was described using the chi-square test.
Of 160 participants in the database, 125 (78 %) met inclusion criteria. The most common preoperative goals were improvement in bulge (26.7 %), defecation (23.9 %), urinary incontinence (18.1 %), and pain/discomfort (6.2 %). Functioning goal categories included: sexual (7 %), emotional (7 %), physical (6.2 %), and social function (3.3 %). Postoperatively, goal categories in which improvement was achieved were urinary continence (70.5 %), sexual function (58.8 %), bulge reduction (56.9 %), defecation (51.7 %), physical (33.3 %), emotional (29.4 %), and social functioning (25 %). Of the women reporting postoperative defecatory or incontinence symptoms, half reported successful improvement in both goals.
Women predominantly reported symptom-related goals, and those goals are most frequently achieved postoperatively. Of women who reported defecatory and incontinence symptoms postoperatively, many still reported successful goal achievement in those areas.
我们的目标是描述盆腔脏器脱垂（PFD）手术前患者的个人治疗目标，以及术后12个月实现和未实现的目标，并评估术后症状与目标成功实现之间的关联。
我们使用了一项随机试验的去识别数据库进行二次分析，该试验比较了自体组织与移植物增强直肠膨出修补术。女性用自己的话列出了她们的前四个治疗目标，以及术后12个月这些目标是否实现。我们将目标分为症状改善（排便、膨出、尿失禁、疼痛/不适）和功能（身体、社交、情感、性功能）。女性在术前和术后完成症状问卷。目标用简单统计数据描述。排便、膨出和尿失禁症状与目标实现之间的关联用卡方检验描述。
数据库中的160名参与者中，125名（78%）符合纳入标准。最常见的术前目标是改善膨出（26.7%）、排便（23.9%）、尿失禁（18.1%）和疼痛/不适（6.2%）。功能目标类别包括：性功能（7%）、情感（7%）、身体（6.2%）和社会功能（3.3%）。术后，实现改善的目标类别有尿失禁（70.5%）、性功能（58.8%）、膨出减轻（56.9%）、排便（51.7%）、身体（33.3%）、情感（29.4%）和社会功能（25%）。在报告术后排便或尿失禁症状的女性中，一半报告这两个目标均成功改善。
女性主要报告与症状相关的目标，且这些目标术后最常实现。在术后报告排便和尿失禁症状的女性中，许多人仍报告在这些方面目标成功实现。
