From the University of Iowa Carver College of Medicine, Iowa City, IA.
University of Wisconsin School of Medicine and Public Health, Madison, WI.
Female Pelvic Med Reconstr Surg. 2021 Jun 1;27(6):337-343. doi: 10.1097/SPV.0000000000001069.
Using the American Urogynecologic Society multicenter Pelvic Floor Disorder Registry for Research, we (1) compared generic quality of life (QOL) in women planning pelvic organ prolapse (POP) treatment (surgery vs pessary), (2) correlated generic and condition-specific QOL scores, and (3) identified associations between generic QOL and other factors.
This cross-sectional analysis assessed generic physical and mental QOL using the Patient-Reported Outcomes Measurement Information System Global Health Scale at baseline. Global Physical and Mental T-scores center on a representative US population sample (mean [SD], 50 [10]; higher scores, better health). Condition-specific QOL was assessed with Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and POP/Urinary Incontinence Sexual Function Questionnaire. Linear regression models identified associations between clinical factors and Global Physical/Mental scores.
Five hundred sixty-eight women (419 surgery, 149 pessary) were included. Surgery patients were younger, heavier, and more often sexually active (all P's ≤ 0.01). Global Physical scores were lower in the surgery versus pessary group, but not likely clinically meaningful (mean [SD], 48.8 [8.1] vs 50.4 [8.5]; P = 0.035); Global Mental scores were similar (51.4 [8.4] vs 51.9 [9.5], P = 0.56). Global Health scores correlated with Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and POP/Urinary Incontinence Sexual Function Questionnaire scores (all P's < 0.0001). In multivariable models, menopause was associated with better physical QOL, and constipation, coronary artery disease, pelvic pain, and increased body mass index with worse physical QOL. Age was associated with better mental QOL, and constipation, fecal incontinence, pelvic pain, and coronary artery disease with worse mental QOL.
Women choosing POP surgery versus pessary had similar physical and mental generic QOL.
利用美国泌尿妇科协会多中心盆底功能障碍研究注册中心，我们（1）比较了计划接受盆腔器官脱垂（POP）治疗（手术与阴道子宫托）的女性的通用生活质量（QOL），（2）分析了通用和特定于疾病的 QOL 评分之间的相关性，以及（3）确定了通用 QOL 与其他因素之间的关联。
本横断面分析在基线时使用患者报告的结局测量信息系统全球健康量表评估通用身体和精神 QOL。全球身体和精神 T 评分以代表性的美国人群样本为中心（平均[标准差]，50[10]；分数越高，健康状况越好）。特定于疾病的 QOL 使用盆底窘迫量表、盆底冲击问卷和 POP/尿失禁性功能问卷进行评估。线性回归模型确定了临床因素与全球身体/精神评分之间的关联。
共纳入 568 名女性（419 例手术，149 例阴道子宫托）。手术组患者更年轻、更重且更常活跃，这一点均具有统计学意义（所有 P 值均≤0.01）。与阴道子宫托组相比，手术组患者的全球身体评分较低，但差异无临床意义（平均[标准差]，48.8[8.1] vs 50.4[8.5]；P=0.035）；全球心理评分相似（51.4[8.4] vs 51.9[9.5]，P=0.56）。全球健康评分与盆底窘迫量表、盆底冲击问卷和 POP/尿失禁性功能问卷评分相关（均 P<0.0001）。在多变量模型中，绝经与更好的身体 QOL 相关，而便秘、冠心病、盆腔痛和体重指数增加与更差的身体 QOL 相关。年龄与更好的心理 QOL 相关，而便秘、粪便失禁、盆腔痛和冠心病与更差的心理 QOL 相关。
选择 POP 手术与阴道子宫托的女性具有相似的身体和精神通用 QOL。
