Medical University of South Carolina - College of Medicine, Charleston, SC, USA.
Int Urogynecol J. 2024 Oct;35(10):2003-2011. doi: 10.1007/s00192-024-05910-4. Epub 2024 Sep 10.
Pelvic organ prolapse (POP) has a profound influence on a woman's quality of life (QoL). Assessment of QoL using patient-reported outcome (PRO) measures in pelvic organ prolapse surgery is common practice in developed countries, but despite the burden of POP in developing countries, such as Ethiopia, the use of PROs to record preoperative and postoperative QoL scores is limited. This study is aimed at assessing the QoL among Ethiopian women with POP before and after surgery using the validated Pelvic Organ Quality of Life (P-QoL) questionnaire. Additionally, we will compare postoperative QoL measurements of reconstructive procedures with those of obliterative procedures.
This is a prospective observational study conducted at a single hospital in Ethiopia on women who were scheduled for surgery for symptomatic POP. Patients' QoL was assessed preoperatively using the P-QoL questionnaire and at each subsequent follow-up visit for 1 year (3, 6, 9, and 12 months). Patients undergoing an obliterative procedure were evaluated and compared with those having reconstructive procedures.
The mean score for general health perceptions, prolapse impact, role limitations, physical limitations, social limitations, and emotions was 0 at 12 months postoperatively. Despite significant improvements from baseline, personal relationships, sleep or energy disturbance, and symptom severity measures continued to negatively impact QoL at 12 months postoperatively.
Quality of life among Ethiopian women with POP is poor across all domains. Native tissue repair employing either reconstructive or obliterative methods significantly improves QoL across all domains up to 12 months postoperatively. The use of validated tools to assess PROs is essential to provide evidence-based care that improves QoL in ways that are meaningful to patients.
盆腔器官脱垂（POP）对女性的生活质量（QoL）有深远影响。在发达国家，对接受盆腔器官脱垂手术的患者使用患者报告的结局（PRO）测量来评估 QoL 是常见做法，但尽管 POP 在发展中国家（如埃塞俄比亚）的负担很重，使用 PRO 来记录术前和术后 QoL 评分的做法却很有限。本研究旨在使用经过验证的盆腔器官生活质量（P-QoL）问卷评估埃塞俄比亚 POP 女性手术前后的 QoL。此外，我们将比较重建性手术与闭塞性手术的术后 QoL 测量结果。
这是在埃塞俄比亚的一家单家医院进行的前瞻性观察性研究，研究对象为计划因症状性 POP 而接受手术的女性。患者在术前使用 P-QoL 问卷评估 QoL，并在术后 1 年的每次随访中（3、6、9 和 12 个月）进行评估。评估并比较了行闭塞性手术的患者与行重建性手术的患者。
术后 12 个月时，一般健康感知、脱垂影响、角色限制、身体限制、社会限制和情绪的平均得分均为 0。尽管与基线相比有显著改善，但个人关系、睡眠或精力紊乱以及症状严重程度等方面仍在术后 12 个月对 QoL 产生负面影响。
埃塞俄比亚 POP 女性的生活质量在所有领域都很差。使用天然组织修复（无论是重建性方法还是闭塞性方法）在术后 12 个月内显著改善了所有领域的 QoL。使用经过验证的工具来评估 PRO 对于提供以患者为中心、改善 QoL 的循证护理至关重要。
