Advertisement

Prolapse-related knowledge and attitudes toward the uterus in women with pelvic organ prolapse symptoms

      Objective

      The objective of the study was to describe the basic knowledge about prolapse and attitudes regarding the uterus in women seeking care for prolapse symptoms.

      Study Design

      This was a cross-sectional study of English-speaking women presenting with prolapse symptoms. Patients completed a self-administered questionnaire that included 5 prolapse-related knowledge items and 6 benefit-of-uterus attitude items; higher scores indicated greater knowledge or more positive perception of the uterus. The data were analyzed using descriptive statistics and multiple linear regression.

      Results

      A total of 213 women were included. The overall mean knowledge score was 2.2 ± 1.1 (range, 0–5); 44% of the items were answered correctly. Participants correctly responded that surgery (79.8%), pessary (55.4%), and pelvic muscle exercises (34.3%) were prolapse treatment options. Prior evaluation by a female pelvic medicine and reconstructive surgery specialist (beta = 0.57, P = .001) and higher education (beta = 0.3, P = .07) was associated with a higher mean knowledge score. For attitude items, the overall mean score was 15.1 (4.7; range, 6–30). A total of 47.4% disagreed with the statement that the uterus is important for sex. The majority disagreed with the statement that the uterus is important for a sense of self (60.1%); that hysterectomy would make me feel less feminine (63.9%); and that hysterectomy would make me feel less whole (66.7%). Previous consultation with a female pelvic medicine and reconstructive surgery specialist was associated with a higher mean benefit of uterus score (beta = 1.82, P = .01).

      Conclusion

      Prolapse-related knowledge is low in women seeking care for prolapse symptoms. The majority do not believe the uterus is important for body image or sexuality and do not believe that hysterectomy will negatively affect their sex lives.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Swift S.
        • Woodman P.
        • O'Boyle A.
        • et al.
        Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects.
        Am J Obstet Gynecol. 2005; 192: 795-806
        • Lowder J.L.
        • Ghetti C.
        • Nikolajski C.
        • Oliphant S.S.
        • Zyczynski H.M.
        Body image perceptions in women with pelvic organ prolapse: a qualitative study.
        Am J Obstet Gynecol. 2011; 204: 441.e1-441.e5
        • Jelovsek J.E.
        • Barber M.D.
        Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life.
        Am J Obstet Gynecol. 2006; 194: 1455-1461
        • Shah A.D.
        • Massagli
        • Kohli N.
        • Rajan S.S.
        • Braaten K.P.
        • Hoyte L.
        A reliable, valid instrument to assess patient knowledge about urinary incontinence and pelvic organ prolapse.
        Int Urogynecol J. 2008; 19: 1283-1289
        • Branch L.G.
        • Walker L.
        • Wetle T.T.
        • DuBeau C.E.
        • Resnick N.M.
        Urinary incontinence knowledge among community-dwelling people 65 years of age and older.
        J Am Geriatr Soc. 1994; 42: 1257-1262
        • Holst K.
        • Wilson P.D.
        The presence of female urinary incontinence and reasons for not seeking treatment.
        N Z Med J. 1988; 101: 756-758
        • Kiyosaki K.
        • Ackerman A.L.
        • Histed S.
        • et al.
        Patients' understanding of pelvic floor disorders: what women want to know.
        Female Pelvic Med Reconstr Surg. 2012; 18: 137-142
        • Senekjan L.
        • Heintz K.
        • Egger M.J.
        • Nygaard I.
        Do women understand urogynecologic terminology?.
        Female Pelvic Med Reconstr Surg. 2011; 17: 215-217
        • Geoffrion R.
        • Robert M.
        • Ross S.
        • et al.
        Evaluating patient learning after an educational program for women with incontinence and pelvic organ prolapse.
        Int Urogynecol J. 2009; 20: 1243-1252
        • Olson A.L.
        • Smith V.J.
        • Bergstrom J.O.
        • Colling J.C.
        • Clark A.L.
        Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence.
        Obstet Gynecol. 1997; 89: 501-506
        • Wu J.M.
        • Kawasaki A.
        • Hundley A.F.
        • Dieter A.A.
        • Myers E.R.
        • Sung V.W.
        Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050.
        Am J Obstet Gynecol. 2011; 205: 230.e1-230.e5
        • Kuppermann M.
        • Learman L.A.
        • Schembri M.
        • et al.
        Predictors of hysterectomy use and satisfaction.
        Obstet Gynecol. 2010; 115: 543-551
        • Chauvin C.
        • Chereau E.
        • Ballester M.
        • Darai E.
        Potential relevance of pre-operative quality of life questionnaires to identify candidates for surgical treatment of genital prolapse: a pilot study.
        BMC Urol. 2012; 12: 9
        • Zielinski R.
        • Low L.K.
        • Tumbarello J.
        • Miller J.M.
        Body image and sexuality in women with pelvic organ prolapse.
        Urol Nurs. 2009; 29: 239-246
      1. Siddiqui NY, Fulton RG, Kuchibhatla M, Wu JM. Sexual function after vaginal versus nonvaginal prolapse surgery. Female Pelvic Med Reconstr Surg;18:4:239-42.

        • Kenton K.
        • Pham T.
        • Mueller E.
        • Brubaker L.
        Patient preparedness: an important predictor of surgical outcome.
        Am J Obstet Gynecol. 2007; 197 (654.e1-6)