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A generic health-related quality of life instrument for assessing pelvic organ prolapse surgery: correlation with condition-specific outcome measures

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Abstract

Introduction and hypothesis

The aim of this study was to investigate the use of a generic and globally accessible instrument for assessing health-related quality of life (HR-QoL) in pelvic organ prolapse (POP) surgery.

Methods

In a prospective multicenter setting, 207 women underwent surgery for apical prolapse [stage ≥2, Pelvic Organ Prolapse Quantificcation (POP-Q) system] with or without anterior wall defect. Demographic and surgical characteristics were collected before surgery. Results of the 15-dimensional (15D) instrument and condition-specific pelvic floor symptoms as assessed using the Pelvic Floor Distress Inventory questionnaire (PFDI-20), including its subscales Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Colorectal–Anal Distress Inventory-8 (CRADI-8), and Urinary Distress Inventory-6 (UDI-6), were assessed preoperatively and 2 months and 1 year after surgery.

Results

HR-QoL as estimated by 15D was improved 1 year after surgery (p < 0.001). Prolapse-related 15D profile-index measures (excretion, discomfort, sexual activity, distress, and mobility) were significantly improved after surgery (p < 0.05–0.001). Significant inverse associations were detected between increased 15D scores and a decrease in PFDI-20 and subscale scores (p < 0.001), indicating improvements on both instruments.

Conclusions

Generic HR-QoL as estimated by 15D improved significantly after apical POP surgery and correlated with improvements of condition-specific outcome measures. These results suggest that a comprehensive evaluation of global HR-QoL is valid in assessing pelvic reconstructive surgery and may provide novel and important insights into previously understudied areas, such as cost–utility and cost-effectiveness analysis after urogynecological surgery.

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Funding

The study was supported by an investigator-initiated grant from Boston Scientific, grants from the Finnish Medical Foundation, and the Swedish Research Council.

Statistical analysis was performed in collaboration with statistician Fredrik Johansson, M.Sc, Department of Clinical Sciences, Medical Library, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.

The multicenter study was supported by an investigator-initiated grant from Boston Scientific, grants from the Finnish Medical Foundation, and the Swedish Research Council.

Author information

Authors and Affiliations

  1. Stockholm Urogynecological Clinic, Stockholm, Sweden

    Daniel Altman

  2. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Daniel Altman

  3. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    Kirk Geale

  4. Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, S-182 88 Danderyd, Stockholm, Sweden

    Christian Falconer & Edward Morcos

Authors
  1. Daniel Altman
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  2. Kirk Geale
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  3. Christian Falconer
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  4. Edward Morcos
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Corresponding author

Correspondence to Edward Morcos.

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Ethical approval

The study was approved by the Stockholm Regional Ethical Review Board of Ethics at Karolinska Institutet, Stockholm, Sweden, and ethic review committees in the participating countries as appropriate.

Conflicts of interest

E. Morcos reports no conflicts of interest. K. Geale provides consulting services as an employee of Quantify Research, although this work was done independently. D. Altman has received speaking and advisory honoraria from Gedeon Richter, Pfizer, Astellas, Invent Medic, and Gynecare. C. Falconer has received speaking and advisory honoraria from Boston Scientific and Johnson & Johnson.

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Altman, D., Geale, K., Falconer, C. et al. A generic health-related quality of life instrument for assessing pelvic organ prolapse surgery: correlation with condition-specific outcome measures. Int Urogynecol J 29, 1093–1099 (2018). https://doi.org/10.1007/s00192-018-3587-5

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  • DOI: https://doi.org/10.1007/s00192-018-3587-5

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