Medical and social profile of patients with pelvic organ prolapse/stress urinary incontinence indicated for reconstructive surgery

Introduction. Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common urogynecological diseases that cause serious damage to the psychoemotional state of patients and have an extremely negative impact on their quality of life. The study of the medical and social profile of patients with these pathologies contributes to the choice of treatment tactics, informed decision-making on surgical treatment and shortening the period from the moment of the first doctor's recommendation about the need for surgery to the time of its implementation.

Objective. To study of the medical and social profile of patients with POP/SUI who have indications for reconstructive surgery. Conducting a comparative analysis of profiles in patients with POP and SUI. Determination of the factors that influenced the timing of patient’s decision on surgical treatment (decision-making period, DMP).

Materials & methods. The current single-center prospective study included 1176 patients with POP (n = 860) or SUI (n = 316) requiring pelvic floor reconstructive surgery. Upon admission to the department, all patients filled out a questionnaire specially designed for this study, which included socio-demographic information, information about previous treatment, gynecological and obstetric history, region and place of residence, labor status, financial situation, anthropometric indicators, physical activity level, sports/gymnastics, smoking status, and diet.

Results. The average age of the patients was 57.6 ± 11.7 years. When analyzing the data obtained, the following differences were found between the groups of patients with POP and SUI. Patients with POP are older than patients with SUI (p < 0.001). In the SUI group, the proportion of women with higher education (p = 0.023), working patients (p < 0.001), not following proper nutrition and not exercising (p < 0.001), as well as living a sexual life (p < 0.001) is higher. The duration of complaints related to POP / SUI averaged 6.7 ± 6.4 years. This period is longer in the group with SUI (p < 0.001). The duration of the decision-making period is significantly longer in the SUI group (p < 0.001). On average, the preparation for the operation took 3 ± 5.3 years. The decision-making period (DMP) is longer in patients with POP compared to those with SUI (p < 0.001). We have found differences in DMP duration depending on patients' level of education and employment. Women with higher education have a shorter DMP (p = 0.018 for the whole sample; p = 0.008 for the POP group). Retired women have a longer DMP compared to non-working women of working age (p = 0.028 for the entire sample; p = 0.026 for the POP group). For patients with stages POP 3 and 4, the duration of DMP is significantly longer than for women with stage 2 POP (p = 0.007). For women with SUI, there is no correlation between DMP and the degree of urinary incontinence at the time of surgery (p > 0.05).

Conclusion. In this study, the medical and social characteristics of patients in need of reconstructive surgery were demonstrated. These factors must be considered to make an informed decision about surgical treatment.

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