Conceptual framework for patient-important treatment outcomes for pelvic organ prolapse

Authors

  • Vivian W. Sung,

    Corresponding author
    1. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
    • Correspondence to: Vivian W. Sung, M.D., M.P.H., Division of Urogynecology and Reconstructive Pelvic Surgery, Women and Infants' Hospital/Warren Alpert Medical School at Brown University, 695 Eddy Street, Providence, RI 02903. E-mail: vsung@wihri.org

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  • Rebecca G. Rogers,

    1. Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico
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  • Matthew D. Barber,

    1. Center for Urogynecology and Reconstructive Pelvic Surgery, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio
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  • Melissa A. Clark

    1. Department of Epidemiology and Obstetrics and Gynecology, Alpert Medical School and Program in Public Health of Brown University, Providence, Rhode Island
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  • Mickey Karram led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of Interest: None.

Abstract

Aims

To develop a comprehensive conceptual framework representing the most important outcomes for women seeking treatment for pelvic organ prolapse (POP).

Methods

Twenty-five women with POP were recruited and participated in four semi-structured focus groups to refine and assess the content validity of a conceptual framework representing patient-important outcomes for POP. Specifically, the focus groups addressed the following three aims: (1) to evaluate the content and appropriateness of domains in our framework; (2) to identify gaps in the framework; and (3) to determine the relative importance of our framework domains from the patient perspective. Sessions were transcribed, coded, and qualitatively and quantitatively analyzed using analytic induction and deductive analysis to identify themes and domains relevant to women with POP.

Results

Our focus groups confirmed the importance of vaginal bulge symptoms (discomfort, bother, and adaptation), and the overarching domains and subdomains of physical (physical function and participation), social (social function, relationships, and sexual function), and mental health (emotional distress, preoccupation, and body image). Patients ranked outcomes in the following order of importance: (1) the resolution of vaginal bulge symptoms, (2) improvement in physical function; (3) improvement in sexual function; (4) improvement in body image perception; and (5) improvement in social function.

Conclusions

We developed a conceptual framework for patient important outcomes of women seeking treatment for POP. This framework can improve the transparency and interpretation of POP study findings from the patient perspective. Vaginal bulge and its associated discomfort are most important for the definition of POP treatment success from the patient perspective. Neurourol. Urodynam. 33:414–419, 2014. © 2013 Wiley Periodicals, Inc.

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