Quality of life (QoL) improvement is one of the main outcomes in the management of pelvic organ prolapse as a chronic illness in women. This systematic review aimed to investigate the impact of surgical or pessary treatment for pelvic organ prolapse (POP) on quality of life.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. Electronic databases, including PubMed, Scopus, and Web of Science, were searched for original articles that evaluated the QoL before and after surgical interventions or pessary in pelvic organ prolapse from 1 January 2012 until 30 June 2022 with a combination of proper keywords. Included studies were categorized based on interventions, and they were tabulated to summarize the results.
Overall, 587 citations were retrieved. Of these, 76 articles were found eligible for final review. Overall, three categories of intervention were identified: vaginal surgeries (47 studies), abdominal surgeries (18 studies), and pessary intervention (11 studies). Almost all interventions were associated with improved quality of life. The results of the meta-analysis showed a significant association between the employment of surgical approach techniques (including vaginal and abdominal surgeries) and the quality of life (Pelvic Floor Distress Inventory (PFDI) (MD: -48.08, 95% CI: -62.34 to -33.77, p-value < 0.01), Pelvic Floor Impact Questionnaire (PFIQ) (MD: -33.41, 95% CI: -43.48 to -23.34, p < 0.01)) and sexual activity of patients with pelvic organ prolapse (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) (MD: 4.84, 95% CI: 1.75 to 7.92, p < 0.01)). Furthermore, narrative synthesis for studies investigating the effect of the pessary approach showed a positive association between the use of this instrument and improvement in the quality of life and sexual activity.
The results of our study revealed a significant improvement in the women's quality of life following abdominal and vaginal reconstructive surgery. The use of pessary was also associated with increased patient quality of life.
Journal of clinical medicine. 2022 Dec 01*** epublish ***
Zinat Ghanbari, Marjan Ghaemi, Arman Shafiee, Parivash Jelodarian, Reihaneh Sadat Hosseini, Shahla Pouyamoghaddam, Ali Montazeri
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran 1417613151, Iran., Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj 3149969415, Iran., Department of Obstetrics and Gynecology, Fertility Infertility and Perinatology Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6135715794, Iran., Health Metric Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran 1983963113, Iran.