The study – involving the NMAHP-RU unit at Glasgow Caledonian University, the University of Leicester and NHS Greater Glasgow and Clyde – involved four focus groups with a total of 22 women who have received prolapse care through urogynaecology services across three NHS UK regions.
Women were asked about their experiences of living with prolapse and of interacting with health professionals when seeking help for symptoms, receiving a diagnosis, making treatment decisions, undergoing treatments, and follow-up care. They were also asked about their thoughts on improving services and care in future to meet the needs of women.
The team found that women received little or no choice in terms of prolapse treatment and had little involvement in decision-making. Health professionals often influenced treatment decisions by the way they outlined the available options and there was little or no discussion around the pros and cons of certain treatments, women’s lived experience of prolapse, and experience of any prior treatments.
In addition, the study found that women regarded the process of undergoing different prolapse treatments – such as pelvic floor muscle training (PFMT), vaginal pessaries, or surgery – as one of trial and error. Physiotherapy-based treatments, including PFMT, were valued by women as it helped them to regain control over their symptoms, improving their quality of life.
Dr Abhyankar said: “Our findings echo women’s experiences from across the world – including Europe, America and Asia – but also provide new evidence and unique insights into their experiences of involvement in decisions around diagnosis and treatment.
“The study highlights a need for greater awareness and education among women, as well as healthcare professionals about prolapse and its treatment. Women presenting with prolapse symptoms need to be listened to by healthcare professionals, offered better information about treatment choices, and supported to make a decision that is right for them.
“We hope our research will provide a foundation for designing and improving health services in the UK and internationally.”
The research, Women’s experiences of receiving care for pelvic organ prolapse: a qualitative study, is published in BMC Women’s Health. It forms part of the larger PROPEL study, funded by the National Institute for Health Research (NIHR) and led by Principal Investigator Professor Margaret Maxwell, Director of NMAHP-RU at Stirling.