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Published in: International Urogynecology Journal 8/2018

01-08-2018 | Original Article

Effect of generalized anxiety disorders on the success of pessary treatment for pelvic organ prolapse

Authors: Fang-Fang Ai, Meng Mao, Ye Zhang, Jia Kang, Lan Zhu

Published in: International Urogynecology Journal | Issue 8/2018

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Abstract

Introduction and hypothesis

Our aim was to evaluate the impact of generalized anxiety disorders (GAD) on the effectiveness of pessary treatment for pelvic organ prolapse (POP) in postmenopausal women.

Methods

One-hundred and ten women with symptomatic POP who underwent pessary treatment were enrolled in this prospective study. Subjective evaluations of pelvic floor symptoms were assessed using the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), both at baseline and at the 3-month follow-up visit after pessary use. GAD was measured by the Generalized Anxiety Disorder-7 (GAD-7). Independent samples t tests, Mann–Whitney U test, chi-square test, Fisher’s exact test, and Wilcoxon signed rank test were used to analyze data.

Results

Twenty-one patients (20.6%) had GAD at baseline. After 3 months of pessary use, PFIQ-7, PFDI-20, and GAD scores were significantly improved in all participants (P < 0.001). In the GAD-negative group, total PFIQ-7 and PFDI-20 scores, including all subscales scores, were significantly decreased from baseline to posttreatment (P < 0.05). However, in the GAD-positive group, both PFIQ-7 and PFDI-20 scores, including subscales, were also significantly decreased from baseline to posttreatment (P < 0.05), except for subscale Colorectal–Anal Impact Questionnaire (CRAIQ-7) of PFIQ-7 (P = 0.225), which represented the impact on quality of life (QoL) from bowel dysfunction.

Conclusions

Both groups of women with or without GAD showed significant improvement in QoL scores after 3 months of pessary treatment. GAD had no influence on the success of pessary treatment for POP.
Literature
2.
go back to reference Ghetti C, Skoczylas LC, Oliphant SS, Nikolajski C, Lowder JL. The emotional burden of pelvic organ prolapse in women seeking treatment. Female Pelvic Med Reconstr Surg. 2015;21:332–8.CrossRefPubMedPubMedCentral Ghetti C, Skoczylas LC, Oliphant SS, Nikolajski C, Lowder JL. The emotional burden of pelvic organ prolapse in women seeking treatment. Female Pelvic Med Reconstr Surg. 2015;21:332–8.CrossRefPubMedPubMedCentral
3.
go back to reference Vrijens D, Berghmans B, Nieman F, van Os J, van Koeveringe G, Leue C. Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions-a cross sectional cohort study at a pelvic care Centre. Neurourol Urodyn. 2017;36:1816–23.CrossRefPubMed Vrijens D, Berghmans B, Nieman F, van Os J, van Koeveringe G, Leue C. Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions-a cross sectional cohort study at a pelvic care Centre. Neurourol Urodyn. 2017;36:1816–23.CrossRefPubMed
4.
go back to reference Yazdany T, Bhatia N, Reina A. Association of depression and anxiety in underserved women with and without urinary incontinence. Female Pelvic Med Reconstr Surg. 2014;20:349–53.CrossRefPubMed Yazdany T, Bhatia N, Reina A. Association of depression and anxiety in underserved women with and without urinary incontinence. Female Pelvic Med Reconstr Surg. 2014;20:349–53.CrossRefPubMed
6.
go back to reference Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000;157:669–82.CrossRefPubMed Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. Am J Psychiatry. 2000;157:669–82.CrossRefPubMed
7.
go back to reference Tolin DF, Robison JT, Gaztambide S, Blank K. Anxiety disorders in older puerto rican primary care patients. Am J Geriatr Psychiatry. 2005;13:150–6.CrossRefPubMed Tolin DF, Robison JT, Gaztambide S, Blank K. Anxiety disorders in older puerto rican primary care patients. Am J Geriatr Psychiatry. 2005;13:150–6.CrossRefPubMed
8.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–602.CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–602.CrossRefPubMed
9.
go back to reference Bogner HR, Gallo JJ, Swartz KL, Ford DE. Anxiety disorders and disability secondary to urinary incontinence among adults over age 50. Int J Psychiatry Med. 2002;32:141–54.CrossRefPubMedPubMedCentral Bogner HR, Gallo JJ, Swartz KL, Ford DE. Anxiety disorders and disability secondary to urinary incontinence among adults over age 50. Int J Psychiatry Med. 2002;32:141–54.CrossRefPubMedPubMedCentral
10.
go back to reference Khan ZA, Whittal C, Mansol S, Osborne LA, Reed P, Emery S. Effect of depression and anxiety on the success of pelvic floor muscle training for pelvic floor dysfunction. J Obstet Gynaecol. 2013;33:710–4.CrossRefPubMed Khan ZA, Whittal C, Mansol S, Osborne LA, Reed P, Emery S. Effect of depression and anxiety on the success of pelvic floor muscle training for pelvic floor dysfunction. J Obstet Gynaecol. 2013;33:710–4.CrossRefPubMed
11.
go back to reference Cundiff GW, Weidner AC, Visco AG, Bump RC, Addison WA. A survey of pessary use by members of the American urogynecologic society. Obstet Gynecol. 2000;95:931–5.PubMed Cundiff GW, Weidner AC, Visco AG, Bump RC, Addison WA. A survey of pessary use by members of the American urogynecologic society. Obstet Gynecol. 2000;95:931–5.PubMed
12.
go back to reference Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;75(1):10–7.CrossRef Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;75(1):10–7.CrossRef
13.
go back to reference Haylen BT, de Ridder D, Freeman RM, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.PubMed Haylen BT, de Ridder D, Freeman RM, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.PubMed
14.
go back to reference Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13.CrossRefPubMed Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13.CrossRefPubMed
15.
go back to reference Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed
16.
go back to reference He XY, Li CB, Qian J, Cui HS, Wu WY. Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients. Shanghai Arch Psychiatry. 2010;22:200–3. He XY, Li CB, Qian J, Cui HS, Wu WY. Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients. Shanghai Arch Psychiatry. 2010;22:200–3.
17.
go back to reference Ghetti C, Lowder JL, Ellison R, Krohn MA, Moalli P. Depressive symptoms in women seeking surgery for pelvic organ prolapse. Int Urogynecol J. 2010;21:855–60.CrossRefPubMedPubMedCentral Ghetti C, Lowder JL, Ellison R, Krohn MA, Moalli P. Depressive symptoms in women seeking surgery for pelvic organ prolapse. Int Urogynecol J. 2010;21:855–60.CrossRefPubMedPubMedCentral
18.
go back to reference Zeleke BM, Ayele TA, Woldetsadik MA, Bisetegn TA, Adane AA. Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia. BMC Psychiatry. 2013;26(13):236.CrossRef Zeleke BM, Ayele TA, Woldetsadik MA, Bisetegn TA, Adane AA. Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia. BMC Psychiatry. 2013;26(13):236.CrossRef
19.
go back to reference Ghetti C, Lee M, Oliphant S, Okun M, Lowder JL. Sleep quality in women seeking care for pelvic organ prolapse. Maturitas. 2015;80:155–61.CrossRefPubMed Ghetti C, Lee M, Oliphant S, Okun M, Lowder JL. Sleep quality in women seeking care for pelvic organ prolapse. Maturitas. 2015;80:155–61.CrossRefPubMed
20.
go back to reference Krause HG, Hall BA, Ng S, Natukunda H, Singasi I, Goh JTW. Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda. Int Urogynecol J. 2017;28:893–7.CrossRefPubMed Krause HG, Hall BA, Ng S, Natukunda H, Singasi I, Goh JTW. Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda. Int Urogynecol J. 2017;28:893–7.CrossRefPubMed
21.
go back to reference Lim L, Ng TP, Chua HC, Chiam PC, Won V, Lee T, et al. Generalised anxiety disorder in Singapore: prevalence, co-morbidity and risk factors in a multi-ethnic population. Soc Psychiatry Psychiatr Epidemiol. 2005;40:972–9.CrossRefPubMed Lim L, Ng TP, Chua HC, Chiam PC, Won V, Lee T, et al. Generalised anxiety disorder in Singapore: prevalence, co-morbidity and risk factors in a multi-ethnic population. Soc Psychiatry Psychiatr Epidemiol. 2005;40:972–9.CrossRefPubMed
22.
go back to reference Lowder JL, Ghetti C, Nikolajski C, Oliphant SS, Zyczynski HM (2011) Body image perceptions in women with pelvic organ prolapse: a qualitative study. Am J Obstet Gynecol 204:441.e1-5. Lowder JL, Ghetti C, Nikolajski C, Oliphant SS, Zyczynski HM (2011) Body image perceptions in women with pelvic organ prolapse: a qualitative study. Am J Obstet Gynecol 204:441.e1-5.
23.
go back to reference Steele TO, Mace JC, Smith TL. Does comorbid anxiety predict quality of life outcomes in patients with chronic rhinosinusitis following endoscopic sinus surgery? Int Forum Allergy Rh. 2015;5:829–38.CrossRef Steele TO, Mace JC, Smith TL. Does comorbid anxiety predict quality of life outcomes in patients with chronic rhinosinusitis following endoscopic sinus surgery? Int Forum Allergy Rh. 2015;5:829–38.CrossRef
24.
go back to reference Adogwa O, Elsamadicy AA, Cheng J, et al. Pretreatment of anxiety before cervical spine surgery improves clinical outcomes: a prospective, single-institution experience. World Neurosurg. 2016;88:625–30.CrossRefPubMed Adogwa O, Elsamadicy AA, Cheng J, et al. Pretreatment of anxiety before cervical spine surgery improves clinical outcomes: a prospective, single-institution experience. World Neurosurg. 2016;88:625–30.CrossRefPubMed
25.
go back to reference Griebling TL. Vaginal pessaries for treatment of pelvic organ prolapse in elderly women. Curr Opin Urol. 2016;26:201–6.CrossRefPubMed Griebling TL. Vaginal pessaries for treatment of pelvic organ prolapse in elderly women. Curr Opin Urol. 2016;26:201–6.CrossRefPubMed
26.
go back to reference Cheung RY, Lee JH, Lee LL, Chung TK, Chan SS. Vaginal Pessary in women with symptomatic pelvic organ Prolapse: a randomized controlled trial. Obstet Gynecol. 2016;128:73–80.CrossRefPubMed Cheung RY, Lee JH, Lee LL, Chung TK, Chan SS. Vaginal Pessary in women with symptomatic pelvic organ Prolapse: a randomized controlled trial. Obstet Gynecol. 2016;128:73–80.CrossRefPubMed
27.
go back to reference Barber MD, Walters MD, Cundiff GW, PESSRI Trial Group. Responsiveness of the pelvic floor distress inventory (PFDI) and pelvic floor impact questionnaire (PFIQ) in women undergoing vaginal surgery and pessary treatment for pelvic organ prolapse. Am J Obstet Gynecol. 2006;194:1492–8.CrossRefPubMed Barber MD, Walters MD, Cundiff GW, PESSRI Trial Group. Responsiveness of the pelvic floor distress inventory (PFDI) and pelvic floor impact questionnaire (PFIQ) in women undergoing vaginal surgery and pessary treatment for pelvic organ prolapse. Am J Obstet Gynecol. 2006;194:1492–8.CrossRefPubMed
Metadata
Title
Effect of generalized anxiety disorders on the success of pessary treatment for pelvic organ prolapse
Authors
Fang-Fang Ai
Meng Mao
Ye Zhang
Jia Kang
Lan Zhu
Publication date
01-08-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 8/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3562-1

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