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Management of complex pelvic floor disorders in a multidisciplinary pelvic floor clinic.

Kapoor DS, Sultan AH, Thakar R, Abulafi MA, Swift RI, Ness W

Mayday University Hospital, Department of Urogynaecology and Colorectal Surgery, London Road, Croydon, Surrey, UK.

OBJECTIVE: To identify symptom clusters, management strategies and survey patient satisfaction in our combined multidisciplinary pelvic floor clinic (PFC). METHOD: Retrospective cohort study, patient satisfaction questionnaire. SAMPLE: Secondary and tertiary referrals with complex pelvic floor disorders. MAIN OUTCOME MEASURES: symptom clusters and treatment received; patient satisfaction. RESULTS: A total of 113 new cases over a 3-year period. There were two main symptom clusters: (i) obstructed defaecation with rectoceles (n = 55); of these, 23 had abdominal sacrocolpopexy with rectopexy, six had transvaginal rectocele repairs; and (ii) of the 33 with double incontinence, 10 had anal sphincter repairs, five had tension-free vaginal tapes and two had colposuspensions. Patient satisfaction audit: 73% found the care to be excellent/good, 12% satisfactory and 6% unsatisfactory. CONCLUSION: Combined PFCs led to a more pragmatic approach in treating patients' symptoms. Combined surgery was undertaken in one-fourth of patients and is associated with cost savings and a single recuperation period. Overall, patients rated this service very highly.

Published 17 January 2008 in Colorectal Dis, 10(2): 118-23.
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