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Impact of an informational flipchart on lifestyle advice for Nepali women with a pelvic organ prolapse: a randomized controlled trial

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Abstract

Introduction and hypothesis

Pelvic floor muscle training (PFMT) and lifestyle advice are effective at improving the symptoms and severity of pelvic organ prolapse (POP) in a range of populations; however, the impact of these interventions in Nepali women is unknown. We aimed to evaluate the impact of an informational flipchart on PFMT and lifestyle advice on the quality of life (QOL) for Nepali women with a POP.

Methods

This prospective randomized controlled trial recruited 140 women with a stage I–III POP from Kathmandu Valley. The intervention group were instructed on PFMT and lifestyle advice through an informational flipchart and the control group were provided usual care. The primary outcome measure was the Prolapse Quality of Life questionnaire (P-QOL) and was completed at baseline, 6 weeks, 12 weeks and 6 months. The secondary outcome measure was the Pelvic Organ Prolapse Quantification (POP-Q) system and Modified Oxford Scale (MOS) assessed by clinical examination at baseline and 6 months. Differences in mean P-QOL scores for each domain were evaluated using analysis of covariance.

Results

Compared with usual care, the women in the informational flipchart group experienced significant improvement in six of the nine P-QOL domains and for the prolapse, bladder and bowel symptoms. Only a small percentage (20%) of women were able to attend the 6-month clinical assessment so we were unable to assess the secondary outcomes.

Conclusions

A one-time intervention of an informational flipchart on PFMT and lifestyle advice is effective at improving QOL and symptoms for Nepali women with a stage I–III POP.

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Acknowledgements

We thank Asmita Shakya, Dr. Rekha Poudel and Dr. Nishma Bajracharya and the staff at Kathmandu Model Hospital for graciously assisting in our study.

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Authors and Affiliations

  1. Discipline of Obstetrics and Gynaecology and Neonatology, The University of Sydney, Sydney, Australia

    Delena Caagbay & Kirsten I. Black

  2. Sydney School of Public Health, The University of Sydney, Sydney, Australia

    Camille Raynes-Greenow & Kevin Mc Geechan

  3. Department of Obstetrics and Gynaecology, Kathmandu Model Hospital, Kathmandu, Nepal

    Ganesh Dangal

Authors
  1. Delena Caagbay
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  2. Camille Raynes-Greenow
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  3. Ganesh Dangal
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  4. Kevin Mc Geechan
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  5. Kirsten I. Black
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Contributions

D Caagbay: project development, data collection, data analysis, manuscript writing.

C Raynes-Greenow: project development, data interpretation, manuscript writing.

G Dangal: data collection, manuscript writing.

K Mc Geechan: data analysis, data interpretation, manuscript writing.

K Black: project development, data interpretation, manuscript writing.

Corresponding author

Correspondence to Delena Caagbay.

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Financial disclaimer

Delena Caagbay is supported by the Dr. Albert S McKern Research Scholarship. Associate Professor Camille Raynes-Greenow is supported by a National Health and Medical Research Council (of Australia) Career Development Fellowship #1087062.

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Caagbay, D., Raynes-Greenow, C., Dangal, G. et al. Impact of an informational flipchart on lifestyle advice for Nepali women with a pelvic organ prolapse: a randomized controlled trial. Int Urogynecol J 31, 1223–1230 (2020). https://doi.org/10.1007/s00192-020-04228-1

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  • DOI: https://doi.org/10.1007/s00192-020-04228-1

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