Skip to main content

Advertisement

SpringerLink
Log in

Starting a peripartum pelvic floor disorder clinic: what to expect in the first thirty-six months

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Subspecialty peripartum pelvic floor disorder (PFD) clinics provide care to a unique patient population. We aim to describe the experiences of such a clinic in the first 36 months after its establishment.

Methods

This is a descriptive case series of all women who presented to a subspecialty PFD clinic at an academic medical center over 36 months (January 2018–December 2020). Patient characteristics, referral patterns, and care plans will be described.

Results

Four hundred eighty-three women presented for care. Women were a mean age of 31.0 ± 4.2 years, most were primiparous (404, 83.6%), and over half (279, 57.8%) had a spontaneous vaginal delivery. Three hundred eighteen women (66.9%) had obstetric anal sphincter injury (OASI), which was also the primary referral indication in 313 (64.8%). Most consultations were from an obstetrician (246, 51.3%), and the median time from delivery to evaluation was 17 days (IQR 11.0–34.0). The majority of women had one additional follow-up visit (330, 68.3%). One hundred forty-one (29.9%) women underwent minor office procedures, and 26 (5.4%) underwent surgery. The number of referrals sequentially increased from year 1 (59, 12.2%) to year 3 (215, 44.5%).

Conclusions

The 36-month experiences in our growing subspecialty peripartum PFD clinic demonstrate both sustainability and feasibility of this new service line, with consistent clinical growth over time and 483 new consultations, 2/3 of which were for OASI and the other 1/3 for a variety of peripartum pelvic floor indications. Our data outline a model for care, including timeline for follow-up, treatments administered, and number of interventions, both office and surgical.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Elliot V, Yaskina M, Schulz J. Obstetric anal sphincter injuries and the need for adequate care. Female Pelvic Med Reconstr Surg. 2019;25:109–12.

    Article  PubMed  Google Scholar 

  2. Wan OYK, Taithongchai A, Veiga SI, Sultan AH, Thakar R. A one-stop perineal clinic : our eleven-year experience. Int Urogynecology J. 2020;31:2317–26.

    Article  Google Scholar 

  3. Fehlmann A, Reichetzer B, Ouellet S, Tremblay C, Clermont ME. Establishing a peripartum perineal trauma clinic: a narrative review. Int Urogynecol J. 2021;32:1653–62.

    Article  PubMed  Google Scholar 

  4. Hickman LC, Propst K, Swenson CW, Lewicky-Gaupp C. Subspecialty care for peripartum pelvic floor disorders. Am J Obstet Gynecol. 2020;223(5):709–14.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Andrew Fantl J. Short forms to assess life quality and symptom distress for urinary incontinence in women: the incontinence impact questionnaire and the urogenital distress inventory. Neurourol Urodyn: Published online; 1995.

    Google Scholar 

  6. Rockwood TH, Church JM, Fleshman JW, et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum. 1999;42(12):1525–32. https://doi.org/10.1007/BF02236199.

    Article  PubMed  CAS  Google Scholar 

  7. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6. 

    Article  PubMed  CAS  Google Scholar 

  8. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975;1(3):277–99. 

    Article  PubMed  Google Scholar 

  9. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002;347(3):194–9. 

    Article  PubMed  Google Scholar 

  10. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.

    Article  PubMed  Google Scholar 

  11. Brincat C, Crosby E, McLeod A, Fenner DE. Experiences during the first four years of a postpartum perineal clinic in the USA. Int J Gynecol Obstet. 2015;128:68–71.

    Article  Google Scholar 

  12. Fitzpatrick M, Cassidy M, O’Connell PR, O’Herlihy C. Experience with an obstetric perineal clinic. Eur J Obstet Gynecol Reprod Biol. 2002;100:199–203.

    Article  PubMed  Google Scholar 

  13. Pretlove S, Thompson P, Toozs-Hobson P, Radley S. The first 18 months of a new perineal trauma clinic. J Obs Gynaecol. 2004;24(4):399–402.

    Article  Google Scholar 

  14. Freeman R, de Leeuw J, Wilson P. Maternal birth trauma and its consequences: time to raise awareness. Int Urogynecol J. 2021;32(7):1609–10.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urogynecology & Reconstructive Pelvic Surgery, Department of Ob/Gyn, The Ohio State University Wexner Medical Center, 345 W. 10th Avenue, Columbus, OH, 43210, USA

    Lisa C. Hickman

  2. Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA

    Meng Yao

  3. Division of Urogynecology & Reconstructive Pelvic Surgery, Ob/Gyn & Women’s Health Institute at the Cleveland Clinic, Cleveland, OH, USA

    Katie Propst

Authors
  1. Lisa C. Hickman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meng Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katie Propst
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Hickman LC/Propst K- Project development, data collection/management/interpretation, manuscript writing and editing, final manuscript approval; Yao M- Data analysis/interpretation, manuscript writing/editing, final manuscript approval

Corresponding author

Correspondence to Lisa C. Hickman.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hickman, L.C., Yao, M. & Propst, K. Starting a peripartum pelvic floor disorder clinic: what to expect in the first thirty-six months. Int Urogynecol J 33, 3429–3434 (2022). https://doi.org/10.1007/s00192-022-05246-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-022-05246-x

Keywords

Search

Navigation