Genital Prolapse

Until recently, there was not a validated genital prolapse QOL instrument. For the last 3 years, we have utilized the Prolapse Symptom Inventory and Quality of Life Scale (PSI-QOL) (Figure 14-3.6). This tool was used clinically after validation by Kobashi, Leach, and colleagues.6 It contains 15 items: 11 regarding prolapse symptoms and 4 regarding QOL impact (relationships, sexual activity, physical activities, leisure activities).

We are aware of new questionnaires designed to assess QOL impact from genital prolapse, but have not implemented their use at our institution.

I AJ l'ORM 1Í; PELVICORGAN PROI.APSE/UK1NARY CjJJ INCONTINENCE SEXUAL FUNCTION QUESTIONNAIRE

INSTRUCTIONS

The folkm-infi is a list of questions about you arvdyanr partner's sex Iifo. All information is strictly confidential. Your nnsivers will be used only to help doctors understand what is important to pa!¡«its about I heir sci lives.

Please dwdttbe box (X) that best answers the question for you. While .inswcrinft the questions, consider your sexuality over the pa.« six moptfo.

Patient Name:

(Tltii- ciucstiuniiÄirr is Sot Applicable In mt t. How frequently <1° you fee! sexual desirc?This [ feeling may include wTinti ng to have sex. plantiing lu '—' have MX. fitting fnisi rated due to lack of sex. rte ahrays

usually

sometimes

seldom

3.1X> >ou climax (ha\t sn ut*asm) «Hen having iesu.il inury-mry: with your partner?

3_ Do you feel sexually excited (turned on) when Having wxu.il activity with your partner?

A. HowsaiLifnrdareyouwiththi; variety of sexual activities in your current sex life?

usually

sometimes

seldom

5. Do you feel pain during sexual intercouree?

usually

sometimes

seldom

seldom

6, Are >«u ineontinent of urine (leak urine) with sexual activity?

n alwuys

usually

sometimes

seldom

J. Dues (ear of incontinence (either stool or urine) fest riet your sexual activity?

always

Do you avoid sexua] intercourse because of r—i bulging in the vagina (either the blackler, rectum, or '—* vagina falling out)? always

usually

sometimes

seldom

seldom

never

9. When you haw sex with jour partner, do you haw r~| negatiw emolional reactions such as fear, disgust, -—»

10. Does your partner have ;i problem with erections [_ tliat affects jtxir sexual act i vi ly? always ti. Does >our partner luve a problem with premature qaculalton that affects > our sexual activity?

usually

sometimes

seldom neve

sometimes

sometimes

seldom n never il. Compared to orgasms you have had in the past, how intense are the otRasms you have hid in the past 6 months? □ □ □ □ □

much less intense text irtlenw same intensity more intense much moie intense

CONFIDENTIAL

Figure 14-3.4. Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire.

FORM G: McCOY FEMALE SEXUALITY QUESTIONNAIRE

INSTRUCTIONS

Please tilde the number from I to 7i>')iieh most closely corresponds loyour experience during the past 30 ATI's, Your responses wfl] be kept completely oonfwientinl.

Patient Narrn-:_

g 11iiA(iimtHitltijirr in Nut A pptlC-lbV ta mo t. Arc >xiu ntixfied t\ilh >viur preterit frequency -<t ncxud] activity? Fjtrrmcly Unsatisfied

2, How many times a day haveyiou hadaexual thoughts or funt&saeN during the L-month? Nrvt'r

Extremely Satisfied

Every Time

3. H civ. enjoyable is sci foi you? Not at all Enjoyable

Very Enjoyable

4, Hourohen during sex do you feci aroused or cxcitcd (for Instance, increased heart beat/flushing/vaginal wetness/heavy breathing)?

Nmr Everytlme rr

5. How often do you have an orguoi during sex?

Never

Every Time

12 3 4 5

• " ' 1

6.1 low often do you suffer from lack of vaginal lubrication (wetness) during sex? Never

Every Time

12 3 4 5

€ 7

7, How often do you suffer from pain during intercourse? Never

Evwy Time

1 2 3 4 5

€ 7

Figure14-3.5. McCoy Female Sexuality Questionnaire.

Figure 14-3.6. Prolapse Symptom Inventory and Quality of Life Scale.

FORM F; PROLAPSE SYMPTOM INVENTORY (PSI) AND QUALITY OF LIFE SCALE (QOL)

INSTRUCTIONS: llca^iiidicate how frequently yuu hate experienced the following symptoms by placing £ elteck in I the box ivluch best describes your symptoms o* er I lie past mont h

Polietit Same:

1 t frei that t have to path or strain lo empty urine (rom my bladder

All of the tW

Most of the time

Some of the lime

Rjrrty

j

2.1 JLvMtf my bbdtlrr to empty by placing my finger in the vagina or preset ng on the ¿tin ruitnidt the vagina

All oí The time

Most of the lime

Some of the time

Rtrely

Never

3-1 experience leakage of urú»c (incontinence) when I engage m iclMki *uch m coughing, snceong. laughing, lifting «talking, or changing position

All of the time

Most of the time

Some of the time

Rarely

Now

4-1 fun to the balhruuta so 1 will no* wet myself

All of the lime

Mon oí the time

Some of the time

Rifely

□I

5,1 wear protection (such u pads, diapers, or toilet paper) or change ray undergarment to protect my clot be* from urinary leakage

All oí Ihr lime

Most of the time

Some oi the time

Rarely

Never

6.1 c*pcrKl>rc ctKutijulioa due to difficulty in moving the rtool ou* OÍ ray rrctum

AU «fil* time

Mo&t of the lime

Some o1 the time

Rarely

Keen

j 7.1 .Tii¿st rajwlíto empty raybtwrí by placing a finger in the vagina

All «flhc time

Mart oí the lime

Some of the time

Rarely

Never

8.1 experience incontinence oí »toob

All of the time

Most of the tune

Some of the time

Kjn-k

Never

9 I feel as though there i» a ball between my leg« or thai 1 am ¡ailing on a hall

All of the lime

Most of the lime

Same of the time

Rjrrty

Never

to. I feel a pressure in my vagina when »landing which may lessen when lying down

AH of ll* time

Mail of the lime

Some of the time

Rwr)>

11. Do )t*i need to change position or posture to help )ou em pty )wr bladder?

All of the time

Most of the lime

Some of the time

Rjuly

Never

ta, Some or all of the symptoms whkh are described above prevent me from pursuing new relationships with people

A3 of the time

Most oí the time

Some of the time

Rarely

□Í

Some of all oí the symptom* which are described above interféré with my sexual relationships

All of the time

M ml of the time

Some of the time

Rarely

□ 1

14 Some or all of the tymptomi. which are described above prevent me from engaging in physical recreation (dancing, sports, ele.)

All of the time

Most of the time

Some of the time

Rarely

□ I

15. Some or all of the symptoms which are described abme píratet mc from engaging in nonmenuotu leisure activities (eating out, going to a show, ele.)

All oí the time

Mort of the lime

Some of the time

Rarely

In clinical use, we focus on the QOL impact questions (12-15) and look at their individual scores, as we obtain much of the symptom information during our routine clinical assessment. There is some overlap with data obtained in the IIQ, IIIQ, and UDI. Because the data collected are also a symptom inventory, we do not calculate a global score for this questionnaire.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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