Treatment decision-making process among postmenopausal women with pelvic organ prolapse before gynecological surgery: A qualitative study from Romania

Pelvic organ prolapse (POP) affects quality of life of many women. This paper aims to identify the experience of postmenopausal women in treatment decision-making process about POP before gynecological surgery. The characteristics of twelve postmenopausal women with stage II, III and IV POP, such as age, body mass index (BMI), physical exercise, education, parity, abortions, comorbidities, previous surgical interventions, and smoker/nonsmoker were evaluated. Each woman was given a semi-structured interview consisted of open-ended questions describing different treatments for POP. Interviews were conducted from January 2022 from May 2022, audio-recorded, transcribed verbatim and analyzed. The mean age was 64 years and most women were obese (BMI ≥ 30, 66.66%) with associated hypertension (58.33%). After constant comparison of the data using qualitative descriptive design, 7 dominant themes were obtained, namely: lack of information about prolapse; the decisive moment for the choice of treatment; the most disturbing symptoms; sources of information on prolapse; decisions regarding the treatment; preferences for conservative treatment; and uncertainty about treatment options. Most of the postmenopausal women stated that treatment decision-making process was mainly influenced by the physician, while supervised pelvic floor muscle (PFM) training was seen as an alternative to surgical treatment (58.33%). Therefore, it is essential to inform in time such women about different treatment options, allowing to decide on their preferred treatment.