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Sintomas, expectativas e qualidade de vida na abordagem do prolapso de órgãos pélvicos
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O prolapso de órgãos pélvicos é um problema comum que afeta até 50% das mulheres. O aumento da esperança média de vida leva a que o prolapso de órgãos pélvicos seja uma condição com importância crescente, particularmente desde que a maioria das mulheres passam agora um terço da sua vida na pós-menopausa. Para uma avaliação correta e completa das pacientes e do seu prolapso devem ser avaliados: os sintomas, o exame físico, o impacto na qualidade de vida, assim como as expectativas das pacientes. A avaliação de uma doente com prolapso requer uma visão ampla dos sintomas e uma avaliação de como estes afetam a sua qualidade de vida. A avaliação das expectativas das pacientes tem vindo a ganhar uma relevância crescente na decisão terapêutica e deve servir como base ao aconselhamento pré-operatório, especialmente numa área onde os resultados funcionais e a melhoria da qualidade de vida são a base para a intervenção cirúrgica. Existem opções terapêuticas conservadoras e cirúrgicas. No entanto, a definição do sucesso terapêutico tornou-se um desafio e não existe uma definição padrão universalmente aceite. O sucesso terapêutico, assim como o conceito de “cura”, ainda hoje não estão bem definidos. A abordagem do prolapso deve ter em conta a melhoria anatómica, reduzir ou eliminar os sintomas e o seu impacto na qualidade de vida e satisfazer as expectativas da paciente. No entanto, atualmente, ainda não existe um consenso de como abordar, avaliar e tratar o POP.
Pelvic organ prolapse is a common problem affecting up to 50% of women. The increase of life expectancy leads to pelvic organ prolapse being a condition of increasing importance, particularly since most women now spend a third of their life in postmenopause. For a correct and complete evaluation of patients and their prolapse, the following aspects should be evaluated: symptoms, physical examination, impact on quality of life, as well as patients' expectations. The assessment of a prolapse requires a broad view of the symptoms and an evaluation of how they affect their quality of life. The assessment of patient expectations has gained increasing relevance in the therapeutic decision and should serve as a basis for preoperative counseling, especially in an area where functional outcomes and improvement of quality of life are the basis for surgical intervention. There are conservative and surgical therapeutic options. However, the definition of treatment success has become a challenge, and there is no universally accepted definition. Treatment success, as well as the concept of "cure", are still not well defined. The prolapse approach should consider anatomical improvement, reduce or eliminate symptoms and their impact on quality of life, and meet patient expectations. However, currently, there is no consensus on how to approach, evaluate and treat pelvic organ prolapse.
Pelvic organ prolapse is a common problem affecting up to 50% of women. The increase of life expectancy leads to pelvic organ prolapse being a condition of increasing importance, particularly since most women now spend a third of their life in postmenopause. For a correct and complete evaluation of patients and their prolapse, the following aspects should be evaluated: symptoms, physical examination, impact on quality of life, as well as patients' expectations. The assessment of a prolapse requires a broad view of the symptoms and an evaluation of how they affect their quality of life. The assessment of patient expectations has gained increasing relevance in the therapeutic decision and should serve as a basis for preoperative counseling, especially in an area where functional outcomes and improvement of quality of life are the basis for surgical intervention. There are conservative and surgical therapeutic options. However, the definition of treatment success has become a challenge, and there is no universally accepted definition. Treatment success, as well as the concept of "cure", are still not well defined. The prolapse approach should consider anatomical improvement, reduce or eliminate symptoms and their impact on quality of life, and meet patient expectations. However, currently, there is no consensus on how to approach, evaluate and treat pelvic organ prolapse.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Pelvic organ prolapse Quality of life Patient-centered goal Obstetrícia Ginecologia